What is it?

Delayed sexual development and puberty is when the child's body does not begin to have adult characteristics until by the age 14 in boys or 13 in girls. Puberty consists of several stages of changes such as the development of breast buds and pubic hair, enlargement of the penis and scrotum in boys, ance, armpit hair, height increase and having the first period. When these changes occur too late, it is usually constitutional- meaning that no adequate cause has yet been found. Other causes may include genetic disorders, chromosomal abnormalities, chronic medical conditions, and brain tumors.

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Delay in sexual development and puberty.

Additional names

This group contains additional names:
- Arrested puberty
- Constitutional delay of growth and puberty
- Delayed adrenarche

Signs & symptoms

Symptoms of delayed sexual development and puberty:
In girls, no breast development by the age of 13 years or a prolonged time between breast development and getting the first period, or no period at all until the age of 15.
In boys, no growth of the testicles until the age of 14, or no (or minimal) growth of pubic hair by the age of 15 or more than 5 years from the beginning of puberty until its completion.


Diagnosis of delayed sexual development is done by physical examination, according to Tanner scale. Family history is very important as well, to look for familial patterns. Blood tests may be done to measure hormone levels in blood. In some cases, a brain MRI will be performed.


In many cases treatment will not be needed, and puberty will happen later in the child’s life. In other cases, treating the underlying cause will be necessary.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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