Overview
Delayed puberty is a condition where physical signs of sexual development appear later than usual. It can affect both boys and girls and may be due to hormonal, genetic, or chronic health factors. In Korea, pediatric endocrinologists at hospitals like Seoul National University Hospital, Asan Medical Center, and Samsung Medical Center specialize in diagnosing and managing delayed puberty to support healthy growth and development.
What is Delayed Puberty?
Delayed puberty is defined as the absence of breast development in girls by age 13 or testicular enlargement in boys by age 14. It can be classified as:
- Constitutional delay – a normal variation in growth and development
- Primary hypogonadism – gonads fail to produce hormones
- Secondary hypogonadism – hormonal signaling from the brain is impaired
This condition can affect physical growth, bone development, and psychosocial health.
Symptoms
- Lack of breast development in girls by age 13
- Lack of testicular enlargement in boys by age 14
- Slow or absent pubic and underarm hair growth
- Delayed growth spurt
- Small genitalia or delayed menstrual periods in girls
- Emotional or social difficulties due to delayed development
Causes
- Genetic factors and family history of delayed puberty
- Chronic illnesses such as diabetes, kidney disease, or cystic fibrosis
- Hormonal disorders affecting the pituitary or hypothalamus
- Nutritional deficiencies or eating disorders
- Excessive physical activity or stress
- Chromosomal disorders such as Turner or Klinefelter syndrome
Risk Factors
- Family history of late puberty
- Chronic medical conditions
- Low body weight or malnutrition
- Severe stress or psychological factors
- History of chemotherapy or radiation
Complications
- Short stature due to delayed growth spurt
- Reduced bone density or osteoporosis
- Emotional distress, social anxiety, or low self-esteem
- Fertility issues if underlying hormonal problems persist
- Delayed secondary sexual characteristics affecting overall development
Prevention
- Early monitoring of growth and development in children
- Balanced nutrition with adequate calories, protein, and vitamins
- Management of chronic illnesses from early childhood
- Avoid excessive physical stress or restrictive diets
- Regular pediatric check-ups for early detection of endocrine disorders
Treatment Options in Korea
Treatment focuses on stimulating puberty, correcting underlying disorders, and supporting growth.
- Diagnosis
- Physical examination of growth and sexual development
- Blood tests to evaluate hormone levels (LH, FSH, estradiol, testosterone)
- Bone age assessment using X-rays
- Genetic and chromosomal testing if indicated
- Medical Treatments
- Hormone replacement therapy (estrogen for girls, testosterone for boys)
- Treatment of underlying medical conditions (thyroid disorders, chronic illness)
- Nutritional supplementation if deficiencies are present
- Rehabilitation & Supportive Care
- Psychological counseling for adolescents dealing with delayed development
- Education for parents and children about normal growth variations
- Coordination with endocrinologists and pediatricians for ongoing monitoring
- Specialized Hospitals in Korea
- Seoul National University Hospital – Pediatric endocrinology and growth clinics
- Asan Medical Center – Comprehensive hormone and growth management
- Samsung Medical Center – Advanced diagnostics and hormone therapy
- Regional pediatric clinics for regular follow-up and monitoring
- Long-Term Follow-Up
- Regular hormone level monitoring and growth assessments
- Adjustment of therapy based on development progress
- Psychological support to improve social and emotional well-being
- Planning for fertility and reproductive health if necessary
