What is Delayed Puberty?

Children reach puberty at different ages. Delayed puberty is when boys have little to no genital growth by age 14, or girls have no breast development by age 13, or no periods by age 16. You may also hear this called being a “late bloomer”.

Delayed puberty may happen in children who have chronic medical conditions. Diet and family history can also affect normal growth and development. If either parent was a “late bloomer,” the chances are greater that their child may also have a late start to puberty.

Symptoms

With delayed puberty, you might see the following in your child:

In boys:

• Small testicles
• No facial hair
• Shorter than other boys their age

In girls:

• Small or no breast development
• Has not started their period
• Shorter than other girls their age

Preparing for Your Visit

Bringing the following information to your child’s visit will help the provider evaluate your child.

• Your child’s growth charts
• Parents’ history (when father started to shave, when mom first started her period, etc.)
• Any testing done before the visit related to your child’s growth

During the Visit

The doctor will examine your child to see what stage of puberty they are in based on their current growth and development. They may also order testing for your child, which might include:

• Bone age X-ray
• Blood tests
• Leuprolide stimulation testing

Treatment

Often, children will not need any treatment – they may just be a late bloomer. These children will often grow for a longer period of time than their friends.

For some children, the doctor may make the following suggestions for treatment:

• For boys: testosterone shots every month over a period of three to six months to jump-start their puberty.
• For girls: may need to take estrogen replacement therapy over a period of three to six months to jump-start their puberty

The provider will talk with you about any needed follow-up visits for your child.