Delayed puberty

Template

Tap a choice or type a Repertoire Line to see how the note changes. Defaults are what the template inserts on its own.

Try a Repertoire Line

Practice wording only: leave out patient details. Nothing typed here is saved or sent.

PresentationChoose oneFirst line

ReviewedChoose any

Tanner stageChoose one

Growth chartChoose one

Family historyChoose any

Red flags presentChoose any

Red flags absentChoose any

Initial testingChoose any

Hormone testingChoose one

Additional testingChoose any

AssessmentChoose one

ReferralChoose one

SupportChoose any

Follow-upChoose one

Counseling paragraphChoose oneParagraph

Note when inserted as is

Delayed puberty
• Pubertal development, growth, nutrition, chronic illness, medications, and family timing reviewed
• Growth chart reviewed; height velocity normal for prepubertal growth
• No decreased sense of smell, symptoms of chronic illness, restrictive eating or intense exercise, headaches or vision changes, or features of Turner syndrome
• Ordered: Bone age x-ray and TSH and free T4
• Delayed puberty most consistent with constitutional delay, pending results
• Referred to pediatric endocrinology
• Follow up after the results

Most teens who start puberty later than their peers are healthy late bloomers and go on to develop normally; the tests and the specialist visit check growth and hormone signals to confirm this. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Presentation (boy by 14, girl by 13, stalled)
Tanner stage; growth chart and height velocity
Family history of late puberty
Red flags present or absent (smell, chronic illness, restrictive eating, headaches or vision, Turner features)
Bone age, TSH; LH, FSH with testosterone or estradiol
Chronic illness labs, IGF-1, prolactin, karyotype, MRI
Constitutional delay pending results vs needs evaluation

Sources

HealthyChildren.org: Delayed Puberty in Boys

Few formal guidelines cover this topic, so the template also leans on expert opinion.