Management of puberty in constitutional delay of growth and puberty

Constitutional delay of growth and puberty (CDGP) is the most common presen ting form of short stature, but no single test can infallibly discriminate CDGP and isolated hypogonadotrophic hypogonadism. Management of puberty in CDGP aims to optimise not only growth maintaining body proportions and impr oving peak bone mass without impairing growth potential - but also well-bei ng; for example, the distress boys often suffer because of their lack of gr owth and pubertal progression can affect their school performance and socia l relationships. Typical sex steroid treatments to induce puberty in boys w ith CDGP include testosterone (T) enanthate, T undecanoate, mixed T esters, T transdermal patches, and oxandrolone p.o. Compared with other regimens, short-course low-dose depot T i.m. is an effective, practical, safe, well t olerated, and inexpensive regimen. Some unresolved problems in management i nclude optimal timing and dose of sex steroid treatment, the role of GH in CDGP, and the management of CDGP in girls.