RT Book, Section
A1 Dunkel, Leo
A1 Sarafoglou, Kyriakie
A1 Rey, Rodolfo
A1 Lee, Peter A.
A2 Sarafoglou, Kyriakie
A2 Hoffmann, Georg F.
A2 Roth, Karl S.
SR Print(0)
ID 1140320505
T1 Variants of Pubertal Progression
T2 Pediatric Endocrinology and Inborn Errors of Metabolism, 2e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071773140
LK accesspediatrics.mhmedical.com/content.aspx?aid=1140320505
RD 2024/04/19
AB Delayed  puberty  is  defined  as  the  absence  of  testicular  enlargement  in  boys  or  breast  development  in  girls  2  to  2.5  standard  deviations  (SDs)  later  than  the  population  average.  Although  a  single  definition  does  not  apply  to  all  populations,  a  practical  definition  for  girls  is  the  lack  of  breast  development  by  age  13  years  and  for  boys,  a  testicular  volume  of  less  than  4  mL  by  14  years.1,2,3  Because  of  a  downward  trend  in  pubertal  timing  in  the  United  States4,5  and  other  countries6,7  and  differences  in  pubertal  timing  among  ethnic  groups,  some  advocate  for  updated  definitions  with  younger  age  cutoffs  for  the  general  population,  or  perhaps  for  particular  countries  or  ethnic  groups.  Development  of  pubic  hair  is  usually  not  considered  in  the  definition  because  pubarche  may  result  from  maturation  of  the  adrenal  glands  (adrenarche),  and  onset  of  pubic  hair  can  be  independent  of  hypothalamic-pituitary-gonadal  (HPG)  axis  activation.