Types of Disorders of Puberty

Endocrinologists at Hassenfeld Children’s Hospital at NYU Langone treat children and adolescents who have disorders of puberty, which include precocious, or early, puberty and delayed puberty. These conditions are caused by problems with hormones produced by endocrine glands, such as the hypothalamus and pituitary glands. These glands play a part in releasing hormones that lead to reproductive development.

Precocious Puberty

When signs of puberty appear before age 8 in girls and age 9 in boys, a diagnosis of precocious puberty is made. These signs can include underarm and pubic hair growth and body odor. Girls may develop breasts or begin menstruation, whereas boys may experience early growth of the testicles, penis, and facial hair and a lowering of the voice.

Children with precocious puberty grow quickly at first but tend to stop growing earlier than usual, making them shorter than average as adults.

Though the cause of precocious puberty in most children is unknown, it can sometimes be caused by a brain tumor or an injury to the endocrine glands. That injury may result from trauma or the combined effects of surgery and radiation therapy for cancer.

Precocious puberty can also be caused by congenital adrenal hyperplasia, an inherited condition in which the adrenal glands release abnormal levels of hormones. Rarely, early puberty in girls is caused by a neuroendocrine disorder called McCune–Albright syndrome, which causes fibrous growths to replace healthy bone. In boys with the rare genetic condition testotoxicosis, excess amounts of testosterone are released, leading to precocious puberty.

Delayed Puberty

When signs of puberty aren’t noticeable until age 14 in boys and age 12 in girls—with an absence of menstruation by age 14—a child is diagnosed with delayed puberty.
Causes can include chronic illnesses like diabetes, anorexia or bulimia, excessive exercise, trauma to the head, and chemotherapy or radiation treatments for cancer. Problems with the pituitary gland or the thyroid gland, which regulates the body’s metabolism, can lead to delayed puberty. These include hypothyroidism, or underactive thyroid.

Other causes include genetic disorders that prevent endocrine glands from working properly. These include Turner syndrome, in which one of a girl’s two X chromosomes is irregular or missing, and Klinefelter syndrome, when a boy is born with an extra X chromosome.

Sometimes, a noncancerous or cancerous tumor on or near a gland in the brain can prevent the release of hormones that trigger puberty.