In a girl with pubertal delay, timely medical assessment is important as studies have shown that as many as half of these girls have an underlying pathology. Irrespective of the cause of pubertal delay, appropriate treatment, including estrogen therapy to stimulate pubertal development, may lessen the negative psychosocial impact and improve biologic factors such as bone density. When caused by a constitutional delay in normal growth and development, temporary treatment is needed and normal adult gonadal function is expected. When the delay is associated with a permanent dysfunction, hormone substitution is lifelong and the potential for fertility must be assessed.
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