Aetiology

The most common cause of delayed puberty is constitutional delay of puberty which accounts for about 90% of cases. This is a diagnosis of exclusion.

Other causes include:

• hypothalamic suppression e.g. systemic illness, anorexia nervosa
• chromosomal abnormalities e.g. Klinefelter's, Turner's
• gonodotrophin releasing hormone deficiency, pituitary lesion e.g. cranipharyngioma, gonadal failure, hypothyroidism, hyperprolactinoma