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Delayed puberty
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=== Primary failure of the ovaries or testes (hypergonadotropic hypogonadism) === [[File:Hypothalamus pituitary testicles axis.png|alt=|thumb|Hypothalamic-pituitary-testicular axis and the hormones produced by each part of the axis. The + signs indicate that the organ is stimulated by the hormones released from the previous organ in the chain.]] Primary failure of the [[Ovary|ovaries]] or [[testes]] ([[gonad]]s) will cause delayed puberty due to the lack of hormonal response by the final receptors of the [[HPG axis]].<ref name=":0" /> In this scenario, the brain sends a lot of hormonal signals (high [[gonadotropin]]), but the gonads are unable to respond to said signals causing [[hypergonadotropic hypogonadism]].<ref name=":0" /> Hypergonadotropic hypogonadism can be caused by congenital defects or acquired defects.<ref name=":5">{{Cite book|title=Goldman-Cecil Medicine|last=Goldman|first=Lee | name-list-style = vanc |publisher=Elsevier|year=2015|isbn=978-1455750177}}</ref> ==== Congenital disorders ==== Congenital diseases include untreated [[cryptorchidism]] where the [[testicle]]s fail to descend from the abdomen.<ref name=":2" /> Other congenital disorders are genetic in nature. In males, there can be deformities in the [[seminiferous tubule]] as in [[Klinefelter syndrome]] (most common cause in males),<ref name=":9">{{cite journal | vauthors = Villanueva C, Argente J | title = Pathology or normal variant: what constitutes a delay in puberty? | language = en | journal = Hormone Research in Paediatrics | volume = 82 | issue = 4 | pages = 213–21 | date = 2014 | pmid = 25011467 | doi = 10.1159/000362600 | s2cid = 23869989 | doi-access = free }}</ref> defects in the production of testicular steroids, receptor mutations preventing testicular hormones from working, chromosomal abnormalities such as [[Noonan syndrome]], or problems with the cells making up the testes.<ref name=":2" /> Females can also have chromosomal abnormalities such as [[Turner syndrome]] (most common cause in girls),<ref name=":9" /> [[XX gonadal dysgenesis]], and [[XY gonadal dysgenesis]], problems in the ovarian hormone synthesis pathway such as [[aromatase deficiency]]<ref name=":2" /> or congenital anatomical deformities such as [[Müllerian agenesis]].<ref name=":5" /> ==== Acquired disorders ==== Acquired diseases include [[mumps]] [[orchitis]], [[Coxsackievirus]] B infection, irradiation, [[chemotherapy]], or trauma; all problems causing the gonads to fail.<ref name=":1" /><ref name=":5" />
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