Delayed Puberty, Short Stature, and Tall Stature



Normal Puberty: The onset of puberty is heralded by an increase in pulsatile GnRH secretion by the hypothalamus, which leads to increased secretion of LH and FSH by the pituitary and of testosterone and estrogen by the gonads. The normal age range for onset of puberty is 8–13 years in girls and 9–14 years in boys. This often corresponds to a bone age of 11 in girls or 12 in boys. The onset of puberty is characterized by breast budding in girls (thelarche or Tanner II breast development) or testicular size greater than 3 mL in boys, most easily measured with a Prader orchidometer. The development of axillary and pubic hair, adult body odor, and acne may be related to the increased secretion of androgens subsequent to maturation of the gonads (gonadarche), or adrenals (adrenarche), or both.


Growth Hormone Short Stature Turner Syndrome Adult Height Noonan Syndrome 
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References and Additional Readings

  1. Brook C., Brown R., Handbook of Clinical Pediatric Endocrinology. Hoboken, NJ: Wiley-Blackwell, 2008.Google Scholar
  2. Rogol A., diagnostic approach to short stature. In B. Rose (Ed.), UpToDate. Available from
  3. Saenger P., Overview of precocious puberty. In B. Rose (Ed.),UpToDate. available from
  4. Sperling M., ed. Pediatric Endocrinology, Third Edition. Philadelphia: W.B. Saunders, 2008.Google Scholar
  5. Styne D., Pediatric Endocrinology. Core Handbooks in Pediatrics. Philadelphia: Lippincott Williams & Wilkins, 2004.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of Pediatric EndocrinologyMassGeneral Hospital for ChildrenBostonUSA

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