Clinical challenge: When is delayed puberty more than a “late bloomer”?

Puberty is perhaps the most striking period of human development. Puberty results from the activation of the hypothalamic-pituitary-gonadal (HPG) axis and culminates in full reproductive capacity. Wide ranging changes of puberty include development of secondary sex characteristics, accelerated linear growth, changes in body composition, as well as increased strength and bone mass. Testicular enlargement (testicular volume of 4  mL) is the initial sign of male pubertal onset, while breast budding (Tanner II breast development) notes onset in females.
Source: Journal of Pediatric Nursing - Category: Nursing Authors: Tags: Pediatric Endocrinology Nursing Society Department Source Type: research