Delayed Puberty: When to Consult an Internist

Is there something wrong with the body?

Hello doctor, I am 20 years old and my genitalia still looks like that of a middle school student and has not developed.
Is this a case of endocrine disorder? Today I saw a case where the lack of development was related to the pituitary gland.
If there is an issue in this area, should I see an internist? What tests should be conducted? Should I supplement with growth hormone or male hormones?

Yazhong, 10~19 year old female. Ask Date: 2007/05/25

Dr. Cai Yaozhou reply Internal Medicine

To see an endocrinologist for the evaluation of male hormones and other related metabolic assessments.

Reply Date: 2007/05/25

More Info

Delayed puberty can be a concerning issue for many young individuals, particularly when it comes to self-esteem and social interactions. At 20 years old, if you feel that your sexual development has not progressed as expected, it is essential to seek medical advice. This condition can arise from various underlying causes, including hormonal imbalances, genetic factors, or issues with the pituitary gland, which is responsible for regulating hormone production.

When considering whether to consult an internist or an endocrinologist, it is crucial to understand the potential causes of delayed puberty. One common reason is hypogonadism, where the body does not produce enough sex hormones, which can be due to problems with the testes or the pituitary gland. The pituitary gland releases hormones that stimulate the testes to produce testosterone, and if there is a dysfunction, it can lead to insufficient sexual development.

To address your concerns, the first step is to schedule an appointment with a healthcare provider. An internist can evaluate your overall health and refer you to an endocrinologist if necessary. During your visit, the doctor will likely conduct a thorough medical history and physical examination, focusing on your growth patterns, development milestones, and any other symptoms you may be experiencing.

The following tests may be recommended to assess your condition:
1. Blood Tests: These tests can measure levels of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Low levels of testosterone combined with high levels of LH and FSH may indicate primary hypogonadism, while low levels of all three hormones could suggest a problem with the pituitary gland.

2. Imaging Studies: An MRI of the pituitary gland may be performed if there is suspicion of a tumor or structural abnormality affecting hormone production.

3. Bone Age Assessment: A hand X-ray can help determine your bone age, which can provide insight into your growth potential and whether you are still in a growth phase.

4. Genetic Testing: In some cases, genetic testing may be necessary to rule out conditions such as Klinefelter syndrome or Turner syndrome, which can affect sexual development.

Regarding treatment, it will depend on the underlying cause of your delayed puberty. If hormonal deficiencies are identified, hormone replacement therapy may be recommended. This could involve testosterone therapy to promote the development of secondary sexual characteristics, such as increased muscle mass, body hair, and changes in voice.

In some cases, if the issue is related to growth hormone deficiency, growth hormone therapy may be indicated, but this is less common in cases of delayed puberty in males.

It is essential to approach this situation with a healthcare professional who can guide you through the diagnostic process and recommend appropriate treatment options. Remember, you are not alone in this, and many individuals experience similar challenges. Seeking help is a positive step toward understanding your health and achieving the development you desire.

Similar Q&A

Understanding Delayed Menstruation: When to Seek Endocrine Care

My daughter is 14 years old and in the 9th grade. While her classmates have started menstruating, she has not yet had her period. An ultrasound showed that her ovarian development is at a level typical of a 7 to 8-year-old. Should we continue to see an adult endocrinologist or a ...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, it is recommended to see an obstetrician-gynecologist and have a blood test to check hormone levels. Wishing you good health.

Signs of Growth Delay: When to Seek Endocrine Evaluation for Your Child

"From birth to puberty, if a child grows less than four centimeters per year, it may indicate signs of slow growth. Therefore, if parents notice this phenomenon in their child at a young age, they should promptly take the child to seek treatment from an endocrinologist. For ...

Dr. Zeng Fenyu reply Internal Medicine
Hello, we are very pleased to receive your inquiry. Regarding your question, individual growth and development can vary significantly from person to person. We recommend that you consult with an endocrinologist for a detailed evaluation.

Understanding Delayed Menstruation in Adolescents: What to Do?

Hello doctor, my son is in the first year of junior high school, has a slim build, and has a slight hunchback. However, he hasn't grown in the past two months. What should we do? His daily life is normal. Thank you.

Dr. Lin Wenbin reply Obstetrics and Gynecology
Come to the hospital for an examination.

Understanding Adolescent Development: Concerns About Delayed Maturation

In general, most adolescents reach full physiological maturity between the ages of 18 and 21. If you are currently 18 years old and your sexual organs appear to be underdeveloped, similar to those of a child, it may indicate a potential health issue. You mentioned that you have c...

Dr. Lai Ronghao reply Urology
Hello: I recommend that you visit the Metabolism Department for an examination to determine if the issue is related to hormonal factors. This is a response from Dr. Lai Rong-Hao, Director of the Urology Department at Hsinchu Hospital, Ministry of Health and Welfare.