How Do Doctors Evaluate Delayed Puberty?

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

Your child might have an early morning blood test to help us measure your child’s hormone levels. Hormones, like estrogen, reach 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 pelvic ultrasound or head MRI.