This is called cryptomenorrhea. Nevertheless, a doctor should be consulted if no secondary sexual characteristics appear by the age of 13. The causes of amenorrhea apply to delayed puberty also. The diagnosis of delayed puberty is based on physical, neurological and pelvic examinations, measurement of the level of gonadotropin, and karyotyping, and an endocrine profile. Gonadal steroid replacement with oestrogen or progesterone is the usual treatment.
Precocious puberty can be Heterosexual or isosexual.
Heterosexual precocious puberty involves the development of secondary sexual characteristics that do not match the genetic sex of the child. Isosexual precocious puberty is the early development of secondary sexual characteristics that are consistent with the genetic sex of the child. The majority of these cases have no obvious underlying cause. Today, progestational agents and GnRH analogues constitute effective treatment of precocious puberty. All rights reserved.