Delayed male puberty

Delayed male puberty

Some cases of delayed puberty are just normal variation. Some result from other disorders like diabetes, kidney diseases, cystic fibrosis and anemia because they hinder development and sexual maturation. Delayed or halted sexual maturation may result from radiation and chemotherapy used to treat cancer.

Chromosomal anomalies like Klinefelter syndrome and other genetic defects may alter the release of sexual hormones. Some testicular disorders like testicular contusion may delay puberty as well.

iseases that cause delayed puberty

Some diseases can significantly contribute to delayed male puberty:

  • Celiac disease.
  • Ulcerative colitis.
  • Hypothyroidism.
  • Diabetes.
  • Cystic fibrosis.
  • Sickle cell anemia.
  • Kidney and liver diseases .
  • Autoimmune diseases .
  • Addison’s disease.
  • Chemotherapy and radiation therapy .
  • Gonadal agenesis.


Delayed male puberty can be diagnosed by:

  • Clinical examination
  • X-ray imaging to determine bone age
  • Blood tests
  • MRIs
  • Hormonal assays: to determine the level of some hormones like thyroid hormones and sex hormones

Symptoms of delayed male puberty

Delayed puberty may lead teenagers to feel upset and experience anxieties and confusion as a result of differences form their peers. Some signs may indicate delayed puberty:

  • Small and immature penis at age 13.
  • Scarce or no body hair at 15.
  • high-pitched voice.
  • short an lean body.

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Possible complications of delayed puberty:

Decreased level of sex hormones may lead to:

  • problems of erections and erectile dysfunction.
  • infertility
  • osteoporosis
  • generalized weakness

Treatment of delayed puberty of males:

It depends on the cause of delay. Some cases with family history of delayed puberty will spontaneously resolve with time.

Delayed puberty prevalence in children?

2 to 5% of male infants suffer from undescended testis or testes. It is common in premature infants born before full gestation at the 37th week. Undescended testis affecting both sides is very rare.

What are undescended testes?

An undescended testicle is a testicle that did not descend to the scrotum before birth.

Symptoms of undescended testes:

Testes form inside the abdomen during gestation and they descend gradually through a tube called the inguinal canal into the scrotum in the last two months of gestation.

An undescended testicle indicates a disturbance in the development process

Causes of undescended testes

A definitive cause for the condition has yet to be highlighted. It may be a result of multiple genetic factors and maternal health conditions. Some factors increase the risk of undescended testis:

  • Low birth weight.
  • Premature birth.
  • Family history of undescended testis or other sexual organ development disorders.

Complications of undescended testes

The optimal temperature for the testes is lesser than that of the body between 33 to 34 degrees. Undescended testis are exposed to higher temperature inside the body causing increased risk of complications later in life 

Some of those complications are:

  • Testicular cancer
  • Fertility disorders
  • Testicular torsion
  • Inguinal hernia
  • Testicular disorders

Diagnosis of undescended testes

It can be diagnosed by:

  • Ultrasound.
  • MRI.
  • Endoscopy.
  • Open surgery.

Treatment of undescended testes

The main objective of treatment is repositioning the testis into their normal position. This is done by surgery and the surgeon gently and gradually moves the testicle into position and anchors it in place using sutures. This surgery needs multiple small incisions and it can be performed through endoscopy

External factors affecting penis sizes in children

Some parents may worry about what seems to be small sized penis that is in fact normal sized

The normal length of infant genitals

Measurement of the genital starts at the base of the penis at the pubic bone. In overweight infants, this part may be covered by fatty tissue giving the appearance of a small genital

The average penis length of a newborn is about 4 cm and 90% of newborn males span between 2.5 to 5.5 com. Some growth occur between birth to the age of 5 and rare growth between the age of 5 till puberty.

Causes of shortened male genitals in children

There are some factors that greatly affect genital sizes in children:

  • Hormonal factors
  • Genetic factors or hereditary diseases

Treatment of the condition 

Testosterone may be briefly prescribed and stopped to avoid precocious puberty. But hormonal treatments don’t produce satisfactory results. Surgery may be required according to the cause and the condition. Surgery is done before circumcision and surgical restructuring creates proper morphology and physiology


At birth. The infant is clinically examined and checked for any abnormalities including small genitalia, Hypospadias or other abnormalities of external genitalia

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