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Puberty results from activation of gonads (testes in boys/ ovaries in girls) by pituitary hormones LH and FSH. Activated gonads produce sexual hormones (testosterone in boys and estrogen in girls ) which are responsible for gender specific physical changes at puberty along with behaviour changes. Testosterone in boys is responsible for hair growth over pubic area and face with maturation of genital organs, breaking of voice, development of muscular and skeletal system. Similarly, estrogen in girls is responsible for breast development, maturation of genital organs with feminisation of body. Bone maturation with rapid height gain is seen at puberty both in boys and girls. Various systemic and hormonal disorders can result in either late or early puberty.
LATE PUBERTY -
Most of the boys show signs of puberty latest by age of 14 years and most girls start showing signs of puberty latest by age of 13 years. The earliest sign of puberty in boys is enlargement of testes and in girls is height spurt/breast development. When boys older than 14 years and girls older than 13 years don't have any signs of puberty it is called delayed puberty.
CAUSES OF DELAYED PUBERTY -
- Constitutional delay is most common cause of delayed puberty. The constitutional delay means child is not having any illness and he is going to develop puberty spontaneously at later age. But diagnosis of this condition can be made only after physical examination and investigations so that other causes of delayed puberty are ruled out.
- Functional hypogonadotropic Hypopogonadism - Delayed but spontaneous puberty develops. This condition can be seen in systemic illnesses like chronic infections, poor nutritional status etc.
- Hypogonadotropic Hypogonadism - Disorders of pituitary gland result in low LH and FSH so that testes/ovaries are not stimulated and sex hormone is not produced. This can be caused by various genetic disorders, brain tumours, head injury, brain radiation etc.
- Hypergonadotropic Hypogonadism - In this scenario, LH and FSH levels are normal but gonadal are not able to produce sex hormones resulting in delayed puberty.
CONSEQUENCES OF DELAYED PUBERTY -
The absence of age specific pubertal changes cause anxiety and distress in children and their parents. These children may develop low self-esteem and are teased by their peers. Along with the poor development of physical signs of puberty, fertility is also affected in hypogonadism. And most importantly, delayed puberty can be the symptom of serious underlying illness like intracranial tumours etc. These children deserve medical attention to get best results.
Serum testosterone/estradiol with LH and FSH is done to find out where is defect i.e. whether at the level of pituitary gland or at the level of testes/ovaries. Further investigations depend on levels LH, FSH, estradiol/testosterone. Other useful investigations include prolactin, T4, TSH, ray hand for bone age, ultrasound pelvis, MRI pituitary gland etc.
After diagnosis is established, Testosterone/estrogen replacement should be started to boys older than 14 year and girls older than 13 years respectively. Hormone replacement is very effective and usually safe. In adulthood those with hypogonadotropic hypogonadism can be treated with LH and FSH to produce sperms/ eggs so that they can achieve fertility. If you wish to discuss about any specific problem, you can ask a free question.
I have an eye problem and my eyes flow a lot and everyday when I wake up my eyes become wet so what should I do?
Sir, I am very disturbing because of neighbours and my friends, relatives teased me. Because my short height and I am going in depression slowly slowly. please tell me treatment of this problem.
Total loss of memory for some seconds. Unable to concentrate, some times mind just become blank and cannot even participate in a simple discussion. Feels a blunt pain some times at the back of my head. I take a mild medicine for blood pressure. For this forgetfulness, loss of memory, finding it extremely difficult for perform in the organisation as because I am in a senior position in the company. Regards, Subhadeep.
From yesterday my heart beat normal that is 60 BPM but the heart beat is strong. What is the problem with my body please tell me.
Could you please breifly explain that what type of vactinations/ injections should we give for newely born baby. If any drops are there to cure jaundice.
In grown hair in moustache and beard. Help me to find any solution to grow more hair with high density.
What are the side effects of overmasturbation? How one can confirm he overmasturbated and the problems he is facing are the consequences of It? Please explain it in detail? Because now a days not only me but maximum students are misguided by someone in their early adolescent period?
In most Indian homes, a family is not complete with just one child. Until about a couple of decades ago, a family with a single child was very rare. The most common response would be 'with whom the child will play'. Between the siblings, there is always so much love. Starting from getting attention from the parent to education at all stages of life, this is one relationship which just grows and grows. While it definitely is a feel-good factor, scientifically too, it has been proven to have multiple benefits.
Read on to know some benefits of having siblings and how it can help you stay healthy and positive.
- A constant companion: With a sibling around, there is no need to look for a play or study companion. There is always one available right in the same home. This provides for a happy, healthy equation with a lot of give and take that just extends through life.
- Continuous learning environment: With a sibling around, the learning never stops. There is a constant teacher/mentor-student relationship with the elder one having an upper hand and trying to teach the younger one all sorts of things from using a chalk to spoon to math to magic.
- Sharing begins at home: Whether it is your toys or colours, stationary or chocolates, siblings share a lot of stuff and so from a very young age, there is a behaviour that encourages sharing of all sorts of things. Studies have shown that children with siblings show a lot more sympathy and are more open to sharing things as compared to single children.
- Builds selflessness: The next time you see two siblings, notice how the elder one is always so protective of the younger one. The elder one is willing to give up their chocolate just so the younger one smiles. Similarly, the younger one also would give up a toy so that the elder one is happy. This selflessness is ingrained in children with siblings, which extends into their other relationships too later in life.
- Tougher individuals: Problem solving is something which gets built in early in life when children have siblings. This comes in handy later in life too, which makes them tougher individuals. They are also better skilled at negotiating, good at setting and achieving goals, managing relationships (both professional and personal), and are so more successful.
The relationship with a sibling just continues through life. The above are some pointers as to how having a sibling makes for a happy, healthier, and positive life. Anyone with a sibling would definitely vouch for these!
In case you have a concern or query you can always consult an expert & get answers to your questions!