Abstract
Delayed puberty affects between 2% and 3% of the population and is a common reason for seeking endocrine consultation. Evaluation involves ruling out pathologic functional conditions disrupting puberty. Adolescents with constitutional delay of puberty (CDP) will initiate puberty spontaneously, albeit later than peers. However, some individuals have congenital hypogonadotropic hypogonadism (CHH) and will neither initiate nor progress in pubertal development. No single gold standard test differentiates CDP from CHH, posing diagnostic challenges for clinicians. This report provides an overview of normal/disrupted puberty, highlights clinical “red flags” facilitating identification of CHH, and emphasizes comprehensive and interprofessional approaches to care.
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