Editing Delayed puberty (section)

=== Constitutional and physiologic delay ===
If a child is healthy with a constitutional delay of growth and puberty, reassurance and prediction based on the bone age can be provided.<ref name=":7" /><ref name=":8" /> No other intervention is usually necessary, but repeat evaluation by measuring serum testosterone or estrogen is recommended.<ref name=":1" /><ref name=":11" /><ref name=":0" /> Furthermore, the diagnosis of [[hypogonadism]] can be excluded once the adolescent has started puberty by age 16–18.<ref name=":11" /><ref name=":9" />

Boys over 14 years of age whose growth is severely stunted or are experiencing severe distress secondary to their lack of puberty can be started on [[testosterone]] to increase their height.<ref name=":7" /> Testosterone treatment can also be used to stimulate sexual development, but it can close bone plates prematurely stopping growth altogether if not carefully administered.<ref name=":6">{{Cite book|title=Brody's human pharmacology : molecular to clinical| first=Lynn|last=Wecker | name-list-style = vanc |date=2010|publisher=Elsevier Mosby|isbn=9780323053747|oclc=804133604}}</ref><ref name=":0" /> Another therapeutic option is the use of [[aromatase inhibitor]]s to inhibit the conversion of androgens to estrogens as estrogens are responsible for stopping bone growth plate development and thus growth.<ref name=":7" /> However, due to side effects, therapy with testosterone alone is most often used.<ref name=":7" /> Overall, neither growth hormone nor aromatase inhibitors are recommended for constitutional delay to increase growth.<ref name=":8" /><ref>{{cite journal | vauthors = Wit JM, Oostdijk W | title = Novel approaches to short stature therapy | journal = Best Practice & Research. Clinical Endocrinology & Metabolism | volume = 29 | issue = 3 | pages = 353–66 | date = June 2015 | pmid = 26051296 | doi = 10.1016/j.beem.2015.01.003 | series = Hormone replacement strategies in paediatric and adolescent endocrine disorders }}</ref>

Girls can be started on [[estrogen]] with the same goals as their male counterparts.<ref name=":7" />

Overall, studies have shown no significant difference in final adult height between adolescents treated with sex steroids and those who were only observed with no treatment.<ref name=":02">{{cite journal | vauthors = Zhu J, Chan YM | title = Adult Consequences of Self-Limited Delayed Puberty | journal = Pediatrics | volume = 139 | issue = 6 | pages = e20163177 | date = June 2017 | pmid = 28562264 | doi = 10.1542/peds.2016-3177 | pmc = 8579478 | s2cid = 41944095 }}</ref>