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==Overview==
==Overview==
Delayed puberty is almost always due to [[physiologic]] exaggerated prolongation of [[puberty]] timing; a condition called [[Constitutional delay of puberty|constitutional delay of growth and puberty (CDGP)]]. Other forms of delayed puberty include hypergonadotropic [[hypogonadism]], permanent [[hypogonadotropic hypogonadism]], and functional [[hypogonadotropic hypogonadism]].
Delayed puberty is almost always due to [[physiologic]] exaggeration of the prolongation of [[puberty]] timing; a condition called [[Constitutional delay of puberty|constitutional delay of growth and puberty (CDGP)]]. Other forms of delayed puberty include hypergonadotropic [[hypogonadism]], permanent [[hypogonadotropic hypogonadism]], and functional [[hypogonadotropic hypogonadism]].


==Classification==
==Classification==
* Delayed puberty may be classified according to etiology into 4 subtypes, including [[Constitutional delay of puberty|constitutional delay of growth and puberty (CDGP)]], hypergonadotropic [[hypogonadism]], permanent [[hypogonadotropic hypogonadism]], and functional [[hypogonadotropic hypogonadism]].
* Delayed puberty may be classified according to etiology into 4 subtypes which includes:<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref>
**[[Constitutional delay of puberty|Constitutional delay of growth and puberty (CDGP)]]  
**Hypergonadotropic [[hypogonadism]]
**Permanent [[hypogonadotropic hypogonadism]]
**Functional [[hypogonadotropic hypogonadism]]
* The most common subtype of delayed puberty, [[Constitutional delay of puberty|constitutional delay of growth and puberty (CDGP)]], has no pathological etiology and is completely physiologic.
* The most common subtype of delayed puberty, [[Constitutional delay of puberty|constitutional delay of growth and puberty (CDGP)]], has no pathological etiology and is completely physiologic.
* Other subtypes of delayed puberty are classified upon the serum levels of [[sex hormones]] and also [[gonadotropins]].  
* Other subtypes of delayed puberty are classified upon the serum levels of [[sex hormones]] and also [[gonadotropins]].  
* The complete classification of delayed puberty is as follows:<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref>
* The complete classification of delayed puberty is as follows:


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{{Family tree | | | |!| | | | E01 | | | E02 | | | E03 | | | |E01= Hypergonadotropic [[hypogonadism]]<br>(primary [[hypogonadism]])|E02=Permanent [[hypogonadotropic hypogonadism]]<br>(secondary [[hypogonadism]])|E03=Transient [[hypogonadotropic hypogonadism]]<br>(functional [[hypogonadism]])}}
{{Family tree | | | |!| | | | E01 | | | E02 | | | E03 | | | |E01= Hypergonadotropic [[hypogonadism]]<br>(primary [[hypogonadism]])|E02=Permanent [[hypogonadotropic hypogonadism]]<br>(secondary [[hypogonadism]])|E03=Transient [[hypogonadotropic hypogonadism]]<br>(functional [[hypogonadism]])}}
{{Family tree | | | |!| | | | |`|-|-|-|-|+|-|-|-|-|'| | | | | |}}
{{Family tree | | | |!| | | | |`|-|-|-|-|+|-|-|-|-|'| | | | | |}}
{{Family tree | | | C01 | | | | | | | | C02 | | | | | | |C01= [[image:Flow diagram showing normal hormonal control of puberty.gif|thumb|Diagram showing normal hormonal control of puberty, via Wikimedia.org - By Neil Smith <ref name="http://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0> "https://commons.wikimedia.org/wiki/File%3AFlow_diagram_showing_normal_hormonal_control_of_puberty.gif">via Wikimedia Commons</ref>]]| C02=[[image:Diagram showing the disruption of the hormonal pathways of puberty due to the failure of GnRH release seen in KS and HH.gif|thumb|Diagram showing the disruption of the hormonal pathways of puberty, via Wikimedia.org - By Neil Smith <ref name="http://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0>"https://commons.wikimedia.org/wiki/File%3ADiagram_showing_the_disruption_of_the_hormonal_pathways_of_puberty_due_to_the_failure_of_GnRH_release_seen_in_KS_and_HH.gif">via Wikimedia Commons</ref>]]}}
{{Family tree | | | C01 | | | | | | | | C02 | | | | | | |C01= [[image:Flow diagram showing normal hormonal control of puberty.gif|thumb|Diagram showing normal hormonal control of puberty, via Wikimedia.org - By Neil Smith, via Wikimedia Commons<ref name="http://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0> "https://commons.wikimedia.org/wiki/File%3AFlow_diagram_showing_normal_hormonal_control_of_puberty.gif">via Wikimedia Commons</ref>]]| C02=[[image:Diagram showing the disruption of the hormonal pathways of puberty due to the failure of GnRH release seen in KS and HH.gif|thumb|Diagram showing the disruption of the hormonal pathways of puberty, via Wikimedia.org - By Neil Smith, via Wikimedia Commons<ref name="http://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0>"https://commons.wikimedia.org/wiki/File%3ADiagram_showing_the_disruption_of_the_hormonal_pathways_of_puberty_due_to_the_failure_of_GnRH_release_seen_in_KS_and_HH.gif">via Wikimedia Commons</ref>]]}}


{{Family tree/end}}
{{Family tree/end}}
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Latest revision as of 21:15, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Delayed puberty is almost always due to physiologic exaggeration of the prolongation of puberty timing; a condition called constitutional delay of growth and puberty (CDGP). Other forms of delayed puberty include hypergonadotropic hypogonadism, permanent hypogonadotropic hypogonadism, and functional hypogonadotropic hypogonadism.

Classification

 
 
 
 
 
 
 
Delayed puberty
classification
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LH, FSH, and GnRH
plasma level
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Normal
 
 
 
 
 
 
 
Abnormal
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Constitutional delay of growth and puberty (CDGP)
 
 
LH and FSH increased
GnRH increased
 
 
LH and FSH decreased
GnRH decreased
 
 
LH and FSH decreased
GnRH decreased
(transient)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hypergonadotropic hypogonadism
(primary hypogonadism)
 
 
Permanent hypogonadotropic hypogonadism
(secondary hypogonadism)
 
 
Transient hypogonadotropic hypogonadism
(functional hypogonadism)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Diagram showing normal hormonal control of puberty, via Wikimedia.org - By Neil Smith, via Wikimedia Commons[2]
 
 
 
 
 
 
 
Diagram showing the disruption of the hormonal pathways of puberty, via Wikimedia.org - By Neil Smith, via Wikimedia Commons[2]
 
 
 
 
 
 

References

  1. Palmert, Mark R.; Dunkel, Leo (2012). "Delayed Puberty". New England Journal of Medicine. 366 (5): 443–453. doi:10.1056/NEJMcp1109290. ISSN 0028-4793.
  2. 2.0 2.1 CC BY-SA 3.0> "https://commons.wikimedia.org/wiki/File%3AFlow_diagram_showing_normal_hormonal_control_of_puberty.gif">via Wikimedia Commons

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