ABSTRACT
Puberty is a period of changing patterns of hormone secretion resulting in physical and physiological changes which culminate in sexual maturation and fertility. There is great variability in the onset of these changes, but 95% of girls will have commenced puberty by the age of 13 years and 95% of boys will have commenced before the age of 14 years. Precocious puberty may be central (true) resulting from activation of the hypothalamic-pituitary-gonadal axis, or peripheral (false), involving an abnormal pathway and usually resulting in incomplete maturity. Precocious puberty is more common in girls (10:1) but is usually idiopathic. In boys, the majority will have a pathological cause and they therefore require more careful investigation. Delayed puberty is more common in boys and is usually constitutional.
