Puberty is a huge turning point in the lives of girls. They experience great changes and growth, which can be exciting for them. These changes don’t happen overnight, and the process can last for several months to several years.
However, there are girls who may feel left out because they haven’t experienced the changes that their peers are going through. They may be experiencing delayed puberty, and here’s everything you need to know about it.
When is puberty considered delayed?
A girl’s body goes through several changes during puberty. This often includes growth of body hair, development of breasts, and an increase in height among others. These usually begin between the ages of 8-14.
But in delayed puberty, these changes don’t occur at all; if they do, they don’t progress normally. Breasts may not develop by age 13 or menstrual periods may not begin by age 16 or within 5 years since breast development.
What causes delayed puberty in females?
Family history
In most cases, puberty changes just occur later than usual. But once it begins, it progresses normally. Such cases are known as constitutional delay, or ‘later bloomers.’
This is the most common cause of delayed puberty, and the pattern runs in the family. Late bloomers don’t usually need treatment.
Medical conditions
Those with chronic conditions may go through puberty a bit later than usual. That’s because their illness can hinder their bodies from growing and developing at a normal pace. These medical conditions include:
- Diabetes
- Cystic fibrosis
- Liver and kidney disease
- Autoimmune diseases, such as Hashimoto thyroiditis or Addison disease
- Turner syndrome, a genetic disorder
- Hypothyroidism
- Inflammatory bowel disease (IBD)
- Celiac sprue
- Hypogonadism, when the ovaries produce too little or no hormones
Treating and controlling these conditions can lessen the chances for delayed puberty.
Besides illnesses, there are also medical treatments that can cause hypogonadism, such as chemotherapy or radiation treatment that damages the ovaries.
Lack of body fat
Body fat also plays a role in producing hormones. So if someone has too little body fat, their puberty may be delayed. This case is common among girls who are undernourished, dealing with eating disorders, or extremely active in sports.
How is delayed puberty diagnosed?
The doctor — usually an endocrinologist — will conduct a physical exam, examine the patient’s medical history and ask about any medications or treatments being taken.
Blood tests could also be requested to check for thyroid, pituitary, chromosomal, or other problems, as well as a bone age x-ray to see if the bones are maturing normally.
How is delayed puberty treated?
Treatment isn’t always required for late bloomers and those who don’t have underlying health problems. As for girls with too low body fat, eating more and gaining weight could jumpstart puberty changes. Meanwhile, girls with primary ovarian insufficiency or a permanent deficiency of gonadotropins may be given low doses of estrogen for four to six months. They could also be given progestin after 12-18 months.
Delayed puberty in girls. (n.d.). MedlinePlus. https://medlineplus.gov/ency/article/007694.htm#:~:text=Delayed%20puberty%20in%20girls%20occurs,8%20to%2014%20years%20old
Delayed Puberty in Girls: Information for Parents. (June 9, 2015). American Academy of Pediatrics. https://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Delayed-Puberty-in-Girls-Information-for-Parents.aspx
Grunwald, T. (September 2019). Delayed Puberty. Kids Health. https://kidshealth.org/en/teens/delayed-puberty.html
