Delayed puberty is defined as the failure of secondary sexual characteristics to appear by the age of 14 years.
Delayed puberty is classified based on the causes into two:
- central (hypogonadotrophic hypogonadism)
- gonadal (hypergonadotrophic hypogonadism).
Central causes of delayed puberty includes conditions that prevent hypothalamic GnRH production/release, such as:
- Excessive exercise
- Anorexia nervosa
- Kallman’s syndrome
- Pituitary tumour
- Chronic illness (sickle cell disease, diabetes mellitus, etc).