Puberty

Question 1

Define premature and delayed puberty.

Answer 1

Premature =
Girls = 8 yrs
Boys = 9 yrs
True precocious puberty is more than 10 times more common in girls than boys.
Boys are more likely to have an underlying pathological cause.

Delayed =
Puberty is delayed if onset is after 13 years in girls and 14 years in boys.

Question 2

When do growth spurts in puberty occur?

Answer 2

A growth spurt occurs early in puberty for girls, but at the end of puberty for boys.

Question 3

When does menarche occur? What is the definition of delayed menarche?

Answer 3

Menarche occurs at the end of puberty. Delay is defined as no periods by 16 years of age.

Question 4

What are the first signs of puberty?

Answer 4

Boys =  testicular enlargement 
Girls =  breast budding

Question 5

How is puberty evaluated?

Answer 5

Puberty is evaluated by clinical examination of the genitalia, breasts and secondary sexual characteristics. The scale used is known as Tanner staging.

Question 6

What to do if you suspect your patient has delayed puberty?

Answer 6

Phone referral to paediatric endocrinologist - could have serious underlying pathology that needs urgent investigation