QS Study

Abnormalities of Puberty

Puberty means the onset of adult sexual life. It is the time in life when a boy or girl becomes sexually mature. It is a healthy and normal part of growing up. It may be defined as the period when the endocrine and gametogenic functions of the gonads have first developed to the point where reproduction is possible. It causes physical changes and affects boys and girls differently.

Abnormalities – It is vital to identify abnormal timing and sequence of puberty. This may necessitate a combination of clinical evaluation, investigations, and specialist advice.

(A) Precocious Puberty.

  1. True Precocious Puberty: Early development of secondary sexual characteristic with gametogenesis.

Causes: Ventral hypothalamic lesions and Pineal tumor.

  1. Precocious pseudopuberty: Early development of secondary sexual characteristics without gametogenesis.


  1. Excess administration of androgen in male and estrogen in the female.
  2. Adrenal: Androgen secreting tumor (male) estrogen-secreting tumors (in female)
  3. Gonadal: Leydig cells tumors of testes Granulosa cells tumors of the ovary.

(B) Delayed or Absent Puberty

  1. Primary amenorrhea: Menarche does not appear by the age of 17 years.
  2. Eunuchoidism: Failure of testicular function to develop by the age of 20.


  • Panhypopituitarism.
  • XO chromosomal pattern (Turners syndrome).


Treatment depends on the individual, their symptoms, and the underlying cause of the puberty disorder.

Treatment may include:

  • Observation and regular checkups – in cases where the disorder will likely resolve on its own
  • Hormone therapy
  • Surgery – for anatomical corrections
  • Counseling – to help children and families deal with the emotional and social challenges of disorders of puberty.