Delayed Puberty: What You Should Know
May 27, 2022
Learn about the late bloomer and whether your child is experiencing delayed puberty.
One of the most common questions I get from teenagers is, Why am I not growing?
The most important thing for you to know is that teens enter puberty at different times. Literally, your child could enter puberty as early as 8 or 9 years old (called precocious puberty) and as late as 14 or 15 years (called delayed puberty).
In this article, we’ll take a deeper look at delayed puberty, otherwise known as being a late bloomer, and what you can do about it.
How Long Does Puberty Last for Boys and Girls?
Puberty is a period of time during adolescence when sexual maturation occurs.
For girls, the onset of puberty is generally around age 10 and full maturation is achieved by age fourteen.
For boys, puberty begins on average at age eleven and they are fully mature by age sixteen.
During this period, growth of the reproductive organs occurs. By the end, boys and girls are capable of reproduction.
The timing of puberty is different for each child and relies mostly on their genetic make-up. In other words, if you were a late bloomer, for instance, there’s a good chance your child will be, too. Likewise, the tendency is the same for early puberty.
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What is Delayed Puberty?
Delayed puberty is a condition whereby the onset of puberty is later than what is considered normal. For example, when girls don’t show signs of breast development by age 13 or start their periods by age 16, they may be experiencing delayed puberty.
Similarly, delayed puberty in boys is suspected when there aren’t signs of testicular maturation, pubic hair, or a deepening of the voice by 14 years of age.
What Causes Late Puberty?
Often, there isn’t an obvious cause of delayed puberty. Sometimes it can be traced to a family genetic tendency. Other times it may be a mystery as to why your child might be a late bloomer.
However, there are some identifiable reasons for why the onset of puberty might be delayed:
- Not enough nutrition. This leads to a calorie or protein deficit, such as in the case of extreme picky eating, or an eating disorder like anorexia nervosa.
- Too much exercise leading to an imbalance of energy availability for the body.
- An underactive thyroid, called hypothyroidism.
- An underactive pituitary gland, called hypopituitarism.
- Tumors of the pituitary or thyroid gland.
- Chronic illness or a syndrome that interferes with production and use of sexual hormones.
The Signs and Symptoms of Late Puberty
Although you may suspect late puberty, it’ important not to panic. Every child is different, even within families!
There are some classic signs and symptoms of delayed puberty, however. If you see these, you should talk with your doctor:
In girls:
No breast buds or breast growth by age 12
More than 5 years between the appearance of breasts and starting the menstrual cycle
No period by age 15
In boys:
No enlargement of the testicles by age 14
No pubic hair by age 15
Slow maturation of the genitals (more than 5 years to complete full maturation)
What are the Signs of Full Maturation?
A girl who is fully matured will have developed breasts, pubic and underarm hair, a regular (or irregular) period and will have stopped growing in height. Your pediatrician will identify your daughter at Tanner Stage V.
A boy who is fully matured will have experienced enlargement of the testicles, scrotum and penis; will have pubic, underarm and facial hair; a deeper voice, and have stopped growing in height. The pediatrician will identify your son as Tanner Stage V based on pubic hair and genital development.
How is Late Puberty Diagnosed?
There are several ways to diagnose delayed puberty. A physical exam and a Tanner Scale rating by your pediatrician can tell you where your teen is along the puberty continuum.
Blood tests can be done to check your child’s hormone levels, chromosomal problems, or other factors that may interfere with puberty, such as diabetes and anemia.
Other tests such as x-rays to check bone age, CT scans or MRI may be used.
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The Emotional Toll of Being a Late Bloomer
A late bloomer may experience stress. It’s developmentally normal to self-compare to others during this age and stage, and many teens will inadvertently compare themselves to their peers.
This can cause embarrassment, which may lead to low self-esteem, and other mental health concerns.
It’s important to focus on your teen’s inner qualities and characteristics, rather than on their outward appearance, and provide the love, encouragement, and emotional support they need.
Treatment for the Late Bloomer
If you’re seeing the signs and symptoms of late puberty or have concerns about your teen’s growth and development, talk with your healthcare provider.
Delayed puberty is treated based on its root cause. Sometimes it’s not treated at all.
If late puberty is common in your family, or an inherited trait, there’s usually no reason to treat it. In this case, it’s a waiting game. Puberty will eventually happen on its own time table.
However, if a delay in puberty is due to other reasons, such as inadequate nutrition, an eating disorder, or a hormonal imbalance, these can be addressed and corrected.
Once these are treated, puberty often proceeds normally.
Sometimes, however, hormone therapy is used to correct abnormalities. This is something your pediatrician and/or endocrinologist will address with you specifically, if needed.
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