Puberty may be defined as the physiological process resulting in the attainment of sexual maturity and reproductive capacity. Puberty is an integral component of the evaluation and treatment of endocrine disorders in children and adolescents. Not only does it impact on sexual maturation, but it has other effects with lifelong consequences, including linear growth, changes in body composition, and skeletal mineralization. Patients with disorders of puberty, including precocious and delayed puberty, make up a large percentage of the children and adolescents who consult paediatric endocrinologists. An understanding of delayed or absent puberty requires a foundation in the normal processes regulating the onset of puberty, and factors essential for its progression and completion. In this chapter, we will first review the mechanisms of normal growth and puberty, particularly with regard to their interdependence. We shall then discuss the differential diagnosis of delayed or absent puberty, and present diagnostic algorithms for hypergonadotropic and hypogonadotropic hypogonadism, emphasizing some gender-specific aspects.
What is hypogonadism?
Hypogonadism occurs when your sex glands produce little or no sex hormones. The sex glands, also called gonads, are primarily the testes in men and the ovaries in women. Sex hormones help control secondary sex characteristics, such as breast development in women, testicular development in men, and pubic hair growth. Sex hormones also play a role in the menstrual cycle and sperm production.
Hypogonadism may also be known as gonad deficiency. It may be called low serum testosterone or andropause when it happens in males. Most cases of this condition respond well to appropriate medical treatment.