Is it just a matter of waiting to grow up late? Warning signs of delayed puberty in boys Don't let your youth be absent from puberty

Author: Jiang Xiaohui, Chief Physician, West China Second Hospital, Sichuan University

Reviewer: Pu Jie, Chief Physician, West China Second Hospital, Sichuan University

Puberty is a critical period of growth and development. All parts of the boy's body change synchronously. In addition to growing taller, his "little brother" and "balls" grow longer, and his beard also grows. However, some children are too "calm". At the age of 13 or 14, there is still no movement. People often joke that it doesn't matter, it's "late growth". In fact, "early growth" and "late growth" are both growth, and there is no need to "force growth". But the fear is that it really "does not grow", which makes the boy miss the puberty that he should have.

1. Introduction to constitutional delayed puberty

In medicine, whether it is "late growth" or "no growth", there is a medical term collectively referred to as "delayed puberty". There are two main causes of delayed puberty, one is "constitutional delayed puberty (CDGP)", and the other is "congenital hypogonadism" (CHH). The former is "late growth" in the true sense. Although it grows slowly at the beginning, it is a "potential stock". If it grows later, there will still be a chance for the height to "jump", and the "balls" will develop to normal, which will not affect the final height and fertility in adulthood; while CHH is "no growth", which will seriously affect the growth and development of adolescents and the fertility of childbearing age, and needs to be discovered and treated early.

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2. What should we do if puberty is delayed due to physical disorder?

Most adolescents who are clearly diagnosed with CDGP do not need any medication, and most boys can achieve normal puberty development between the ages of 15 and 18. During this period, it is recommended to ensure balanced nutrition intake, adequate sleep, and appropriate physical exercise, and to follow up regularly, with a focus on changes in the size of the "balls", body hair growth, and the child's psychological changes. Some boys with CDGP who are more delayed in development need to use small doses and short courses of androgens to induce puberty under the guidance of a specialist. However, if there is still no development after more than one year of androgen induction treatment, or if development stops after stopping treatment, further evaluation is needed to determine whether CHH is still possible. However, parents should not be overly anxious and nervous, and compare their children with "other people's children" in the so-called "ball size", so as not to bring inferiority and frustration to their children, or even lay the hidden dangers of mental illness.

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The development of boys during puberty is like triggering an accelerator. Some parents have not noticed that their children's bodies have undergone great changes. However, if the accelerator fails to start, it must be taken seriously. Is it because the accelerator has not been pressed or the engine has already failed? Parents should be the closest "co-pilot" to boys. I hope that every parent has a keen eye for observation and a calm and tolerant love to escort the healthy growth of male teenagers.

Warning signs of delayed puberty

Although "late growth" is not a big deal, we are afraid that some "short growth" will deceive people under the guise of "late growth". Therefore, as long as there are signs that seem to be "late growth", it is worth parents' attention, because these signals may have sounded the "warning whistle" for "short growth".

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So, what are the warning signs of delayed puberty? If your child is already 14 years old and still hasn't grown, his "little brother" and "balls" are similar to those of childhood, he has no beard and body hair, his voice has not changed, and there is a visible growth and development gap between him and boys of the same age, then you must be alert and go to a regular medical institution for evaluation as soon as possible to determine whether there is a cause of CHH. The doctor will implement early intervention after a full evaluation.

Parents should be sufficiently vigilant about "late growth", but many boys are too shy to express themselves or even avoid their parents' gaze, especially those CHH who "do not grow". It requires the joint efforts of parents and our professional medical staff to ensure that boys do not miss the puberty that they should have, and to allow those boys with delayed growth and development to catch up with youth.