DR Medhat MRCP

• Def :
Delayed growth & puberty
- Normally : average age of onset of puberty
o In girls : 11.5 years.
o In boys : 12 years.
- Delayed puberty i.e absence of 2ndry sex characters in relation to their
corresponding age
Secondary sex characters
In males
In females
سؤال sign) ↑ size of testes (>5ml), (1 st
Growth of body hair :
- Axillary, chest, abdominal, pubic
- Facial (bear ,moustache)
↑ larynx & deepening of the voice
↑ height (more than in girls).
↑ waist : hip ratio (fat distribution)
↑ muscle mass e.g broad shoulders
Breast bud & ↑ breast size,(1 st sign)
Growth of body hair :
- Axillary, pubic ,head
- Starts 9-14y, complete up to 16y.
↑ height (earlier than in boys).
Sharp voice.
↓ waist : hip ratio.
Menarche (occurs late ,11-15 years)
The growth spurt at puberty :
It`s brought about by secretion of androgens in males & estrogen in females.
Estrogens are responsible for skeletal (bone) maturation ,fusion of epiphysis &
خد بالك مهم hence termination of growh in both males & females