Most often, a child’s puberty may be delayed simply because of being a late bloomer, which usually does not need medical treatment. Once the stages of puberty start, they develop normally. However, there are other rare late puberty causes like chronic medical disorders, genetic disorders, and more. Read on to learn about the various late puberty causes in Indian girls and boys.
Constitutional delay in growth and puberty (CDGP)
Constitutional delay of growth and puberty is the most common reason for the delay in puberty in Indian children. Children affected by this condition often have a family history of one or both parents being late bloomers. They tend to have a short-stature compared to peers of their age because of delay in bone growth. But once puberty starts, the pubertal stages progress as expected.
“60% of boys affected by delayed puberty are diagnosed
with a constitutional delay in growth and puberty.”
Since short stature is one of the main indications of the delay in Indian girls and boys, medical experts will have to rule out the following conditions before making a diagnosis of CDGP:
- Familial short stature: The shortness of the child being hereditary and does not have a pathological cause.
- Growth hormone deficiency (GHD): The pituitary gland secretes an insufficient amount of growth hormone (GH) during puberty.
- Hypothyroidism: Insufficient amount of thyroid hormone, which is also important for growth.
- Early-onset of puberty: Also known as precocious puberty, this can result in an early growth spurt.
- Nutritional imbalances: Nutrient deficiencies and inability to absorb nutrients properly can also play a factor in delaying puberty.
Consult with a dietitian to learn more about providing a balanced Indian diet for your child.
- Achondroplasia: This is a bone disorder that prevents cartilage from changing into bone.
- Babies born small: Babies born small for the gestational age can experience a short stature as they grow up.
In some cases, a chronic illness can affect the hormonal balance of a child and result in a late puberty. The following are some of the most common chronic causes of delayed puberty in females and males.
Causes of delayed/ late puberty in females and males can also include diabetes. Diabetes is a metabolic disorder in which decreased insulin production causes blood sugar levels to soar up, which is usually the case in Type I diabetes that affects children at a young age. Symptoms include excessive urination and thirst, extreme fatigue, frequent hunger, blurred vision, and more. If you find your child facing these symptoms, consult with a diabetes specialist to avoid any damage in the future. Treatment is based on the type of diabetes the child is diagnosed with but mostly includes changes in diet, exercise, medications, and in some cases, insulin injections. Management of diabetes in children must be strictly monitored as it is more complex. Deficiency of insulin could also indirectly lead to the suppression of gonadotropin releasing hormone (GnRH), which can lead to late puberty.
2. Inflammatory bowel disease:
Inflammatory bowel disease or IBD occurs when the intestines become inflamed, causing abdominal pain and diarrhoea. The causes of IBD are unknown, but evidence suggests that people with a genetic predisposition may be more prone to the disease because of abnormal immune reactions with the intestinal bacteria.
The two types of IBD are:
Crohn’s disease: Affects any part of the digestive tract and causes chronic diarrhoea and abdominal pain. If you think you may be suffering from diarrhoea, our general physicians on MFine would be able to give you advice on how to stop loose motions.
Ulcerative colitis: Affects only the large intestine and causes bloody diarrhoea and intermittent episodes of abdominal pain.
Hypothyroidism is also one of the main causes of delayed/late puberty in males and females. It occurs when your thyroid gland produces an insufficient amount of thyroid hormones. Your thyroid gland is responsible for providing energy and controlling functions like how your digestive system works and your body’s metabolism. With a decrease in these hormones, your body’s processes begin to slow down. Thus, resulting in slow metabolism.
The most common signs of delayed puberty in males and females include feeling cold, fatigue, dry skin, dullness, and weight gain. Adolescents who are obese are recommeded to try dietary modifications and implement weight loss diet plan charts and medications to ensure adequate levels of thyroid hormones in the body. Ensure that you and your child have a full-body check-up regularly to detect any health conditions early on.
Causes of late puberty in females and males can also include Anaemia. Anaemia is a condition in which your body lacks red blood cells (RBCs) to carry out oxygen to all parts of the body for daily functions. The haemoglobin in RBCs is a protein that enables the process of delivering oxygen to the body. When your haemoglobin count is low, there is an inadequate supply of oxygen in the body. Take a complete blood count test from the comfort of your home to increase chances for treatment and cure.
Symptoms often include fatigue, weakness, pale skin, dizziness, and more. There are different types of anaemia with the most common one is iron deficiency anaemia that affects a large population of young girls and women in India. Treatment for anaemia includes dietary supplements and incorporating a balanced, nutritional diet and exercise.
Nutritional development is highly essential for growth during infancy, childhood, and puberty. This is the time when a child’s body is rapidly growing and preparing for adulthood. A healthy, balanced diet is necessary to ensure growth progresses as expected. A lack of essential nutrients can be one of the main causes of late puberty.
“India is home to about one-third of the world’s
Nutritional needs for adolescents:
Calories: Calories are used to measure the amount of energy delivered to your body. Due to rapid growth, the body demands more calories during adolescence than at any other phase of life.
The daily recommended calorie intake is 2,800 for boys, and 2,200 for girls. Intake of balanced nutrients will ensure good health for your child.
IMPORTANT NUTRIENTS :
6. Sickle cell disease
Sickle cell disease is an inherited condition which can affect the haemoglobin molecules in the blood. Haemoglobin molecules turn into sickle-shaped cells and die early. This affects their capacity to carry oxygen. Children with sickle cell disease often develop at a slower pace than others their own age. They also experience puberty much later due to their decreased haemoglobin count.
7. Cystic fibrosis
Cystic fibrosis is a hereditary disease which affects the lungs. In this condition, the mucus naturally produced by the cells becomes thick and can block the ducts and tubes in the lungs and other organs. Cystic fibrosis can cause lead to puberty occuring much later in both boys and girls.
Hormonal/ genetic disorders
The sex chromosomes determine whether a fetus will be biologically male or female. A pair of XX chromosomes results in a female fetus, and a pair of XY chromosomes results in a male fetus.
Turner syndrome is a sex chromosomal abnormality and is one of the causes of late puberty only in females. The complete or partial absence of one of the X chromosomes in females results in Turner syndrome. This condition can be diagnosed before birth, during infancy, or in early childhood.
Other features identified to be associated with this condition are:
- Absent or stunted growth spurts during the expected age range
- Short stature
- Failure to begin sexual development during the expected age range
- Signs of infertility
- Heart defects
Individuals with Turner syndrome require ongoing medical care and monitoring from a variety of medical experts like endocrinologists, heart specialists, and specialists in women’s health.
Regular follow-ups with an online doctor can ensure that these girls and women lead happy and healthy lives.
Klinefelter syndrome is another sex chromosomal abnormality that causes delayed puberty in males. As previously mentioned, a pair of XY chromosomes results in a male fetus. A person diagnosed with this condition is born with an extra copy of the X chromosome, resulting in adverse effects in their sexual maturation.
Signs and symptoms of Klinefelter syndrome include:
- Less muscle mass
- Enlarged breast tissue (also called gynecomastia)
- Smaller penis and testicles than expected
- Reduced sperm production or infertility
- Less facial and body hair
- Low energy levels
- Psychosocial symptoms like trouble paying attention
- Lack of social or language skills
A slow development during puberty is mostly normal, but it is always best to consult with a doctor if you have any concerns. Young boys with Klinefelter syndrome may require reproductive treatments and therapy to ensure physical development progresses as expected.
Delayed puberty can be caused due to several reasons. The most common reason is a constitutional delay of growth and puberty (CDGP) which is inherited from the parents. There is no particular CDGP treatment as eventually, the child will catch up with their peers. Chronic diseases like diabetes, bowel disease, malnutrition, and anaemia can also contribute to a delay in puberty. Apart from this, hormonal and genetic disorders like Turner syndrome, Klinefelter’s syndrome and hypogonadism can also cause a delay in puberty in girls and boys.
Consult with an endocrinologist to evaluate your child’s risk factors for a late puberty