Chapter 10 DELAYED PUBERTY
In girls, puberty begins with the development of breast buds, which is controlled by estrogens that are produced by the ovaries. This is followed by the appearance of pubic and axillary hair, which is controlled by androgens that are produced by the adrenal cortex and the ovaries. In addition, there is rapid skeletal growth. Menarche is a late occurrence in puberty.
Causes of Delayed Puberty
Constitutional Delayed Puberty
Central nervous system (CNS) tumors and infiltrative diseases
• CHARGE syndrome (coloboma, heart disease, atresia choanae, retarded growth and retarded development and/or anomalies, genital hypoplasia, and ear anomalies and/or deafness)
• LEOPARD syndrome (lentigines, electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retardation of growth, deafness)