Precocious puberty is characterized by early or premature development of secondary sexual characteristics before the age of 8 years in girls and before the age of 9 years in boys. Normally secondary sexual characteristics or physical signs of puberty develop between 8 to 13 years of age in girls and 9 to 14 years of age in boys. Any delay in development of secondary sexual characteristics beyond 13 years in girls and beyond 14 years in boys is called delayed puberty. Both precocious and delayed puberty need endocrine evaluation to determine the underlying cause.
Delayed puberty, like precocious puberty, if not treated or if treatment is delayed can have a significant psychosocial impact on the patient. It also leads to a failure in achieving peak bone density in adolescents due to low or absent sex steroids. Treatment includes administration of sex steroids, testosterone in males and estrogen in females to induce secondary sexual characteristics. In very few instances where sexual maturation develops spontaneously before 18 years of age, after initiation of therapy, it is possible to stop administration of sex steroids. But if there is a failure to develop secondary sexual characteristics, beyond 18 years of age, it implies a permanent cause of hypogonadism and requires sex steroids administration on a long term.
