Precocious puberty and delayed puberty in girls

Puberty can be considered as a phase in the continuum of the development of gonadal function and the ontogeny of the hypothalamus-pituitary-gonadal system to attainment of full sexual maturation and fertility. Although the sequence of changes is reasonably constant, the start of puberty and duration of its course are very variable. A useful definition of precocious puberty in girls is the presence of signs of sexual maturation, and delayed puberty is defined as a lack of physical manifestations of sexual maturation in girls at a chronologic age that is 2.5 standard deviations below or above the mean age at onset of puberty. The ages of 8 years and 13.5 years in girls serve as practical guidelines to determine the need for evaluation. Diagnostics and therapy for precocious and delayed puberty are summarized in this article.