Delayed puberty (male)


Appropriate Tests


Defined as absence of initiation of secondary sexual development by 14 years.

Cessation of pubertal development may occur in some disorders.

History including family history; physical examination including tests of olfaction; assessment of bone age; Luteinising hormone, Follicle stimulating hormone, Prolactin, Thyroid stimulating hormone, Testosterone, Dehydroepiandrosterone sulphate (DHEA sulphate). See also Testicular failure

Constitutional delay

Gonadotrophin releasing hormone stimulation test (consult pathologist): if the boy is within 6 months of spontaneous puberty, the response to the test will be pubertal, rather than prepubertal.

Hypogonadotrophic / Hypogonadism

See Pituitary/hypothalamic disorders.

Gonadotrophin releasing hormone deficiency


  • Kallmann syndrome


Hypopituitarism / Hypothyroidism


Hypergonadotrophic / Hypogonadism

Primary testicular failure.

Chromosomal abnormality


  • Klinefelter syndrome

Usually impaired progression of puberty.

Testicular functional damage


  • Viral orchitis


  • Cytotoxic drugs/irradiation


  • Tumour

See Testicular mass

  • Vanishing testis syndrome


Severe chronic illness

Severe nutritional deficiency, including


  • Anorexia nervosa


  • Gross zinc deficiency


Go Back

Page last updated:

Copyright © 2020 RCPA. All rights reserved.