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Delayed puberty occurs when a female doesn't develop breasts by age 13 or a boy doesn't develop testicles by age 14. This is outside of the normal age range. In many situations, it is a constitutional delay in growth and puberty, where a healthy "late bloomer" starts and finishes puberty later than their classmates but eventually reaches normal adult height and sexual development. However, it can also indicate underlying issues such as chronic diseases (like inflammatory bowel disease, kidney disease, or cystic fibrosis), malnutrition, eating disorders, excessive activity, or endocrine disorders (like hypothyroidism and pituitary hypothalamic dysfunction).

Evaluation usually involves looking at growth charts, checking the bone age, doing hormone tests (LH, FSH, testosterone, oestradiol, and TSH), and sometimes taking pictures of the brain or pelvis. How you manage the situation depends on the cause: a normal delay in growth usually just requires watching and reassurance, while specific medical or hormonal issues need targeted treatment for the underlying problem or, in some teenagers, a short course of sex hormones to start puberty safely. Psychological help is vital since going through puberty late might hurt your self-esteem and social confidence as a teenager.