Delayed puberty (male)

Last updated: Saturday, 27, November, 2010
CausesAppropriate Tests

Defined as absence of initiation of secondary sexual development by 14 years.

Cessation of pubertal development may occur in some disorders.

History including family history; physical examination including tests of olfaction; assessment of bone age; LH, FSH, prolactin, TSH, testosterone, dehydroepiandrosterone sulphate. See also Testicular failure
Constitutional delayGonadotrophin releasing hormone stimulation test (consult pathologist): if the boy is within 6 months of spontaneous puberty, the response to the test will be pubertal, rather than prepubertal.
Hypogonadotrophic hypogonadismSee Pituitary/hypothalamic disorders.

Gonadotrophin releasing hormone deficiency

  • Kallmann syndrome

Hypopituitarism

Hypothyroidism

Hypergonadotrophic hypogonadism Primary testicular failure.

Chromosomal abnormality

Usually impaired progression of puberty.

Testicular functional damage

  • Viral orchitis
  • Cytotoxic drugs/irradiation
  • Tumour
See Testicular mass
  • Vanishing testis syndrome

Severe chronic illness

Severe nutritional deficiency, including

  • Gross zinc deficiency
Zinc.