Delayed Puberty
Puberty
(first sign - balls ♂️ and breasts ♀️)
Males
- first sign is testicular growth at around 12 years of age (range = 10-15 years)
- testicular volume > 4 ml indicates onset of puberty
- maximum height spurt at 14
Females
- first sign is breast development at around 11.5 years of age (range = 9-13 years)
- height spurt reaches its maximum early in puberty (at 12), before menarche
- menarche at 13 (11-15)
- there is an increase of only about 4% of height following menarche
Normal changes in puberty
- gynaecomastia may develop in boys
- asymmetrical breast growth may occur in girls
- diffuse enlargement of the thyroid gland may be seen