Editing Openai/6842ae90-f1b0-8013-890f-f49da7e9b749 (section)

=== Assistant: Here’s a list of red flags to watch for in cases of delayed puberty — these suggest an underlying problem and warrant p… ===
Here’s a list of red flags to watch for in cases of delayed puberty — these suggest an underlying problem and warrant prompt medical evaluation:

===== - Very short stature or growth rate slowing =====
* Crossing down height percentiles on growth chart
* Disproportionate body proportions (e.g. long limbs with short trunk → possible syndromes)

===== - Headaches, visual changes (blurry vision, double vision → possible pituitary tumor) =====
* Loss of sense of smell (anosmia → Kallmann syndrome)
* Seizures or history of head trauma
* History of cranial irradiation or CNS tumor

===== - Chronic diarrhea, weight loss, fatigue (suggesting IBD, celiac disease) =====
* Delayed puberty + signs of hypothyroidism: cold intolerance, constipation, dry skin
* Chronic illnesses: cystic fibrosis, kidney disease, liver disease, diabetes

===== - Girls: Primary amenorrhea + no breast development by 13 or no menses by 15 → consider Turner syndrome (short stature, webbed neck, shield chest) =====
* Boys: Small testes, gynecomastia → possible Klinefelter syndrome

===== - Prior chemotherapy or radiation (especially involving brain/pelvis) =====
* Surgery involving brain or gonads

===== - Extreme exercise (gymnastics, distance running) =====
* Eating disorders (anorexia nervosa)
* Severe psychological stress or trauma

===== - Family history of early menopause (in females) =====
* Family history of syndromic causes of delayed puberty

===== If delayed puberty is accompanied by poor growth, systemic illness, neurological symptoms, or signs of gonadal failure, it should be investigated carefully. =====

If you want, I can also show you a quick flowchart doctors use for evaluating delayed puberty — it helps visualize the process. Want to see it? 📋✅