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Delayed puberty (Aetiology (Congenital/genetic
Turner's syndrome,…
Delayed puberty
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Pathophysiology
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Hypergonadotrophic hypogonadism
Failure at ovary e.g. Turner's, iatrogenic
Normogonadotrophic normogonadism
Constitutional/systemic disruption
Constitutional delay, weight loss, systemic disease
Diagnosis
Examination
Tanner staging
Height, breast growth,
hair distribution
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General
Hirsuitism, Turner's,
chronic disease, height, weight
Investigations
Bedside
Height, weight, BMI
Bloods
FBC, U+E, LFTs, TFTs
Karyotyping (XO)
Hormones: GnrH, FSH/LH, PRL
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History
SH
Support, alcohol, smoking
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PMH
Turner's, systemic disease,
anorexia/bulimia
PC/HPC
Sexual characteristics,
menses, headache, pain,
weight loss
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Management
Conservative
Information, advice, support
Referral to paeds endocrinologist
Identify cause
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