Management
If a child is healthy but simply late, reassurance and prediction based on the bone age can be provided. No other intervention is usually necessary. In more extreme cases of delay, or cases where the delay is more extremely distressing to the child, a low dose of testosterone or estrogen for a few months may bring the first reassuring changes of normal puberty.
If the delay is due to systemic disease or undernutrition, the therapeutic intervention is likely to focus mainly on those conditions.
If it becomes clear that there is a permanent defect of the reproductive system, treatment usually involves replacement of the appropriate hormones (testosterone/dihydrotestosterone for boys, estradiol and progesterone for girls).
Pubertal delay due to gonadotropin deficiency is treated with testosterone replacement or with HCG
Growth hormone is another option that has been described.
Subnormal vitamin A intake is one of the aetiological factors in delayed pubertal maturation. Supplementation of both vitamin A and iron to normal constitutionally delayed children with subnormal vitamin A intake is as efficacious as hormonal therapy in the induction of growth and puberty.
Read more about this topic: Delayed Puberty
Famous quotes containing the word management:
“No officer should be required or permitted to take part in the management of political organizations, caucuses, conventions, or election campaigns. Their right to vote and to express their views on public questions, either orally or through the press, is not denied, provided it does not interfere with the discharge of their official duties. No assessment for political purposes on officers or subordinates should be allowed.”
—Rutherford Birchard Hayes (1822–1893)
“The management of fertility is one of the most important functions of adulthood.”
—Germaine Greer (b. 1939)
“The care of a house, the conduct of a home, the management of children, the instruction and government of servants, are as deserving of scientific treatment and scientific professors and lectureships as are the care of farms, the management of manure and crops, and the raising and care of stock.”
—Catherine E. Beecher (1800–1878)