Slow physical development during adolescence

Introduction Delayed puberty is also known as delayed menarche. About 1% of girls do not have menstruation in their 18-year-old fashion, and then mature gradually, making it difficult to define stunting. Currently, it tends to be completely free of sexual development at the age of 16 or when there is no menstruation at the age of 18, it is stunted or primary amenorrhea.

Cause

(1) Causes of the disease

1. Physical or idiopathic puberty development retardation can not find any cause of developmental delay, and eventually can develop normally, with family tendencies.

2. Pathological developmental delay is caused by systemic malnutrition, chronic diseases, chemical drug treatment during adolescence, mental trauma, mood depression or adolescent endocrine diseases. Women with pineal tumors are rare, and women are rare.

(two) pathogenesis

Delays in puberty development are due to the lack of estrogen in the body, and the lack of estrogen is due to the functional state of the ovary, or the hypothalamus that regulates ovarian function, or the pituitary gland. Since the mechanism for initiating puberty development is unclear, the pathogenesis of constitutional stunting has not been elucidated. However, similar to precocious puberty, genetic factors, environment, and general health status are related to the pathogenesis.

Nutritional factors

Menarche is related to the amount of fat in the body. When the body fat increases to 17% of body weight, menarche will appear. When the body weight is too low, adolescent anorexia nervosa, and heavy exercise training cause weight loss, the menarche is delayed.

2. Hypothyroidism

The pronunciation is often delayed and is associated with low systemic metabolism.

3. Pineal tumor

Increased melatonin production, affecting gonadotropin secretion and delaying development or hypogonadism.

an examination

Related inspection

Chromosome endocrine function test of macroelements

16 years old without sexual development, 18 years old without menstrual sexual dysplasia. Deuhurst also suggested that boys do not develop secondary sexual characteristics at the age of 16 and that girls do not develop secondary sexual characteristics at the age of 15 can be called puberty and sexual development retardation. Although there are differences in the age standard, in general, sexual growth retardation refers to the occurrence of sexual characteristics and the abnormal development of sexual characteristics. In short, children in the age of puberty did not appear secondary sexual characteristics, or although secondary sexual characteristics, but the progress is very slow, are all adolescent stunting performance. Caused by nutritional factors, the clinical weight is significantly lower than the normal mean, the subcutaneous fat layer is thin, anorexia performance. If the thyroid function is low, there may be various manifestations such as low systemic metabolism. The pineal tumor caused by the increase in melatonin.

Can be diagnosed based on clinical manifestations.

Differential diagnosis

Differential diagnosis of adolescent body development:

1, gonadal dysplasia: gonadal dysplasia: also known as Turner's syndrome, xo type, lack of an X chromosome. It belongs to the sex chromosome genetic disease. Due to abnormal sex chromosomes, the ovary cannot grow and develop, so the ovary is a cord-like fibrous tissue with no primordial follicles and no eggs. Therefore, the lack of female hormones, leading to secondary sexual development and primary amenorrhea, is the only monomeric syndrome that humans can survive. Typical gonadal dysplasia is characterized by height and weight loss at birth, obvious swelling of the back of the hands and feet, and sagging skin on the neck. After birth, height growth is slow, the main clinical features are: female phenotype, low hairline, 50% have neck sputum; shield chest, nipple spacing widened; elbow valgus and multiple sputum. About 35% of children have a heart malformation. Aortic coarctation is more common. In addition, kidney deformities (such as horseshoe kidney, ectopic kidney, hydronephrosis, etc.), dysplasia of the nail, and shorter and more metacarpal bones of the 4th and 5th metacarpals are also visible. The external genitalia of the child has been kept in infant type. The labia minora is poorly developed and the uterus cannot be touched. Most children are intelligent. Often due to growth retardation, adolescent sexless development, primary amenorrhea. No treatment can promote ovarian development and will not restore the reproductive function of the patient. The purpose of treatment is to promote height and stimulate the development of the breast and reproductive organs.

2, slow sexual development: sexual infertility is also called sexual dysplasia, the normal development of sexual organs is regulated by hormones in the thalamic-pituitary-gonadal endocrine axis. If the above-mentioned endocrine organs develop lesions, the secretion of the corresponding hormones is significantly reduced or absent, which may lead to sexual organ dysplasia. Sexual naive patients have no secondary sexual characteristics and the genitals are naive. Because the location of the primary lesion is different, the lack of different hormone types, the impact on systemic development, such as pituitary lesions caused by growth hormone deficiency, patients with dwarfism; such as male patients with simple androgen deficiency, long bones Delayed fusion, height is abnormal, the length of the lower body is longer than the length of the upper body, so it is tall when standing and short when sitting. Female patients are deficient in estrogen and the main clinical manifestation is primary amenorrhea. Some normal people develop late in puberty, which can be delayed by 2-4 years compared with the average person. Individual males only develop sexual development after 18 years old, and often have a family history, called puberty delay, which is not a pathological category. Therefore, in the diagnosis of infertility, the puberty delay of normal people should be excluded.

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