Delayed puberty is when a teen goes through these body changes later than the usual age range. For girls, it means no breast development by age 13 or no menstrual periods by age 16. For boys, it means no enlargement of the testicles by age 14.
your child’s delayed puberty won’t need treatment. But if you or your teen are concerned about it, it’s wise to see a doctor, especially if your child started to develop but then suddenly stopped. Your family doctor or pediatrician can tell you if your child should be checked for medical problems. Often, the only thing teens need is reassurance that they’ll catch up to their peers.
Your doctor will ask about your teen’s health and medicines. The doctor will also want to know whether your child has noticed any signs of puberty or if there’s a family history of delayed puberty. Your child will have a physical exam and also might have blood tests to check hormone levels. The doctor will check your child’s growth by measuring height and weight and doing an X-ray of the hand to see if his or her bones are developing more slowly than usual. Sometimes, a doctor can see signs of puberty that you or your teen might not have noticed. Some teens need a brain scan (such as an MRI) to check for problems with the pituitary gland. Girls might need a sonogram to see if their uterus and ovaries are developing as they should.
Less common causes of delayed puberty include:
Medical conditions that keep the intestines from absorbing nutrients from food, such as celiac disease or inflammatory bowel disease
Malnutrition (not getting proper nourishment) due to an eating disorder such as anorexia
Problems with the pituitary or thyroid glands, which make hormones that help children grow and develop
Problems with the ovaries or testicles, which make sex hormones
Genetic problems such as Turner syndrome in girls or Klinefelter syndrome in boys
Some cancer treatments that affect sex hormone production
Medicines that decrease appetite such as stimulants for attention deficit hyperactivity disorder (ADHD)