Delayed puberty

(Threshold ages 13, 14, 16; initial workup CBC, LH/FSH, chromosomes, prolactin, thyroid studies, bone age, pelvic ultrasound)


Ask these questions in the history, or look for on PE.

Physical Exam


Hypergonadotrophic hypogonadism. Think about syndromes and end-organ failure.

Hypogonadotrophic hypogonadism (think syndromes, nutrition, psych, other disease states)

Start with:


Harriet Lane 16th ed
CHLA board review 2005.