Delayed Puberty: Signs, Causes, Diagnosis, And Treatment


Puberty is the phase when the body grows from a child’s to an adult’s, however, sometimes there is delayed puberty. There are changes the body goes through during puberty. Usually, these changes begin between the ages of 8 and 14 for girls and 9 to 15 for boys. This wide range in age is normal and it varies in every individual which may be earlier or later.

What is delayed puberty?

Sometimes, though people pass this normal age range for puberty without showing any signs of body changes and thus the delay in changes is known as delayed puberty.

delayed puberty

Signs of delayed puberty

Signs of puberty seen in girls –

  • Breasts develop
  • Pubic hair grows
  • Growth spurt
  • Menstruation (period)
  • The body gets curvier with wider hips

Signs of puberty seen in boys –

  • Pubic hair and facial hair
  • Growth spurt
  • Testicles and penis get larger
  • Body shape changes like shoulder widen and body more muscular

These signs and changes are seen due to sex hormones testosterone in boys and estrogen in girls.


What really happens in delayed puberty?

Signs of delayed puberty in girls –

  • No breast development by age 14
  • Not having menstruation within 5 years of when breasts start to grow or by age 16

Signs of delayed puberty in boys –

  • Penis and testicles not growing by age 14
  • Genital growth taking longer than 5 years
  • Short stature compared with the peers


Puberty can be delayed for several reasons –

Family history

Usually, it’s simply a pattern of growth and development in a family. A boy or girl may find that family members developed later than usual, too. This is known as constitutional delay (or being a late bloomer) and it usually doesn’t need treatment. Normally, these teens in time will develop, just later than most of the peers.

Medical problems

Some people with chronic illnesses such as diabetes, cystic fibrosis, kidney disease, or even asthma may go through puberty at an older age. That’s because the illnesses can make it harder for the bodies to grow and develop. Proper treatment and better control for these conditions can help make delayed puberty less likely.


Without enough food to eat or without good nutrients may also develop later than peers eat a healthy, balanced diet. For example, teens having eating disorders like anorexia nervosa often lose so much weight that the bodies can’t develop properly. Girls extremely active in sports may be late developers as the level of exercise keeps them so lean. Girls’ bodies need enough fat before going through puberty or to get periods.


Delayed puberty

It can also happen because of problems in the endocrine system like the pituitary or thyroid glands. These glands make hormones that are important for body growth and development.


Problems with the chromosomes can affect normal growth process such as  –

  • Turner syndrome happens when one of a female’s two x chromosomes is abnormal or missing. It causes problems with how a girl grows and with the development of ovaries and the production of sex hormones. Women having untreated Turner syndrome are shorter than normal, may not go through puberty in the usual way, and may have other medical problems.
  • Males with Klinefelter syndrome are born with an extra x chromosome (XXY instead of XY) and this can slow sexual development. Boys are typically tall for age, may have learning problems, and may have other medical problems.


Consult the doctors as can help teens with delayed puberty to develop more normally. If worried about not developing then take an appointment with the doctor –

The doctor will –

  • Do an examination
  • Take a medical history including whether others in the family had a similar growth pattern
  • Ask about any medicines
  • Check the growth chart to see if there’s a pattern that points to a problem

The doctor also might –

  • Perform blood tests to check for thyroid, pituitary, chromosomal or other problems
  • Perform a bone age x-ray, to see if the bones are maturing normally


Often, doctors find no underlying physical problem. Most of the teens with delayed puberty are just developing a bit later than average and will catch up later.


If doctors do find a problem, they might send a teen to see a pediatric endocrinologist, a doctor who specializes in treating kids and teens having growth problems, or to another specialist for further tests or treatment.

Some latecomers struggle with waiting for the changes of puberty to start. So doctors may often hormone treatment.

  • Boys may get a short course of treatment with testosterone (usually a monthly injection for 4-6 months) to get started with the changes of puberty
  • Girls may get low doses of estrogens for 4-6 months to start breast development

After treatment ends, a teen’s hormones usually take over to complete the process of puberty. If don’t, the doctor will discuss long-term sex hormone replacement.

How to deal with delayed puberty?

It can be tough to watch the friends grow and develop when the same thing’s not happening. Even when the doctor or the parents reassure you that things will be ok, it’s hard to wait for something that can affect how feeling about yourself.

If feeling depressed or having school or other problems, talk to mother and father. The doctor or another trusted adult about finding a counselor or therapist can talk to. They can help sort out the feelings and suggest ways to cope with them.


Delayed puberty is difficult for anyone to accept and deal with. But it’s a problem that usually gets solved. Ask for help if having concerns about the development.


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