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Review
. 2018 Apr:48:62-89.
doi: 10.1016/j.bpobgyn.2017.11.004. Epub 2017 Nov 14.

Disorders of puberty

Charles Sultan  1 , Laura Gaspari  2 , Laurent Maimoun  3 , Nicolas Kalfa  4 , Françoise Paris  2
Affiliations
Free article
Review

Disorders of puberty

Charles Sultan et al. Best Pract Res Clin Obstet Gynaecol. 2018 Apr.
Free article

Abstract

Over the past 20 years, a clear secular trend toward the earlier onset of puberty has been described. A better knowledge should help clinicians attempting to define both precocious and delayed puberty (PP and DP, respectively). The definition of PP for girls is the appearance of secondary sex characteristics development before the age of 8 years, while DP is based on the absence of thelarche at the age of 13 years. Regarding PP, one should clinically distinguish between true precocious puberty, i.e., complete or central PP, and incomplete PP, which refers to premature thelarche, premature pubarche, and isolated menarche. Evaluation of girls of PP requires careful examination of the clinical expression, a GnRH test, and imaging of the central neurosystem. GnRH analog is considered the gold standard treatment of central precocious puberty. Peripheral PP should be managed according to the underlying causes. DP is suspected in girls with no breast development by the age of 13 years, or absence of menarche at 15 years with secondary sex characteristics. The clinical examination along with endocrine, radiological, and genetic investigation should be able to identify girls with permanent hypogonadism as opposed to those with transitory hypogonadism, who undergo spontaneous but DP. Estrogen therapy should be discussed according to the causes of DP. In all cases, emotional and psychosocial disorders should be considered for these girls with disorders of puberty.

Keywords: Delayed puberty; Girls; Precocious puberty; Pubertal development.

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