Disorders of puberty

Puberty is the process of development of adult secondary sexual characteristics. Disorders of puberty can be classified into early (precocious) and late (delayed) puberty. Early (precocious) puberty can be secondary to either activation of the hypothalamus–pituitary–gonadal axis (gonadotropin dependent or central) or altered regulation of sex hormone production in the gonads, adrenal glands or other tissues (gonadotropin independent or peripheral). Delayed puberty is most often constitutional, but hypogonadotropic (central) and hypergonadotropic (peripheral) hypogonadism should be considered. This article discusses the clinical and biochemical features of normal and abnormal puberty.