[Investigation of delayed puberty]

Delayed puberty is defined as the total or almost total absence of development of sex characteristics at an age exceeding the mean by two standard deviations: approximately 15 years in boys and 13 years in girls. A double sense has been given to this term, which is usually applied to permanent hypogonadism as well as to normal but delayed maturation. In practice, certain signs can assist formulation of a prognosis, and if necessary the type of therapy required. Data on which can be based the diagnosis, surveillance, and medical conduct in sexually immature adolescents are discussed. Their interpretation is simple when elevated gonadotrophins levels indicate a primary gonadal lesion, or when the delayed puberty results from a general disease disturbing body maturation. In other cases, interpretation of data is often very difficult and is sometimes a very slow process. Because of these difficulties, the diagnosis between simple delay and gonadotrophic insufficiency is discussed in this report on the basis of a retrospective study conducted for a long enough period to have arrived at a definite conclusion.