Puberty is defined as the acquisition of secondary sexual characteristics (development of breasts, genitalia, and pubic and axillary hair, and increase in testicular volume) associated with a growth spurt and resulting in the attainment of reproductive function. It usually lasts 3-4 years.

Disorders of puberty are either an abnormality of timing – being too early or too late or loss of the normal harmony of the sequence of acquisition of various secondary sexual characteristics. Those conditions which are gonadotrophin-dependent usually require neuro radiological imaging to exclude a hypothalamic pituitary tumour. Treatments for advancing or arresting sexual maturation are available. The end-point of puberty is the attainment of fertility.

Disorders of pubertal development:

Premature adrenarche-

Premature adrenarche is characterized by precocious development of sexual hair (pubic, axillary or both) before 8 years in girls or 9 years in boys, with no other signs of sexual maturation.The condition is more common in girls than in boys and in black than in white racial groups. It requires no treatment.

Precocious puberty-

GIPP is characterized by pubertal sex steroid concentrations in the presence of prepubertal or suppressed gonadotrophins. CPP is treated with a GnRH agonis. GIPP is treated with drugs that suppress gonadal steroidogenesis, such as cyproterone acetate, ketoconazole.

Isolated premature menarche-

solated premature menarche comprises cyclical uterine withdrawal bleeding with no other signs of sexual maturation.

Delayed puberty-

It is characterized by the  delayed development of secondary sexual characteristic. Delayed puberty is treated for psychological reasons. In boys, treatment options include depot testosterone and low-dose anabolic steroid. In girls,a course of oestrogens is required for at least 6 months.

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Editorial Team
Journal of Child and  Adolescent Behavior