Delayed puberty

Question 1

When does puberty start for girls?

Answer 1

8-14 years

Question 2

When does puberty start for boys?

Answer 2

9-15 years

Question 3

What are the signs of puberty in girls?

Answer 3

breast buds, then pubic hair, then starting menstrual periods about 2 years from the start of puberty.

Question 4

Signs of puberty in boys

Answer 4

enlargement of the testicles, then of the penis, gradual darkening of the scrotum, development of pubic hair and deepening of the voice.

Question 5

What is hypogonadism?

Answer 5

lack of oestrogen and testosterone

Question 6

Hypgonadotrophic hypogonadism

Answer 6

deficiency of LH and FSH

Question 7

Hypergonadotrophic hypogonadism

Answer 7

lack of response to LH and FSH by the gonads (the testes and ovaries)

Question 8

Potential causes of Hypogonadotrophic Hypogonadism

Answer 8

• Damage to pituitary gland
• Growth hormone deficiency
• Hypothyroidism
• Kallman syndrome

Question 9

Potential causes of Hypergonadotropic Hypogonadism

Answer 9

1. Previous damage to the gonads (e.g. testicular torsion, cancer or infections, such as mumps)
2. Congenital absence of the testes or ovaries
3. Kleinfelter’s Syndrome (XXY)
4. Turner’s Syndrome (XO)

Question 10

What is the genotype 47 XXY?

Answer 10

Kilnefelter’s syndrome

Question 11

What is the genotype of androgen insensitivity syndrome?

Answer 11

46, XY

Question 12

What is Kallman syndrome?

Answer 12

A genetic condition causing hypogonadotrophic hypogonadism. Causes a failure to start puberty.
It is associated with a reduced or absent sense of smell (anosmia).

MRI of the brain can look for defects in the olfactory bulbs