Testing & Diagnosis for Delayed Puberty / Delayed Sexual Development in Children

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The first step in treating your child is forming an accurate and complete diagnosis. Your child’s doctor will most likely start by taking the child’s medical history, including questions about the family’s medical history, and performing a physical exam. Other tests might include:

  • bone age examination—a simple x-ray of the left hand and wrist that allows doctors to look at your child’s skeletal development, which changes over time.  If your child’s “bone age”–the age indicated by your child’s skeletal development–is lower than his chronological age, it could be a sign of constitutional growth delay (CGD), which is a variation of normal development.
  • blood tests–to measure hormone levels, including estrogen and testosterone, and screen for underlying disorders if appropriate

It can sometimes be difficult to determine what’s causing a child’s delayed puberty. An extreme case of CGD might delay puberty so long that it appears that it might be caused by an underlying medication condition. 

Sometimes doctors prescribe hormone replacement therapy to see whether they can trigger puberty. Whether this works or not often provides information about what caused the delayed puberty, but it’s far from foolproof—even CGD will sometimes fail to respond to an initial hormone trigger.

After all tests are complete, we will meet with you and your family to discuss the results and outline the best treatment options.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital
300 Longwood Avenue, Boston, MA 02115
For Patients: 617-355-6000 | 800-355-7944
For Referring Providers: 844-BCH-PEDS