Table 5.

Causes of delayed and early puberty

Delay in puberty

• Constitutional delay of growth and puberty (boys)

• Poor nutrition

• Chronic illness

• Eating disorder

• Severe psychosocial stress

• Disorder of hypothalamic-pituitary-gonadal axis

Early puberty

• Familial

• Obesity (girls)

• Benign normal variants of pubertal timing : isolated thelarche (early breast development), premature adrenarche (early pubic hair development)

• Abnormalities of the central nervous system that disrupt the hypothalamic-pituitary-gonadal axis

• Gonadotrophin independent “precocious pseudopuberty”