Medical questions & health advice by board certified doctors
"I'm a 35 year old male and I have not hit puberty yet. What can I do?"
Is this normal not to have hit puberty yet at my age
Most males hit puberty sometime from ages 9 to 14, with a mean age of 11.5 years. At the age of 35 and you have not started puberty yet, it is very late and not normal. To evaluate and diagnose you, it depends on a lot of factors and I recommend you consult a doctor soon. It may occur due to constitutional delay of puberty (a variation of normal development), malnutrition, hormone deficiency, metabolic disorders, or many forms of chronic systemic disease; primary inflammatory bowel disease, gonadal failure (hypergonadotropic hypogonadism) and gonadotropin deficiency (hypogonadotropic hypogonadism). Puberty can be considered to be pathologically delayed when a male fails to reach testicular enlargement by the age 14 and penile and pubic hair growth by the age of 15, or more than five years are required to complete genital enlargement. By this standard, your pubertal delay may be due to an abnormal cause and warrants evaluation by a doctor. Work-up includes a physical exam where height and Tanner stages of development are carefully examined. A simple X-ray of your hands and wrists allows your doctor to assess your bone development. If appropriate, some lab tests to measure hormone levels and screen for underlying disorders (Turner syndrome, Klinefelter syndrome, Kallmann syndrome, and Prader-Willi syndrome, etc.) are important. These are only some of the many causes of pubertal delay. Please seek help from an endocrinologist who can identify an underlying cause of your pubertal delay and outline the best treatment options. In most cases, hormone replacement therapy is able to reverse the delayed puberty and hypogonadism. Good luck.
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