Delayed Puberty/Sexual Development

Also known as: disorders of growth, puberty and sexual development, constitutional growth delay, CGD

What is delayed puberty/sexual development?

Late puberty may be defined as a situation where the body’s timing for sexual maturation is later than usual. In many children late puberty onset runs in the family, and for most cases it is not a cause for alarm.

If a boy does not experience any physical changes (like growth in the testicles) by age 14, or a girls does not have any development of the breasts by age 13, this situation is known as delayed puberty or delayed sexual development.

What causes delayed puberty/sexual development? 

While in most cases, the child is normal and is simply experiencing a constitutional growth delay where the body is developing more slowly than most other children, other causes may include chromosomal abnormalities, genetic disorders, an underlying chronic medical condition, such as a heart condition or celiac disease, or tumors in the brain that prevent the secretion of hormones needed for puberty to develop.

What are the symptoms of delayed puberty/sexual development?

  • In girls, no breast development by age 12 years or a pronged time between breast development and menstruation or no menstruation by age 15 years.

  • In boys, no growth of the testicles by age 14 years, no or minimal pubic hair by 15 years or a long delay (more than 5 years) from the start of puberty to its completion.​


What are delayed puberty/sexual development care options? 

In many cases, puberty will occur normally in these children, just at a later time. Treatment, where this doesn't occur depends on the underlying cause.

Managing an underlying medical condition, or surgically correcting an anatomical problem will be of value- hormone therapy may be helpful  to stimulate the development of the physical changes desired.


Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: 10/31/2017 11:55:10 AM

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