How Do Doctors Evaluate Delayed Puberty in Boys?

Our evaluation of your son’s delayed puberty begins with a discussion about your son’s signs of puberty and a physical exam. If your son has signs of delayed puberty, we will have him get an X-ray of his left hand and wrist called a bone age. A bone age tells us how much his bones have matured. It can also help us figure out much he has left to grow.

Your son might have an early morning blood test to help us measure his hormone levels. Hormones, like testosterone, are at their highest levels first thing in the morning. Additional blood testing done at the same time might include FSH, LH, cortisol, ACTH, thyroid hormone studies, growth factors and a prolactin level. We also do genetic evaluations if they are needed. Depending on the results of the laboratory testing further radiology testing may include a head MRI.