Delayed Puberty - Possible Causes

Possible Causes

• Variation of normal (constitutional delay)
• In females, prolonged high level of physical exertion, e.g. from being an athlete
• Systemic disease, e.g. Inflammatory bowel disease, chronic renal failure
• Undernutrition e.g. anorexia nervosa, zinc deficiency
• Hypothalamic defects and diseases e.g. Prader-Willi syndrome, Kallmann syndrome
• Pituitary defects and diseases e.g. hypopituitarism
• Gonadal defects and diseases e.g. Turner syndrome, Klinefelter syndrome, Testicular failure due to mumps orchitis, Coxsackievirus B, irradiation, chemotherapy, or trauma. Testicular failure is treated with testosterone replacement, Ovarian failure.
• Absence or unresponsiveness of target organs e.g. androgen insensitivity syndrome, mullerian agenesis
• Other hormone deficiencies and imbalances, Endocrine disorders. e.g. hypothyroidism, Cushing's syndrome
• Cystic fibrosis
• Mutations in FSHB
• Frasier syndrome
• Various forms of congenital adrenal hyperplasia.
• Gonadotropin, a deficiency resulting from a number of congenital and acquired abnormalities of the central nervous system
• Biedl-Bardet syndrome
• Brain tumors e.g. craniopharyngioma, prolactinoma, germinoma, glioma; diseases of hypothalamus, irradiation and trauma.