Is your child experiencing delayed puberty? (Delayed Puberty) Let's talk about this!

Sometimes you may think, 'Oh, my child is still a little kid, won't he grow up like other children?' Or if you are a teenager yourself, 'All my friends have changed, what's wrong with me?' This can be a troubling question for many parents, as well as young children. Today, let's talk about what puberty is, why it's late, and what to do at a time like this. Don't worry, we'll explain everything simply.

What does it mean to reach adulthood?

Simply put, puberty is the time when your body changes from that of a child to that of an adult. During this time, your body goes through many changes. You start to notice these changes. Usually, girls start these changes between the ages of 8 and 14. Boys start between the ages of 9 and 15. Now, look at how wide this age range is. That means some kids start puberty a little earlier, some a little later. This is very normal. So don't worry if your body starts changing a few years earlier or later than your friends, right? However, sometimes there are cases where your body doesn't start changing at all even after this normal age. That's what we call `(Delayed Puberty)` or "delayed puberty". But there's no need to worry, because most of the time, doctors can help young children with this delayed puberty and bring them up to par with others.

What are the typical symptoms of puberty?

Okay, now let's see what changes happen to the body when we reach puberty.

Changes for girls:

If you are a girl, you may see these things:

• Your breasts are starting to grow .
• Pubic hair begins to appear in private areas.
• Suddenly you get taller, which means you're having a "growth spurt."
• You are menstruating , meaning your period is starting.
• The shape of the body changes, the hip area widens.

Differences for boys:

If it's a boy, you may notice these changes:

• Pubic and facial hair begins to appear in private areas.
• You also suddenly grow taller (growth spurt).
• Your testicles and penis start to grow.
• The shape of the body changes – the shoulders become broader, the body gains muscle mass, and the appearance becomes more masculine.

All these changes happen because of the sex hormones in our bodies. The hormone called ``Testosterone`` in boys and ``Estrogen`` in girls start to be produced in much greater quantities during this time than before. That's why all these changes happen.

What happens during delayed puberty?

Now let's see what are the symptoms of delayed puberty. These are just common symptoms, but don't panic if you have one or two of these. The best thing to do is to seek medical advice.

Symptoms of delay in boys:

• If the penis and testicles have not started to grow by the age of 14.
• If it takes more than 5 years for the development of the genitals to be complete.
• If you're shorter than your other friends, it's because they're growing faster during this time.

Symptoms of delay in girls:

• If your breasts haven't started to develop by the age of 14.
• If you have not started menstruating within 5 years of breast development, or by the age of 16.

Remember, these are just common signs. If you or your child has any concerns about this, it's best to see a doctor.

Why is puberty so late? What are the reasons?

Just like flowers bloom at different times, so do people. But sometimes there may be special reasons for this delay.

Does family history matter? (Family History)

Often this is a hereditary thing. More precisely, it is a pattern of development that runs in the family. Your mother, father, uncle, aunt, brother, sister, younger brother, younger sister, or other relatives may have reached puberty a little late. This is called "constitutional delay", or simply "late bloomer". This usually does not require treatment. Young children like this reach puberty on time, even if a little later than others, but in a normal way.

Can some diseases also affect it? (Medical Problems)

Yes, some illnesses can also delay puberty.

• Some chronic medical conditions, such as diabetes mellitus, cystic fibrosis , kidney disease, or asthma, can delay puberty. These conditions can affect their growth. However , if these conditions are properly treated and managed, they can help reduce the risk of delayed puberty .
• Similarly, someone who is malnourished – that is, someone who is not getting enough food and nutrients – may reach puberty later than their peers who eat a healthy, balanced diet. For example, young people with eating disorders, such as anorexia nervosa, sometimes become so thin that their bodies do not develop properly.
• If girls work out a lot and play sports, their bodies can become very thin, which can delay puberty. A girl's body needs a certain amount of fat to reach puberty and start menstruating.
• Another thing is that problems with the pituitary gland in our brain and the thyroid gland in our neck can also delay puberty. These glands produce hormones that are important for the body's growth and development.

Chromosome Problems

Sometimes, people who don't reach puberty on time may have problems with their chromosomes. Chromosomes are like pieces of DNA that contain the blueprint for how our bodies will grow. Problems with these chromosomes can affect normal development.

• For example, a condition called `(Turner Syndrome)` . This is caused by an abnormality or loss of one of a girl's two X chromosomes. This affects a girl's growth, development of the ovaries, and production of sex hormones. Untreated women with `(Turner Syndrome)` are shorter than normal, may not reach puberty normally, and may have other health problems.
• In a condition called Klinefelter Syndrome , which affects boys, they are born with an extra X chromosome (XXY instead of XY). This condition can cause delayed sexual development. Boys with this condition are usually taller than their age, may have learning disabilities, and may also have other health problems.

There can be many reasons for this, which is why it's important to see a doctor to find the exact cause.

How is delayed puberty diagnosed?

The good news is that if there is a problem, doctors can usually help young children with delayed puberty and get their development back on track. If you or your child has any concerns about this, be sure to make an appointment with your doctor. The doctor will:

• First, you will be examined (physical exam).
• Ask if anyone in your family has had this type of growth pattern (medical history).
• They ask if you have any medications to take.
• They look at your growth chart and check if there is a pattern that indicates a problem.

In addition, the doctor may also perform tests such as:

• Blood tests may be ordered to check for thyroid, pituitary, chromosome, or other problems.
• A "Bone Age X-ray" may be ordered to see if your bones are developing normally.

How is this treated?

Most of the time, doctors can't find any underlying physical problems. Many young people with delayed puberty are just developing a little later than normal. They catch up with others at the right time. However, if doctors find a problem, they may refer you to a pediatric endocrinologist — a doctor who specializes in treating children and young people with growth problems — or to another specialist for further testing or treatment. For some "late bloomers," doctors may also prescribe hormone therapy:

• For boys, short-term treatment with the hormone ``Testosterone'' (usually given as a monthly injection for 4-6 months) can be given to begin the changes of puberty.
• For girls, low doses of the hormone ``(Estrogen)'' can be given for about 4-6 months to start breast development.

After this treatment is complete, your body's own hormones will usually start working and you will complete the puberty process. If not, your doctor will talk to you about taking sex hormones long-term.

How do you live with this situation? How do you make up your mind?

It can be hard to accept that you're not the only one when all your friends are grown up and different. You may feel like you'll never be like everyone else. Even if the doctor or your parents tell you, "Everything's fine," it's not easy to wait for something to happen that affects you.

If you feel sad, lonely, or frustrated, or if it's affecting your schoolwork or other problems, definitely talk to your mom, dad, doctor, or another adult you trust. They can help you find a counselor or therapist you can talk to. They can understand your feelings and teach you ways to deal with them.

Delayed puberty can be a difficult thing to deal with, no matter how much you admit it. But it's usually a treatable problem. If you have any concerns about your development, it's never too late to seek help.

Finally, things to remember

So, here are some important things for you from what we've talked about:

• There can be a number of reasons for delayed puberty.
• Often this is a common thing that runs in the family ("late bloomer").
• In most cases, medical help is available.
• If you or your child has any doubts about this, don't hesitate to see a doctor.
• To reduce the stress you feel during this time, it is very important to talk to someone you trust.

You are not alone, help is always there!

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