Jeff hates gym class. It's not that he minds playing soccer
or basketball or any of the other activities. But he does dread
going into the locker room at the end of class and showering in
front of his friends. Although the other guys' bodies are
growing and changing, his body seems to be stuck at a younger age.
He's shorter than most of the other guys in his grade, and his
voice hasn't deepened at all. It's embarrassing to still
look like a little kid.
Abby knows what it's like to feel different, too. The bikini
tops that her friends fill out lie flat on her. Most of them have
their periods, too, and she hasn't had even a sign of one.
Both Jeff and Abby wonder if there's anything wrong.
What Is Delayed Puberty?
Puberty
is the time when your body grows from a child's to an
adult's. You'll know that you are going through puberty by
the way that your body changes.
If you're a girl, you'll notice that your breasts
develop and your pubic hair grows, that you have a growth spurt,
and that you get your period (menstruation). The overall shape of
your body will probably change, too - your hips will widen and your
body will become curvier.
If you're a guy, you'll start growing pubic and facial
hair, have a growth spurt, and your testicles and penis will get
larger. Your body shape will also begin to change - your shoulders
will widen and your body will become more muscular.
These changes are caused by the sex hormones (testosterone in
guys and estrogen in girls) that your body begins producing in much
larger amounts than before.
Puberty takes place over a number of years, and the age at which
it starts and ends varies widely. It generally begins somewhere
between the ages of 7 and 13 for girls, and somewhere between the
ages of 9 and 15 for guys, although it can be earlier or later for
some people. This wide range in age is normal, and it's why you
may develop several years earlier (or later) than most of your
friends.
Sometimes, though, people pass this normal age range for puberty
without showing any signs of body changes. This is called delayed
puberty.
What Causes Delayed Puberty?
Puberty can be delayed for several reasons. Most often,
it's simply a pattern of growth and development in a family. A
guy or girl may find that his or her parent, uncle, aunt, brothers,
sisters, or cousins developed later than usual, too. This is called
constitutional delay
(or being a late bloomer), and it usually doesn't require any
kind of treatment. These teens will eventually develop normally,
just later than most of their peers.
Medical problems also can cause delays in puberty. Some people
with chronic illnesses like diabetes, cystic fibrosis, kidney
disease, or even asthma may go through puberty at an older age
because their illnesses can make it harder for their bodies to grow
and develop. Proper treatment and better control of many of these
conditions can help make delayed puberty less likely to occur.
A person who's malnourished - without enough food to eat or
without the proper nutrients - may also develop later than peers
who eat a healthy, balanced diet. For example, teens with the
eating disorder anorexia nervosa often lose so much weight that
their bodies can't develop properly. Girls who are extremely
active in sports may be late developers because their level of
exercise keeps them so lean. Girls' bodies require a certain
amount of fat before they can go through puberty or get their
periods.
Delayed puberty can also happen because of problems in the
pituitary or thyroid glands. These glands produce hormones
important for body growth and development.
Some people who don't go through puberty at the normal time
have problems with their chromosomes (pronounced:
kro
-muh-soamz), which are made up of DNA that contain our body's
construction plans. Problems with the chromosomes can interfere
with normal growth processes.
Turner syndrome
is an example of a chromosome disorder. It happens when one of a
female's two X chromosomes is abnormal or missing. This causes
problems with how a girl grows and with the development of her
ovaries and production of sex hormones. Women who have untreated
Turner syndrome are shorter than normal, are
usually infertile, and may have other medical problems.
Males with
Klinefelter syndrome
are born with an extra X chromosome (XXY instead of XY). This
condition can slow sexual development.
What Do Doctors Do?
The good news is that if there is a problem, doctors usually can
help teens with delayed puberty to develop more normally. So if you
are worried that you're not developing as you should, you
should ask your parents to make an appointment with your
doctor.
In addition to doing a physical examination, the
doctor will take your medical history by asking you
about any concerns and symptoms you have, your past health, your
family's health, any medications you're taking, any
allergies you may have, and other issues like growth patterns of
your family members. He or she will chart your growth to see if
your growth pattern points to a problem and also may order blood
tests to check for thyroid, pituitary, chromosomal, or other
problems. You may also have a "bone age" X-ray, which
allows the doctor to see whether your bones are maturing
normally.
In many cases, the doctor will be able to reassure you that
there's no underlying physical problem; you're just a bit
later than average in developing. If the doctor does find a
problem, though, he or she might refer you to a pediatric
endocrinologist
(pronounced: en-doh-krih-
nah
-leh-jist), a doctor who specializes in treating kids and teens who
have growth problems, or to another specialist for further tests or
treatment.
Some teens who are late developers may have a difficult time
waiting for the changes of puberty to finally get going - even
after a doctor has reassured them that they are normal. In some
cases, doctors may offer teens a short course (usually a few
months) of treatment with hormone medications to get the changes of
puberty started. Usually, when the treatment is stopped a few
months later, the teen's own hormones will take over from there
to complete the process of puberty.
Dealing With Delayed Puberty
It can be really hard to watch your friends grow and develop
when the same thing's not happening to you. You may feel like
you're never going to catch up. People at school may joke about
your small size or your flat chest. Even when the doctor or your
parents reassure you that things will be OK eventually - and even
when you believe they're right - it's difficult to wait for
something that can affect how you feel about yourself.
If you're feeling depressed or having school or other
problems related to delays in your growth and development, talk to
your mom or dad, your doctor, or another trusted adult about
finding a counselor or therapist you can talk to. This person can
help you sort out your feelings and suggest ways to cope with
them.
Delayed puberty can be difficult for anyone to accept and deal
with - but it's a problem that usually gets solved. Ask for
help if you have any concerns about your development. And remember
that in most cases kids will eventually catch up with their
peers.
Reviewed by:
Steven Dowshen, MD
Date reviewed: August 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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