One of the main questions that worries mothers and teenagers is: why do 14-year-old girls experience a delay in menstruation? Surely everyone could have heard about such problems, but not everyone has encountered them. So what is the reason? Can poor ecology and nutrition really lead to such consequences? Or does it depend on each individual? This article will help us answer these questions.

Delayed periods in teenagers

Puberty in girls occurs from approximately 13 to 15 years. Why are periods delayed in 14-year-old girls, and what could be the reason for the delay? During this period, hormonal levels and physical development change; girls should not worry if the cycle is unstable for one or two years. This is natural for a teenage body. There are many factors that can affect hormonal levels. But if, after this time, a 14-year-old teenager continues to have a delay in menstruation, it is worth contacting a pediatric gynecologist.

The menstrual cycle is a cyclical phenomenon that occurs throughout almost the entire life of a girl’s reproductive organs. This phenomenon is characterized by bleeding every 27–30 days. After graduation, an adult woman enters menopause. And from that moment on she cannot get pregnant.

Each teenager begins menstruation at a different age. For some, it begins at age 11, for others at 14. The brain regulates changes associated with menstruation. It is capable of transmitting nerve impulses to the pituitary gland and hypothalamus. The menstrual cycle can last from 22 to 34 days. It is necessary to count from the first day of your period to the first day of the next one.

Reasons for delay

In order to understand why the menstrual cycle is delayed, it is necessary to exclude factors that influence the menstrual cycle. After all, menstruation does not stop and is not disrupted just like that. Reasons for delayed menstruation in girls 14 years old:

• Wrong diet.
• Lack of physical activity or excessive physical stress.
• Moving to another country.
• Weight gain or loss.
• Injuries, bruises of female organs.
• Disruption of the body, most often metabolism.
• Female congenital diseases.

Unbalanced diet

Teenage girls try already in their early years to follow different diets and watch their figure. But without even knowing what consequences diets can lead to. With limited nutrition, the body is not saturated with useful microelements and vitamins. Some parents do not pay the necessary attention to this issue. Although, very in vain. If you do not start consuming the daily norm of useful minerals in time, girls may experience hormonal imbalance, that is, a delay in menstruation. For those who have already started, they may stop for a while. In such a situation, you cannot neglect treatment or eliminate diets.

It is necessary to closely monitor the intellectual development of a teenager, because mental retardation can also negatively affect menstruation. This also occurs due to the fact that the brain does not receive the normal amount of vitamins and microelements.

But you should also not overindulge in food. Excess weight or obesity is also a common cause of period delay.

To avoid these nuances, you should adhere to the following rules:

1. Do not eat store-bought chips, crackers, or corn sticks. Introduce low-fat varieties of fish and meat into your diet.
2. You should switch to five meals a day. The interval between meals should be 2-3 hours. During this time, the body will completely, slowly digest the food.
3. If necessary, it is necessary to replace fats of animal origin with fats of vegetable origin.
4. You need to eat food in small quantities.
5. Take vitamins daily.
6. Whenever possible, you should eat fresh vegetables and fruits all year round.
7. Hot dishes should not exceed 55 degrees, and cold ones - 15 degrees.

Also an important stage in adolescence is a visit to the doctor. You should have a general blood test every year. Thanks to this, you will be able to control sugar, hemoglobin, and other important indicators. After all, a lack of these substances can lead to a stoppage of menstruation. If the results are underestimated, you need to take supplements containing iron and folic acid. Self-medication is not recommended; be sure to follow your doctor’s prescriptions.

Read also 🗓 Delay of menstruation - 14 days

Excessive exercise

Physical exercise has a very good effect on the development of the body during adolescence. The main thing is not to overdo it. It is enough just to attend every physical education lesson at school to keep your body and body in shape. If all this is observed, menstrual cycle disruption will not occur.

If you overuse physical activity or lift heavy objects, heavy bleeding may begin. You cannot exercise from the first to the last day of your period.

Emotional instability

Hormonal levels are very closely related to the psychological emotional state. Stress, overwork, heavy workload at school, anxiety, conflicts and other stressful situations can lead to menstrual irregularities. Teenage girls and parents should approach this issue carefully. It is better not to bother a teenager with intimate questions once again, because the result may be the opposite, since the nervous system affects the hormonal system.

In order for your psychological state to always be normal, it is very important to follow a daily routine. To restore the teenage body, you need a strong and healthy sleep for 10 hours.

Hormonal imbalances

Frequent hormonal disruptions occur in adolescence with the onset of menstrual periods. There may be various factors for this:

• Disease of the endocrine system.
• Improper and irregular nutrition.
• The presence of infection in the body.
• Genetics.

At first glance, the problem that a teenager has may seem harmless. But neglect of health can lead to very fraught consequences. We must not forget that hormonal imbalance often leads to diseases of the reproductive system.

What to do to restore the cycle?

Some teenagers do not fully understand why a missed period at age 14 is dangerous and affects the entire menstrual cycle. In cases of cycle disruption, first of all, you should consult a pediatrician. As already mentioned, self-medication can lead to undesirable consequences. In 14-year-old girls, the body and along with it the hormonal balance are rebuilt. Estrogen begins to be produced very actively - this is a hormone that is involved in the process of ovulation and menstruation.

If for some reason a girl does not begin menstruation, this indicates that the body may be suffering from a lack of hormone. The state of the reproductive system can be studied using diagnostics.

Do you want your child to develop harmoniously? Don’t forget to show it to the endocrinologist - this is what our expert, pediatric endocrinologist Ph.D. says. Tatiana Varlamova.

Is the child’s character deteriorating, is he growing too rapidly or, on the contrary, is he suffering because he is the smallest in the class, too plump and chews all the time, or, on the contrary, he is thin and categorically refuses to eat? “Transitional age,” we say, “time will correct everything.” And, exchanging experiences with other parents, we are convinced that our baby is still nothing, but the neighbors’ son...

Diabetes makes you look younger?

Modern children have become shorter, but fatter, because they do not eat properly, get sick more often and are nervous, to say the least - mentally unbalanced. These are the gloomy conclusions reached by specialists dealing with children’s health at the All-Russian Forum “Health of the Nation,” held in Moscow this spring. The results of recent scientific research have made it possible to assess the real state of children's health, which is very different from official statistics.

Risky inheritance
Diabetes mellitus type I. The risk of inheriting insulin-dependent diabetes mellitus, so-called juvenile diabetes, is low.
The likelihood of a child getting sick:
2-3% - if the mother is sick
5-6% - with diabetes in the father
15-20% - if both parents are sick
10% is the incidence of diabetes among siblings with diabetes.
Diabetes mellitus type II is caused by hereditary predisposition much more strongly:
40-50% - if one of the parents is sick. True, the disease usually occurs after the age of 40.
50-80% - if the parents are also diagnosed with obesity in combination with type II diabetes, the so-called diabetes mellitus of obese adults.

Height and bone age

When a child lags behind his peers in growth, this is perceived as a tragedy by both the parents and himself; adolescents experience this especially painfully.

Why does a person’s height depend? It is influenced by two main factors - genes, that is, heredity, and again nutrition in early childhood. Tall parents usually have taller children, and vice versa. And, if the parents are above average height, and the child is lagging behind, you need to check his somatotropic hormone (GH) level.

Severe (especially chronic) diseases can also reduce growth rates. A weakened baby temporarily switches the energy that should have been spent on growth to the healing process.

An important role is played by the mother’s health during pregnancy, as well as the individual characteristics of metabolic processes in the child’s body.

And the functions of the endocrine glands - the thyroid gland and the sex hormone testosterone - have a very large influence on growth. An increase in its production stimulates bone growth up to a certain limit, but later it begins to suppress growth zones, stopping growth. This can be observed in young men during puberty, when the acceleration of growth is replaced in the period of maturity (at 16-18 years old) by its stop.

Norm and deviations:

It is very important to monitor growth rates during the first two years of life.

• In the first year, children grow by an average of 25-30 cm, in the second - up to 12 cm, and in the third - 6 cm. Then rapid growth gives way to so-called uniform growth, that is, an increase of 4-8 cm per year.
• At the beginning of puberty, children typically experience growth spurts again. This period of rapid growth is caused by the influence of sex hormones - a hormonal “surge”.
• For girls, this period begins at the age of 10 (maximum at 12), when they gain an average of 8 cm per year.
• In boys aged 12-14 years, the increase in height is on average 10 cm per year, with possible individual deviations of 1-1.5 years.
• During the puberty “leap” (for boys this usually occurs at 13-16 years old, for girls at 12-15), both main indicators of physical development - height and body weight - intensively manifest themselves. In a relatively short period of time, height can increase by 20%, and body weight - even by 50%.
  In girls, this “jump” can begin at 10.5 years, reaching its greatest expression by 12.5. And their body growth continues until they are 17-19 years old.
• At the beginning of puberty, boys lag behind girls, and at about 14.5 years old they begin to intensively catch up with them, and their growth continues until about 19-20 years old.

Alarming symptoms:

• Indicators of weight and height may vary - it depends on the individual characteristics of a particular child, so the reason for concern should not be one number, but a stable age-related trend of lagging or accelerating growth. Genes play a big role here, but the hereditary program can fail for some external reasons.
• Adolescents in physical and sexual development may be delayed by 1-2 years compared to their peers who intensively engage in sports with constant physical activity (gymnastics, wrestling, etc.).
• Chronic diseases, for example, gastritis, gastroduodenitis, which sometimes occur almost asymptomatically in adolescents, can significantly affect growth retardation.
• Diseases of the cardiovascular system, such as arterial hypertension, rheumatism, heart defects, and some pulmonary diseases, also contribute to a decrease in height.
• And, of course, endocrine diseases, the first signs of which sometimes appear at an early age, and sometimes only in adolescence, lead to a slowdown in physical growth - and, first of all, to a decrease in growth.

It is important not to waste time, to promptly notice that the child’s growth is not normal, and be sure to contact specialists - a pediatrician and an endocrinologist.

It is also necessary to check the bone age - its correspondence to the passport age - and growth zones. To do this, an X-ray of the hands and wrist joints is taken. The growth zones are clearly visible in the picture. If these zones close at the age of 14-15, it means that the child will no longer grow, and this is an unfavorable sign.

Thyroid

The last two decades have been marked by a steady increase in thyroid diseases in children. In addition to burdened heredity, the region of residence also plays an important role. If there is a lack of iodine in the region, its deficiency must be replenished with the help of iodine preparations - iodomarin, potassium iodide, etc.

How do hormones function?
The endocrine system is the endocrine glands, such as the hypothalamus, pituitary gland, pineal gland, thyroid gland, pancreas, ovaries, testicles, etc. Hormones (endocrine substances) are secreted by the endocrine system directly into the bloodstream and regulate vital processes in the body. All over the world, there has recently been an increase in diseases associated with disruption of the endocrine system. Moreover, most endocrine diseases manifest themselves in childhood. Typical symptoms of endocrine disorders - unreasonable fatigue, sudden mood swings, irritability, obesity or sudden weight loss, too early or delayed puberty - should serve as a serious reason to contact an endocrinologist.

To some extent, insufficient physical activity and even too much time at the computer at an early age can provoke the development of thyroid diseases, such as autoimmune thyroiditis - a deficiency of thyroid hormone, which leads to further functional disorders.

If after a careful examination and ultrasound it turns out that the gland is enlarged, but the level of thyroid hormones is normal, then iodine supplements are sufficient. If the hormone level is increased or decreased, serious correction and treatment with hormonal drugs is necessary.

Doctors do not confirm the widespread belief that the hormones that the mother took during pregnancy also lead to the development of endocrine disorders in children. Hormones, as a rule, are prescribed to women with problems of the reproductive system - miscarriage, etc. Such a course of treatment under the supervision of a doctor almost never - there is a lot of research on this topic - does not affect the health of children. On the contrary, in the correct, precisely selected dosage, the hormonal drug helps maintain pregnancy. Hypothyroidism can also be congenital - it is a hereditary disease when a child is already born with a “bad” thyroid gland. Therefore, since 1992, we have been screening newborns for endocrine diseases.

Such early diagnosis is very important: if treatment is started immediately (and children with hypothyroidism need lifelong treatment), developmental delays can be avoided.

Cases of congenital hypothyroidism in Russia average 1 in 4000 newborns. Therefore, the best prevention of endocrine system disorders in children is examination of pregnant women in the early stages, when the formation of the nervous system and thyroid gland in the fetus occurs.

Alarming symptoms:

• Slowdown in growth rates.
• Weight disorders - both deficiency and excess. If the child is too fat, this may indicate a metabolic disorder.
• With a deficiency of thyroid hormones, children are lethargic, pasty, weak - they get tired quickly compared to their peers, and get up very hard in the morning.
• If the gland is overactive, weight loss and increased emotional excitability are observed, especially in girls. They become tearful, even aggressive, hand tremors, enlarged eyeballs, a difference in pressure - decreased diastolic and increased systolic (pulse), thin, tender, even dry skin and general fussiness of movements may appear.

An experienced doctor can identify violations by the way the child enters the office: this is noticeable in his plastic behavior, hyperactive behavior, and excessive fussiness.

Gender issues

Puberty in children is mainly determined by heredity, but not only genetic characteristics determine the type of development of the child, but also the nationality and race of the parents - children of southern or eastern peoples, for example, mature earlier.

How to determine the ideal weight of a child?
For children from 1 year to 12 years, deviation of body weight from ideal can be assessed in points - from five to two. Body mass index (BMI) for children over 2 years of age is calculated using the same formula as for adults: weight in kg divided by height in cm squared.
5 points - exact correspondence of the child’s weight to his age
+4 – slightly overweight
+3 – moderate overweight
+2 - pronounced excess weight
-4 - mild underweight
-3 - moderate underweight
-2 - severe weight deficiency

Estimation of body weight in girls

Age, years	BMI score in points
	-2	-3	-4	5	+4	+3	+2
1	14,7	15,0	15,8	16,6	17,6	18,6	19,3
2	14,3	14,7	15,3	16,0	17,1	18,0	18,7
3	13,9	14,4	14,9	15,6	16,7	17,6	18,3
4	13,6	14,1	14,7	15,4	16,5	17,5	18,2
5	13,5	14,0	14,6	15,3	16,3	17,5	18,3
6	13,3	13,9	14,6	15,3	16,4	17,7	18,8
7	13,4	14,4	14,7	15,5	16,7	18,5	19,7
8	13,6	14,2	15,0	16,0	17,2	19,4	21,0
9	14,0	14,5	15,5	16,6	17,2	20,8	22,7
10	14,3	15,0	15,9	17,1	18,0	21,8	24,2
11	14,6	15,3	16,2	17,8	19,0	23,0	25,7
12	15,0	15,6	16,7	18,3	19,8	23,7	26,8

Estimation of body weight in boys

Age, years	BMI score in points
	-2	-3	-4	5	+4	+3	+2
1	14,6	15,4	16,1	17,2	18,5	19,4	19,9
2	14,4	15,0	15,7	16,5	17,6	18,4	19,0
3	14,0	14,6	15,3	16,0	17,0	17,8	18,4
4	13,8	14,4	15,0	15,8	16,6	17,5	18,1
5	13,7	14,2	14,9	15,5	16,3	17,3	18,0
6	13,6	14,0	14,7	15,4	16,3	17,4	18,1
7	13,6	14,0	14,7	15,5	16,5	17,7	18,9
8	13,7	14,1	14,9	15,7	17,0	18,4	19,7
9	14,0	14,3	15,1	16,0	17,6	19,3	20,9
10	14,3	14,6	15,5	16,6	18,4	20,3	22,2
11	14,6	15,0	16,0	17,2	19,2	21,3	23,5
12	15,1	15,5	16,5	17,8	20,0	22,3	24,8

You can calculate the ideal weight for your child, taking into account his constitutional body type, using the formula: MI = (P x G): 240, where MI is the ideal body weight in kg; P—height in cm; G - chest circumference in cm; 240 is a constant calculation coefficient.

A sign of normality or deviation can be the sequence of appearance of secondary sexual characteristics: in girls, the mammary glands must first develop, then hair growth occurs in the pubic area, then menstruation occurs. If the sequence is broken, this is not a sign of a disease, but a reason to consult an endocrinologist. When girls have hair on their arms, legs and back, it is necessary to exclude excess androgens by doing special studies. If they are in excess, we can talk about pathology of the adrenal glands. If the hormonal levels are normal, this may be a manifestation of a constitutional feature.

Normally, at the age of 8-9 years, girls show the first signs of maturation: the nipple areas begin to protrude a little, slightly change color and shape. And then, from 10-12 years old, a redistribution of adipose tissue, development of the mammary glands, etc. gradually begins to occur. The first menstruation normally appears at 12-14 years old, but fluctuations are possible in the range from 10 to 16 years - in the northern areas.

Normal puberty in boys usually occurs between 9 and 14 years of age. The first signs are enlargement of the testicles, then, after 6 months, the appearance of pubic hair, reaching a peak in the final stage of growth of the genital organs.

Boys at this age sometimes experience swelling of the mammary glands - one or both; as a rule, this is caused by excess prolactin and does not require treatment. This is not a disease, but a physiological phenomenon - the so-called genicomastia. It may be a consequence of obesity.

Alarming symptoms:

• Pubic hair in girls in the absence of other secondary sexual characteristics can be caused by a malfunction of the adrenal glands, for example, an adrenal tumor. This is a serious reason to contact an endocrinologist.
• Growth retardation compared to peers. In this case, it is necessary to conduct an examination to determine whether the bone age corresponds to the biological age.
• Obesity in boys can also contribute to pathological development of the genitals.
• Endocrine deviation - cryptorchidism, when one or both testicles do not descend into the scrotum in time, but remain in the abdominal cavity.
• Underdevelopment of the genitals, if, for example, a boy at the age of 13 began to develop hair growth (axillary and pubic area), and the genitals are still of child size, the child is taken under the supervision of endocrinologists.
• Precocious puberty can occur in children of both sexes. This is an alarming symptom if secondary sexual characteristics appear in boys under 9 years of age or in girls under 8 years of age. In any case, it is necessary to see an endocrinologist at least once a year, even in the absence of pronounced abnormalities.

Hormones are very important substances for the body that are involved in all metabolic processes. Several organs, whose activities are studied by endocrinology, are responsible for the production of hormones. If any deviations from the normal functioning of these organs are observed, you should contact an endocrinologist.

Endocrinologist - who is this?

A specialist who studies the functioning of organs involved in the secretion of hormones is called an endocrinologist. This doctor knows all the symptoms of diseases caused by hormonal imbalance, the causes that led to such disorders, additional diagnostic methods, as well as treatment methods. This is a very important specialist, since many diseases can be caused by insufficient or excessive production of one or another hormone.

An endocrinologist is competent to monitor patients with diabetes of any type. Recently, there has been a sharp increase in patients with this diagnosis; the situation is especially sad with the statistics of childhood morbidity.

A family doctor or local physician can identify suspicions of diabetes mellitus or other hormonal problems based on the patient’s complaints, as well as the results of clinical urine and blood tests. Most often, it is the therapist who gives a referral for examination by an endocrinologist. But it should be understood that it is easier to cure any disease in the early stages of its development, so it is worth including a visit to the endocrinologist’s office in your annual medical examination. Any public or private clinic has an endocrinologist on staff.

What diseases does an endocrinologist treat?

Various organs and glands are involved in the production of hormones:

• thyroid - it ensures the synthesis of iodine-containing hormones, which are very important for metabolic processes, growth, and general development of the body;
• pancreas - produces enzymes involved in the metabolism of carbohydrates and the breakdown of fats, as well as hormones that regulate glucose levels - insulin and glucagon;
• parathyroid - glands located near the thyroid gland, they produce hormones that regulate calcium levels in the body;

• thymus – responsible for the production of hormones that regulate the body’s immune activity;
• genital – male and female glands that are involved in the secretion of sex hormones necessary for normal maturation and the formation of secondary sexual characteristics;
• the pituitary gland is a gland located in the brain, it is the one that coordinates the work of all endocrine organs;
• the hypothalamus is a part of the brain that connects the work of the endocrine and nervous systems;
• The pineal gland is a gland that has not yet been fully studied, but it is reliably known that it is the one that produces serotonin, the hormone of happiness.

It is clear that an endocrinologist treats all diseases that are caused by a malfunction of the endocrine system. These may be diseases such as:

• adenoma of the thyroid and parathyroid glands - benign neoplasms;
• hyperparathyroidism is a chronic disease of the parathyroid gland, characterized by tissue proliferation or the presence of tumor formations;
• gland hyperplasia - tissue proliferation;
• diffuse toxic goiter is one of the most common autoimmune diseases, characterized by hyperfunction of the thyroid gland and excess thyroid hormones;

• diabetes mellitus is a group of diseases that are caused by a lack of production of the hormone insulin;
• a number of diseases caused by a lack or excess production of various hormones, for example, hypercholesterolemia, hypoglycemia, hyperthyroidism, hyperuricemia, hypocalcemia and others;
• infertility, reduced potency, underdevelopment of the genital organs - can also be caused by disruption of the endocrine system;
• obesity – a lack of production of hormones involved in metabolic processes leads to a sharp increase in body weight.

How to choose a good specialist

How to determine whether a good endocrinologist is good or not? It will be quite difficult for a person without medical education to do this, so when visiting a specialist you need to pay attention to the following:

• appearance - an unkempt person immediately evokes a negative attitude, and a doctor should not be seen at all in dirty or bad-smelling clothes, with unwashed hair, hands, etc.;
• a good doctor will begin collecting information and compiling an anamnesis, will ask many questions concerning not only the patient, but also his immediate relatives, in order to identify a hereditary predisposition;
• the doctor must conduct an examination and palpate the locations of the glands (accessible for palpation);

• changes in blood pressure and pulse are also mandatory procedures during the initial examination;
• a good doctor will definitely prescribe additional tests or issue a referral for an ultrasound examination;
• the hospital where the endocrinologist works must have a good reputation and positive reviews from patients, which should be read before making an appointment;
• A good specialist can be recommended by a family doctor or local therapist.

There are more specialized specialists, for example, an endocrinologist-gynecologist or an endocrinologist-surgeon. Such specialists should be contacted if pathology has already been identified.

How is an endocrinological appointment performed?

Before visiting an endocrinologist at the clinic, you should make an appointment with the doctor in advance. This form of visiting specialists has already spread to public clinics - this eliminates the problem of queues and dissatisfied patients.

The endocrinologist conducts appointments in his own office, which is equipped with:

• desktop;
• several chairs;
• a couch;
• floor scales;
• stadiometer.

The doctor should have the following tools at hand for examination:

• a device for measuring pressure;
• a device for measuring blood glucose levels with replaceable test strips;
• tape measure;
• neurological set.

The whole technique comes down to sequentially performing the following actions:

• drawing up an anamnesis taking into account the patient’s complaints;
• palpation of the lymph nodes and thyroid gland;
• examination of the genitals;
• pressure measurement;
• if the patient has a blood test with a high sugar content, the doctor additionally uses a glucometer;

• Based on the examination, the specialist can draw preliminary conclusions and prescribe additional tests or ultrasound examination;
• Based on the results of ultrasound, blood tests for hormones, urine MRI, the doctor makes a diagnosis and prescribes appropriate treatment;
• if necessary, the patient can be redirected to clarify the diagnosis or treatment to another specialist.

The endocrinologist must constantly monitor the progress of treatment of his patients, monitor, and, if necessary, adjust medications.

When should you contact an endocrinologist?

You should make an appointment with an endocrinologist if the following symptoms occur:

• sudden weight gain or loss;
• fast fatiguability;
• heavy sweating;
• frequent insomnia;
• disruptions of the menstrual cycle;
• difficulty swallowing;
• absent-mindedness and poor memory;
• hand trembling;
• severe hair loss;
• infertility;
• decreased potency.

You should watch out for the symptoms of diabetes:

• severe thirst and dry mouth;
• itching and inflammation of the skin;
• frequent urge to urinate;
• headache;
• drowsiness;
• general weakness;
• loss of visual acuity;
• muscle weakness;
• pain in the calf muscles.

A sharp decline in hormone production is observed in men and women after 40 years of age, which leads to a decrease in potency and the onset of menopause. To delay these processes, you should visit an endocrinologist annually for preventive purposes.

Consultation with a specialist before planning a pregnancy is especially important, so both expectant parents should undergo an examination. The endocrinologist will prescribe treatment if necessary.

Examination of children by an endocrinologist

A pediatric endocrinologist is a doctor who monitors the development of the endocrine system in children under 16 years of age. You should bring your child to see a specialist if:

• the baby is hyperactive, restless or, on the contrary, apathetic, slow, has inhibited reactions;
• the child’s attention is scattered, there is no concentration on the subject;
• there is underdevelopment of the genital organs;
• with a sudden change in body weight;
• with a sharp change in the emotional background;
• for osteoporosis;
• if there is increased hair growth in girls in atypical places or in a male pattern.

You should not neglect a preventive appointment with an endocrinologist, especially during puberty, when there is a hormonal surge, since a timely identified disease can be easily corrected and serious problems can be avoided in the future.

Endocrinologist services in Russian cities

Features of delayed puberty in boys and girls

When puberty occurs much later, delayed sexual development is noted. Disorders of puberty occur due to a number of reasons, which include hereditary, dysfunction of the thyroid gland or pituitary gland, which are responsible for the production of the sex hormone, diabetes, unfavorable environment, poor nutrition, professional sports and a number of others.

Puberty is a stage in the development of the hypothalamic and pituitary gland systems, during which the formation of the gonads occurs. This stage is characterized by the beginning of the development of sexual characteristics and the rapid formation of adult germ cells - gametes. At this stage, the formation of physical and mental characteristics in the young man’s body and a change in sexual behavior occur. All this later will determine the ability to reproduce.

The inhibition of sexual development that sometimes occurs in children is a consequence of a disorder at the level of the central nervous system or pathology of the gonads, frolic or genetic in nature. Also, delayed puberty in adolescents can be caused by disorders at the level of the endocrine system, for example, with suppressed function of the pituitary hormonal glands. Premature puberty in girls is more common than delayed puberty. But the sexual development of boys has the opposite statistics.

Delayed puberty

Delayed sexual development in boys and girls deviates from the norm due to hereditary reasons. Often, when a child develops mental retardation, it becomes clear that at least one of the teenager’s parents suffered from a pathology of a sexual nature. Due to its hereditary nature, delayed puberty accounts for up to 85% of all other causes of pathology of sexual development in boys and girls. In most cases, this disorder occurs in boys and is determined by a greater dependence of androgen reproduction along the genealogical line.

Inhibition of puberty often occurs due to improper, or rather, insufficient nutrition. The lack of a balanced set of microelements, which the body can only obtain from food, slows down the physiological reactions in the production of hormones responsible for the processes of puberty.

Exhaustion caused by poor nutrition or participation in professional sports always adversely affects the formation of primary and secondary sexual characteristics in boys. And in girls, the opposite deviation is more often observed - with obesity, unbalanced and plentiful nutrition, puberty begins to progress at an age much earlier than that of their peers. This occurs due to excessive accumulation of estrogen in adipose tissue.

Physiology

The process of sexual development of a child - at the physiological level, occurs under the influence of increased secretion of sex steroids and is triggered by two physiological reactions in the child’s body. The first reaction begins in middle age from 12 to 14 years - this is an increase in the reproduction and release of adrenal androgens. In young children, the androgen content is very low, and in early puberty it increases sharply.

Androgens, having accumulated in the body in sufficient quantities, trigger a second reaction, which is of utmost importance in the process of sexual development and the formation of genital organs, both external and internal. This secretion begins to function at approximately the age of 14-17 years and is characterized by a sharp release of pituitary gonadotropic hormones into the body - follicle-stimulating hormone, luteinizing hormone and human chorionic gonadotropin.

It is precisely their lack that plays a decisive role in the process of possible delay in sexual development of girls and boys.

Anatomy

The low growth of a child, compared to normal age indicators, especially in the prepubertal period, is combined with delayed sexual development and the formation of the bone skeleton. The diagnosis is made based on the gender of the teenager and studies of heredity.

Collecting information about the presence of short stature and suppressed puberty in the patient’s relatives in 50-80% of cases reveals the presence of late sexual development in one of the family members.

Another of the anatomical features of a child that accompanies a delay in puberty is the discrepancy between the development of the bone skeleton and muscles (in boys) with the average normative age indicators. In girls, this is a pronounced lack of development of the mammary glands and the absence of menstruation.

The next very sure sign of delayed sexual development is the formation of testicles, the volume of which during puberty should exceed 4 ml. Additional signs of delayed puberty in boys include long limbs, a high waist, a high-pitched child's voice, fat in the lower abdomen, and hips wider than the shoulders.

In addition to such external awkwardness, boys during this period develop behavioral traits such as cowardice, pettiness, isolation, and weak-willedness. As a rule, this pathology in 70% of cases is accompanied by various diseases of the cardiovascular system and digestive organs, as well as deviations in the functioning of other organs.

Pregnancy

In addition to the physiological characteristics of the secretion of gonadotropic hormones of the pituitary gland, delays in sexual development may be due to unfavorable factors during pregnancy and childbirth:

• infections suffered by the mother,
• toxic environmental factors,
• all kinds of pathologies during pregnancy and childbirth,
• insufficient receipt of nutrients by the embryo during intrauterine development,
• maternal depression and stress during pregnancy,
• use of contraceptives.

There have been cases of delayed sexual development in boys and girls whose parents suffer from diabetes mellitus and thyroid dysfunction.

Diagnostics

Diagnosis of the disease includes: measuring height and weight, calculating the ratio of body parts, the presence of stigmata of dysmorphogenesis, marking sexual development according to Tanner, mental abilities, suppressing anosmia, examination by an ophthalmologist.

A general urinalysis, a general and biochemical blood test are performed, and a full hormonal examination is required. X-rays of the hand and wrist should be taken to determine skeletal age. Girls are prescribed an ultrasound of the pelvic organs, and boys - an ultrasound of the abdominal cavity and testicles.

Treatment

Hormonal therapy activates the development of sexual characteristics, growth rates, stimulates the saturation of bones with salts, and acceleration of the gonadotropic system. The main criteria for prescribing hormones are: mental problems, a tendency to depression, adaptation problems in boys and girls.

The main thing in such drug treatment is that it should not cause acceleration of bone growth. In case of hereditary delayed puberty, intramuscular injections of drugs of 30 mg are chosen. Frequency: once every 3 weeks for six months.

It is undesirable to use drugs of the gonadotropin group to stimulate puberty, since they cause inhibition of the child’s anatomical growth. In this situation, anabolic drugs that have little androgenic activity are used. They do not influence excessive acceleration of skeletal maturation.

In boys

A significant proportion of boys with delayed puberty do not require medical assistance, but informational and psychological consultation is very important for them. In more complex cases of the disease, children are offered testosterone therapy in the form of an injection at a dose of 40-90 mg for 3-6 months (intramuscularly once a month). Another method of treatment (for example, when it is necessary to influence the increase in testicular volume in boys) is the use of testosterone undecanoate for the same period (10-30 mg/day).

Subcutaneous testosterone implantation is more rarely used. But whatever treatment method is chosen, it must be carried out from six months to a year. Due to visible external anatomical defects, boys always experience a psychologically traumatic disorder. In boys, hypoplasia of the testicles is often detected; after a while they do not lengthen, but remain spherical.

The pathology of the development of the external genital organs is very clearly visually observed: the length of the penis is less than 6 cm, and the volume of the testicles is less than 5 square centimeters, there is no sagging of the scrotum, there is insignificant hair growth, there are no nocturnal emissions.

For girls

Delayed puberty is observed less frequently in girls than in boys, and drug treatments are used much less frequently. The development of female genital organs in girls is usually 10-12 years old and occurs without pathologies. In the presence of pathology, it makes sense to prescribe treatment no earlier than the biological age of 12 years (preferably after 13 years) or the skeletal age of 10-11 years.

The drugs should be used in small doses, which will prevent excessive acceleration of bone development and disproportionate development of the mammary glands, which can subsequently cause serious discomfort for the girl.

Insufficient development of the female genital organs is treated with the well-known drug ethinyl estradiol, usually taken at 0.02-0.9 mcg/kg per day. In other cases, the development of female genital organs is promoted by conjugated estrogens; they are taken at a dose of 0.2 mg for six months, then the dose is increased. Another method of treating delayed puberty, no less effective, is subcutaneous administration of estradiol.

The drug is usually injected into the buttocks or thighs approximately every three days. An important advantage of this method is the possibility of crushing it into smaller doses; it should be taken into account that the individual absorption of estradiol is of great importance, causing the need to constantly measure the amount of estrogen in the blood during treatment. And based on the results of these measurements, the doctor changes the amount of the medicinal substance.

Hormonal balance in a teenager's body

But if we consider changes associated with behavior and relationships with other people, they occur throughout adolescence.

There is such a term as puberty. Translated from Latin, it means “to be covered with hair.” This period marks a time of intense change in the early stages of adolescence.

The process of hormonal changes

The hypothalamus plays the main role in this period. It increases the secretion of substances that produce large amounts of hormones from 8 to 14 years. They are called gonadotropins. Gonadotropins are the same in both boys and girls. As for men, these hormones help increase testosterone, and in girls - tarragon.

For most teenagers, the first symptoms of intense physiological changes are enlargement of the testicles (for boys) and mammary glands (for girls). This happens around age 14. Responsive signs to increased hormones are external symptoms of maturation. As a result, all this is called additional sexual characteristics.

Intensive hair growth (this applies to both boys and girls) and, separately in girls, swelling of the mammary glands are the very first signs of physiological changes. After this, the child begins to grow rapidly and the level of sex hormones increases. At the same time, insulin-like growth factor I and growth hormones increase. At their signal, bone growth stops.

Girls mature 2 years faster than boys. Therefore, they are taller than their peers. In addition, the genitals also grow.

Physiological changes have one difference between girls and boys - growth.

Estrogen stimulates growth hormone in girls more than testosterone in boys. Many girls begin their menstrual cycle at age 12. In boys, the prostate gland enlarges during the period of changes.

2 years after hair appears in the pubic area, it begins to grow in the armpits. There is a possibility of acne appearing on the face. This is due to enlarged sebaceous glands.

Endocrine system disorders

In the modern world, children have become much shorter in height than before, but much fatter. This happens for several reasons:

• poor nutrition;
• high aggressiveness;
• weak immunity (get sick regularly).

If we talk about the endocrine system, then in most children it is disrupted. The reasons for this are obesity and the emergence of type I and type II diabetes. All of the above reasons arose due to ecology and nutrition.

It seems that children eat well, but mostly on food that is harmful to health, namely fast food and sugary carbonated drinks. The lifestyle has become immobile, leading to dysfunction.

The most important risk factor is heredity. If someone in a child’s family has diabetes, he should be examined by an endocrinologist twice a year, and also eat foods that are healthy for the body. Modern children suffer from obesity of both the first and second degrees. And this, as we know, leads to diabetes.

Parents' mistakes are as follows:

• intensive feeding of the baby - if the child is not gaining weight and is not eating well, he should not be force-fed. In this case, you need to contact a gastroenterologist or neurologist. The child may develop gastroenterological diseases;
• lack of constant checking of body mass index;
• feeding babies at night when they wake up. In this case, the baby gets used to constantly drinking and eating. Fat cells are formed up to 2 years of age.

Symptoms

Hormonal disorders have characteristic manifestations:

• long recovery of a child after a viral infection and childhood diseases;
• need for abundant and frequent drinking;
• frequent urination;
• lethargy and irritability for quite a long time;
• intense weight loss.

All these symptoms may be associated with the onset of diabetes; the appearance of any manifestation should prompt parents to undergo an examination.

Child development and hormones

Hormones play a large role in the functioning and development of the body. You need to know which hormones are very important in children and how to identify disorders.

Normal growth and development of children directly depends on hormones. This requires proper functioning of the endocrine system. If thyroid hormone disorders are not treated promptly, there may be undesirable developmental consequences over time.

The resulting disturbances in sex hormones will lead to problems with puberty. When a child’s body begins to grow rapidly, diseases should not be ignored, otherwise they will reoccur in adulthood.

Thyroid hormones

Thyroid hormones T3 and T4 influence many developmental factors. If these hormones are not enough, this can lead to hypothyroidism, and subsequently to disorders of the musculoskeletal system and cretinism.

Signs of thyroid hormone deficiency:

• swelling of the body and face, swelling of the neck and tongue;
• lethargy and inactivity;
• dry skin, which causes irritation;
• poor appetite and constipation;
• developmental delay.

In school-aged children, hypothyroidism can present in the form of constipation, regular fatigue, facial swelling and poor concentration.

Thyroid hormones interact with both growth and sex hormones. If they are deficient, weight loss or growth retardation may occur. In this regard, it is necessary to undergo a number of studies, take tests, and also check the TSH hormone.

Growth hormones

This hormone is necessary for the normal growth of the child. It is responsible for lengthening bones. Girls stretch out much faster, intensive growth begins at the age of 10, and for boys at 12. The growth period for boys ends at 19–20 years old, so they are often taller than girls of their age.

If growth hormone is produced normally, the child's body can lengthen by 10 cm in 1 year. In addition to hormones, heredity greatly influences growth.

Childhood diseases associated with hormones

If there is a huge shortage of a hormone called insulin in a child’s body, this contributes to the development of type 1 diabetes. This is a rather serious disease and if its treatment is not started, there can be serious consequences: stroke, heart attack or death.

Diabetes symptoms:

• weight gain or loss;
• vomiting or pain in the abdomen;
• constant thirst;
• frequent urination;
• dizziness and irritability.

Hormonal problems in teenagers

During adolescence, quite rapid growth and transformation of the body occurs. At this time, the endocrine system begins to work intensively, in particular, the active load goes to the adrenal glands. Hormones cause physical and psychological changes in a teenager’s body. Hormonal imbalance during this period can be caused by:

• incorrect nutritional correction;
• excessive physical fatigue;
• irregular sleep patterns;
• avitaminosis.

In most cases, hormonal changes in adolescents are unnoticeable; no specific treatment is suggested here, since the body itself can normalize the condition after a certain time. But there are also situations when the child needs to be shown to a specialist.

Causes of hormonal imbalances in boys

Hormone balance is a very fragile mechanism, but there are many reasons why it is quite easily disrupted:

• thyroid disease;
• irregular meals;
• severe stressful situations;
• genetic diseases;
• diseases in the genital area;
• sexually transmitted diseases;
• bad ecology;
• drug abuse.

Symptoms of failure

As for the characteristic symptoms of a failure, they are as follows:

• Acne is juvenile acne. They are more common among children of this age. The appearance of acne is associated with disruption of teenage hormones. The balance between estrogens and androgens is disturbed, where male hormones predominate over female ones. The sebaceous glands perceive this process negatively. This symptom usually does not require special treatment and goes away on its own without complications. In rare cases, it is necessary to take antibacterial drugs in the form of tablets or ointments.
• Excessive sweating - in this case, a disease such as hyperhidrosis may occur. Its norms can be considered if no other symptoms are observed. Its appearance is associated with very frequent hormonal disorders in children. These disorders affect the sympathetic system. It, in turn, controls the performance of the sweat glands. In some cases, sweating is a sign of the onset of very dangerous diseases, such as thyroid disease, diabetes and heart disease.

• Growth disorder – bone tissue grows due to growth hormone. It is produced by the pituitary gland. If there is not enough growth hormone in the body, then a person’s growth will slow down significantly, and physical development will also be inhibited. If there is an excess of this hormone in the body, then there is a danger of gigantism.
• Aggression and irritability - changes in the psyche of a teenager appear due to the fact that sex hormones begin to influence the central nervous system. There is a decrease in the threshold of excitability, variability of the autonomic nervous system. In such a situation, emotional disturbances can very often be observed (sharp mood swings, increased experiences and feelings, as well as alienation from the outside world).
• Changes in body weight - intense activity of the adrenal glands, which produce glucocorticoids, contributes to excess weight gain or loss with normal or high appetite.

Pathological processes

Stunted sexual development occurs due to improper hormonal imbalance, that is, lack of testosterone in boys. In this case, the voice does not break, and the height remains low. In rare cases, boys experience enlargement of the mammary glands. This phenomenon goes away after some time. Sometimes the cause of this process is a tumor of the testicles or adrenal glands.

If testosterone increases rapidly, puberty occurs faster. The musculoskeletal system develops intensively, hair appears in the groin area, but the testicles remain of standard size. The boy's physical development is absolutely inconsistent with his psycho-emotional development.

Hormonal imbalance in girls

A symptom of hormonal imbalance is menstrual irregularity. Early puberty appears due to dysfunction of the hypothalamus and the onset of menstruation before the age of 10 years.

In addition, the breasts begin to enlarge, hair appears in the groin and armpits. It is necessary to contact an endocrinologist if menstruation is not observed at the age of 15 years. This is not always a symptom of dysfunction of the ovaries and pituitary gland; it depends on the physiological characteristics of the girl.

Hormonal levels in girls fluctuate at the beginning of hormonal changes. For this reason, the menstrual cycle is not stable. If progesterone levels are quite low, then the uterus cannot reject blood in time. The menstrual cycle is normalized within 2 years. To diagnose a serious glandular disorder, you need to see a doctor if you have not had your period for a long time.

Treatment of hormonal imbalance

After the child has completed all the necessary examinations, the doctor must prescribe individual treatment. Most often, homeopathic drugs or synthetic hormones are prescribed. Constant stress or nervous disorders can lead to hormonal imbalances in children.

If the situation is advanced, then surgical intervention is required, and only after that hormonal treatment is carried out. The main thing is the correct daily routine and nutrition, rest and necessary physical exercise.

You should consult a doctor if your child experiences the following disorders:

• the child does not perceive information well;
• forgets a lot of what he heard or learned in class;
• unable to read, write, or attend classes for long periods of time.

Hormonal balance means a lot for the full development of a teenager. A child’s prosperous future depends on the normal functioning of teenage hormones. Any disorder in the production of hormones leads to pathologies.

About the causes and manifestations of acromegaly

Manifestations of hypertrichosis

Is it possible to restore hormone levels in the body?

How does hypogonadism develop?

What is myxedema?

How to recognize hormonal imbalance in women in labor?

During adolescence, a child requires increased attention from parents. Do not rush to scold him if you notice sudden changes in mood, irritability, decreased interest in studying, or constant fatigue. If these phenomena do not go away quickly, it makes sense to pay attention to them - they may be the result of a disruption of the endocrine system.

The human endocrine system consists of glands that produce hormones that control chemical processes in cells. It is under the influence of hormones that a child grows and develops. There are many features of the teenage endocrine system. Therefore, only a specialist can diagnose deviations from the norm. Diabetes mellitus, obesity or underweight, growth disorders, and sexual development are the main endocrinological problems of adolescents.

If your child complains of discomfort or pain in the front of the neck, goes to the toilet frequently, especially at night, drinks a lot, sexual characteristics appear earlier or later than normal, dry skin, swelling, contact immediately. One of the main factors that disrupts the endocrine system in adolescence is constant stress. It is caused by a break in childhood stereotypes, a discrepancy between the pace of physical and social development, the formation of life attitudes, goals, preferences and passions, spiritual and moral values. Therefore, do not leave your children alone with their problems, do not rush to scold, it is better to help with advice, share your thoughts, do not be afraid to be frank - your child will remember such moments for the rest of his life and will also remain healthy.

You can often hear that adolescence is full of difficulties. At this time, parents are surprised, worried, irritated and even baffled by the child’s behavior. What worries doctors? What diseases should be treated and what diseases can debut in adolescence?

There are several starting points for puberty. Statistically it’s 14-17 years old, but physiologically it’s a little different. Adolescence begins for girls and boys at the age of 10-11, and ends individually for each child. It can end at 14-15 years old, and at 18-19 years old.

During this period, they begin to be actively developed. More active stimulation of the adrenal glands and thyroid gland begins. During this period, all endocrine glands begin to work more actively and may fail. For example, diabetes mellitus often occurs at this time. In addition, problems with both excess body weight and underweight may appear. Because it is at this age that adipose tissue, which is also endocrine tissue, begins to increase its mass. This excess weight can be fixed for life and will cause many other problems not only of an endocrine nature. This is why it is very important for children to maintain a healthy weight during adolescence.

First of all, this is possible due to a rational daily routine with periods of rest and work. The child should not be exhausted. The child should get enough rest. He must go to bed on time. And sleep at least 8 hours a day. There must be sufficient physical activity. And a child must eat to grow. Therefore, dietary restriction is not a priority; sufficient physical activity is the priority.

Sometimes teenagers experience high blood pressure. You need to understand that if, for example, for an adult a blood pressure of 120/60 is normal, then for a child such indicators are a deviation from the norm.

In general, high blood pressure is provoked, first of all, by excess body weight or may be a manifestation of adrenal gland pathology. That is why cardiologists, when a child has high blood pressure, refer him to.

As a rule, an examination by an endocrinologist is aimed at studying the functions of the thyroid gland, which also undergoes certain changes during puberty. Previously, this condition was called “adolescent”. Why is the thyroid gland examined? Because in adolescence it increases due to the fact that the child needs more hormones. Iodine is needed for the normal amount of hormones produced. In adolescence, iodine is released more actively than in younger or older children, especially girls. And therefore, when the thyroid gland experiences iodine starvation, it begins to increase in volume in order to provide more of the necessary hormones due to the volume. This is why adolescence is a risk group for thyroid pathology and requires mandatory intake of iodine supplements. We also must not forget that the body needs the microelement selenium to absorb iodine. Therefore, experts recommend taking supplements containing both microelements - iodine and selenium. The drug is available in pharmacies "YoSen ®". 1 tablet of the drug contains 150 mcg of iodine and 75 mcg of selenium. The drug should be taken 1 tablet 1 time per day during or after meals with water.

Unfortunately, today endocrinologists quite often have to deal with patients with delayed sexual development or premature puberty. This mainly applies to girls. Because there are a number of endocrine genetic diseases that appear and manifest themselves in adolescence. Among such diseases, the most famous is the so-called Shereshevsky-Turner syndrome. This genetic disease has several variants of manifestation depending on the chromosomal abnormality. Typically, such girls have low body weight at birth. In the future they grow slowly, their height does not exceed 140 cm. But at the beginning of puberty, the main symptom of this disease appears - a girl’s delay in the onset of menstruation or irregular menstrual cycles. That is why even before adolescence, parents should pay attention to the child’s growth retardation. It is necessary to carefully examine the child to determine whether this is her physiological condition, or whether it is a pathological situation that requires immediate intervention and adequate correction.

In boys, pathology of sexual development is very often discovered during a medical examination at the military registration and enlistment office. And only then is it determined that the problem has existed since the child’s early childhood, but the parents did not pay attention to it.

Pubertal development in boys begins at approximately 11-12 years of age, in girls - a year earlier.

The first signs of sexual development in boys are voice mutation and intensive growth. Over the course of a year, a child can grow by 9-10 cm. But when a child begins to grow very rapidly at the age of 6-7 years, this is not a good sign and you should definitely consult a doctor. There is no need to be happy that the child is growing actively and very well. This is not always a good sign. The same is true when the child’s growth rate remains at 2-4 cm per year. This also requires a mandatory consultation with a doctor to determine the cause of such growth retardation.

Hormones in teenage girls during puberty, they primarily stimulate the enlargement of the mammary glands. Then hair appears under the arms and on the pubic area. Next comes a growth spurt. If these signs occur in girls under 6-7 years of age, this is a sign of premature physiological sexual development. But if sexual development in girls begins not with enlargement of the mammary glands, but with hair growth, this may be a sign of not entirely normal functioning of the adrenal glands. You definitely need to pay attention to this and consult a doctor in a timely manner.

What is the function of the adrenal glands and how can changes in the function of these glands affect the health and future life of children?

In short, the adrenal glands produce certain types of hormones, including sex hormones and glucocorticoids. When there are too many of them, protein breakdown accelerates, fat is redistributed - the body stores excess fat in the buttocks, thighs, and axillary folds. Pink-violet striae appear there - areas with disturbed pigmentation. These burgundy stripes are 2-4 cm long and about 1 cm wide and are hard to miss. But this, unfortunately, is not all. Obesity contributes to long-term high blood pressure. Therefore, the teenager becomes a direct candidate for the risk group. About a third of these children remain overweight.

To prevent disorders of the endocrine system, it is necessary to ensure that the child maintains a normal daily routine, and also receives normal, adequate, timely nutrition without excess carbohydrates and fats. Under any conditions, the child must rest, because his endocrine system is very dependent on overwork and stress, which is why many diseases arise during puberty. Regarding thyroid disorders, every family needs to replace regular salt with iodized salt in their daily diet. This will provide the daily iodine requirement for a child of any age.