Guest Access | Sign In

Puberty may be defined as the physiological process resulting in the attainment of sexual maturity and reproductive capacity. Puberty is an integral component of the evaluation and treatment of endocrine disorders in children and adolescents. Not only does it impact on sexual maturation, but it has other effects with lifelong consequences, including linear growth, changes in body composition, and skeletal mineralization. Patients with disorders of puberty, including precocious and delayed puberty, make up a large percentage of the children and adolescents who consult paediatric endocrinologists. An understanding of delayed or absent puberty requires a foundation in the normal processes regulating the onset of puberty, and factors essential for its progression and completion. In this chapter, we will first review the mechanisms of normal growth and puberty, particularly with regard to their interdependence. We shall then discuss the differential diagnosis of delayed or absent puberty, and present diagnostic algorithms for hypergonadotropic and hypogonadotropic hypogonadism, emphasizing some gender-specific aspects.