A 20-year-old woman presented at Nghe An Obstetrics and Pediatrics Hospital on 4/9, experiencing delayed puberty. Her medical history showed no prior endocrine disorders, no abnormalities in smell, sight, or hearing, and no family history of similar conditions. Her body mass index (BMI) was 20.2, within the normal range.
Clinical examination revealed underdeveloped secondary sexual characteristics, such as breast tissue and pubic hair. The patient had never menstruated. Lab results indicated low hormone levels and a smaller than normal uterus and ovaries.
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A doctor examines the patient. Photo: Hospital provided |
Based on these findings, doctors diagnosed her with hypogonadotropic hypogonadism, a rare endocrine disorder affecting approximately 1-10 in 100,000 people, with women accounting for about 1/5 of the cases. Doctor Nguyen Thi Them, who treated the patient, explained that the condition causes a deficiency in gonadotropin-releasing hormone, leading to delayed secondary sexual development and primary amenorrhea (absence of menstruation).
The initial treatment involves hormone replacement therapy (HRT) to promote breast and uterine development and stimulate menstruation. Long-term management includes calcium and vitamin D supplements to prevent osteoporosis, a risk associated with prolonged estrogen deficiency.
If the patient wishes to have children, options like ovulation stimulation or pulsatile gonadotropin therapy may be considered. However, due to the rarity of the condition, data on successful pregnancy rates in these patients is limited.
Puberty in girls typically begins around the age of 10.5, marked by breast development. This is followed by a growth spurt, and within six months, the appearance of pubic and underarm hair. Over the next few years, breasts continue to grow, pubic hair and external genitalia develop further, culminating in the first menstrual period, usually around 12.5-13 years of age.
Doctors recommend seeking medical attention if a child shows any signs of delayed or abnormal puberty. Early diagnosis and treatment can improve long-term health and quality of life.
Thuy Quynh
