Overview

Delayed puberty is a condition where sexual development starts later than usual. Boys and girls experience delayed puberty in different ways: Boys: testicle size does not increase by age 14. Girls: no breast development by the time they are 13.

Cause

Common causes of delayed puberty for both males and females can be from functional hypogonadotropic hypogonadism - this is normally a temporary clinical state brought on by different stresses to the body, including chronic illnesses such as severe persistent asthma, sickle cell anaemia, cystic fibrosis or ulcerative colitis. Any cause of nutritional deficiency also merits consideration. In teenagers with a family history of delayed growth, constitutional delay is common and can cause delayed puberty. While the prepubescent growth velocity is normal, the adolescent growth spurt and skeletal maturation are delayed; sexual maturation is also normal but delayed. Other causes include Kallman syndrome undernutrition/eating disorders, excessive physical activity, especially in girls and genetic disorders (Turner syndrome in girls Klinefelter syndrome in boys), central nervous system (CNS) disorders (e.g. hypothalamic or pituitary tumors that reduce gonadotropin secretion) CNS radiation and certain chronic disorders (e.g., poorly controlled diabetes mellitus inflammatory bowel disorders, renal disorders, cystic fibrosis, etc.).

Symptoms

The following are the symptoms of attaining puberty at the right age, which may be delayed. Delayed puberty in boys. Boys begin puberty after the age of nine. 

The key changes are:

•  Larger testes and penis.

•  Growth of facial, underarm and pubic hair. 

• Growth spurt (a sudden increase in height)

•  Broader shoulders and muscular development

• The voice becomes deeper. 

Females have delayed puberty. Girls may begin to show signs of puberty as early as age 8. The primary change in their bodies is the 

• Development of the breasts (the larche) 

• Growth spurt (a sudden increase in height)

• Hair growth in the underarms and pubic area

• Start of periods 

• Wider hips and curvier body shape.

Ayurvedic View

Aartava vyapad (aartavaha sroto dushti) - this is due to hormonal imbalance, the person who is very lean (underweight) and very obese (overweight), will have disruption of the start of the normal menstruation cycle or delay. here, the first menstrual cycle is called menarche. The Ayurveda approach is to correct dosha imbalance, which causes unhealthy BMI (body mass index), and correct the malabsorption of essential nutrients, by ayurvedic panchakarma treatment and encourage the patient to maintain a healthy diet and lifestyle, normal and healthy circadian rhythm.