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Delayed Puberty in Boys

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Andrology

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Abstract

“Puberty” refers to the stage in human life during which maturation from boy to man (or girl to woman) occurs. The primary sexual characteristics of the hitherto infantile organism undergo maturation into the secondary sexual characteristics.

The initiation of puberty is the result of complex regulatory processes in the neuronal network of the hypothalamus. Pulses of GnRH, increasingly secreted by hypothalamic neurons, induce secretion of gonadotropins in the anterior pituitary. The latter stimulate sex steroid hormone secretion by the gonads. Testicular maturation results in both virilization and production of sperm that are capable of fertilizing eggs. Parallel to this, sex drive awakens. The final stage of pubertal maturation is characterized by sexual maturity and fertility.

The onset and progression of puberty in boys are divided into five stages according to Tanner; testicular volumes are estimated by Prader orchidometry.

“Delayed puberty” is present if pubertal enlargement of the testes to a volume ≥4 ml each side has not yet occurred by the age of 14 years, if the passage through puberty takes more than 5.5 years, or if pubertal development has remained arrested for more than 18 months.

Among all boys with delayed puberty, 70% are “late developers” with constitutional developmental delay (CDGD = constitutional delay of growth and puberty).

In 18%, the maturational delay is “functional,” that is, temporary in nature, provided that the underlying problem is removed or successfully treated.

In about 12%, a permanent disorder is present: 7% of these boys with delayed puberty have a permanent hypogonadotropic, 5% a permanent hypergonadotropic disorder.

The therapeutic approach is based on whether maturational delay is transient or permanent. This differential diagnosis is difficult and requires extensive clinical exploration.

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Author information

Authors and Affiliations

  1. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Julia Rohayem

  2. MVZ endokrinologikum Hamburg, Hamburg, Germany

    Carl-Joachim Partsch

  3. Center of Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Eberhard Nieschlag

  4. Center for Reproductive Medicine and Andrology, University Hospital Halle (Saale), Halle (Saale), Germany

    Hermann M. Behre

Authors
  1. Julia Rohayem
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  2. Carl-Joachim Partsch
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  3. Eberhard Nieschlag
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  4. Hermann M. Behre
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Corresponding author

Correspondence to Julia Rohayem .

Editor information

Editors and Affiliations

  1. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Eberhard Nieschlag

  2. Center for Reproductive Medicine and Andrology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany

    Hermann M. Behre

  3. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Sabine Kliesch

  4. Center for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany

    Susan Nieschlag

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Rohayem, J., Partsch, CJ., Nieschlag, E., Behre, H.M. (2023). Delayed Puberty in Boys. In: Nieschlag, E., Behre, H.M., Kliesch, S., Nieschlag, S. (eds) Andrology. Springer, Cham. https://doi.org/10.1007/978-3-031-31574-9_14

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  • DOI: https://doi.org/10.1007/978-3-031-31574-9_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-31573-2

  • Online ISBN: 978-3-031-31574-9

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