Kuroshima A, Sakai K
Department of Obstetrics and Gynecology, Tokyo Women's Medical College, Daini Hospital.
Nihon Rinsho. 1997 Nov;55(11):2947-51.
The developmental changes during puberty occur over a period of 3 to 5 years, usually between ages 9 and 14. The age of onset of puberty is influenced by genetic and environmental factors. Delayed puberty is a rare condition in girls, and a genetic problem or hypothalamic-pituitary-ovarian disorder can be suspected. In addition, anatomic abnormalities of the uterus and ovaries are rare but important factors to consider. The history and physical examination are useful in the diagnostic work-up. Pelvic examination and U.S. should be completed. Also, hormonal analysis should be recommended with diagnostic plan. Although, the possibility of rare diagnoses should always be kept in mind.