Self-Assessment Questions

29. Delayed or absent puberty

• Name the two major classifications of delayed or absent puberty and the major disorders within those classifications.

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  Correct answer:
  The two major classifications are hypogonadotropic hypogonadism and hypergonadotropic hypogonadism. The major disorders producing hypogonadotropic hypogonadism include CNS disorders, Kallmann syndrome and functional gonadotropin deficiencies such as anorexia nervosa and intense exercise. The major disorders producing hypergonadotropic hypogonadism include gonadal dysgenesis such as Turner and Klinefelter syndromes as well as congenital adrenal hyperplasia. If a pathologic cause of delayed puberty is not found, then one may consider the diagnosis of constitutional pubertal delay.