Best Endocrinologist for Pubertal disorders treatment

Pubertal Disorders

Puberty is an internal clock designed by our body, which if triggered, will change the external features of a girl into a woman and a boy into a man. This clock is orchestrated by the sex hormone axis which includes the pituitary gland LH and FSH, and the sex hormones oestrogen and testosterone in the girl and boy respectively.

In boys, puberty occurs between ages 12-16. LH, FSH and Testosterone as a unit, are responsible for effects like male physique, beard growth, masculine voice, baldness, bone and muscle strength, sexual desire/erections and sperm production. A deficiency in these hormones can cause an impairment of the above functions in the male sex.

In girls, puberty occurs between ages 10-14. LH, FSH and oestrogen as a unit are responsible for the development of feminine stature, breast development, regulation of period and egg cycle, bone strength, skin tone and sexual function. A deficiency in these hormones can cause an impairment of the above functions in the female sex.

The various pubertal disorders are:

• Precocious puberty: This happens usually due to an early triggering of the clock leading to early puberty in boys and girls. It is important to treat this disorder, as early puberty will significantly reduce the final height of the girl/boy. Also children with early puberty may not be able to cope with the early sexual changes that are associated with puberty. The condition requires confirmation with sequential endocrine testing. Treatment is easy with monthly/3monthly injections and regular monitoring. Very rarely, the early puberty might be due to an abnormal growth in the pituitary/testes/ovaries or elsewhere which may necessitate surgery.
• Delayed puberty: This is where the pubertal clock has not triggered at an appropriate time. The common causes for this are: 
  • Constitutional delay- where puberty clock is lagging behind. There may be a hereditary aspect to this condition. Sometimes, a chronic illness can delay puberty in the child. No treatment is required and puberty will develop normally even if delayed.
  • Pituitary failure/suppression - due to tumours or other pituitary pathology.
  • Chromosome disorders - like Turner's syndrome in girls and Kleinfelter syndrome in boys.The condition requires confirmation with sequential endocrine testing. Hormone treatment is required to induce puberty, and depending on the condition may have to be continued for life