Delayed puberty (DP) defines a retardation of onset/progression of sexual maturation beyond the expected age from either a lack/delay of the hypothalamo-pituitary-gonadal axis activation or a gonadal failure. DP usually gives rise to concern and uncertainty in patients and their families, potentially affecting their immediate psychosocial well-being and also creating longer term psychosexual sequelae. The most frequent form of DP in younger teenagers is self-limiting and may not need any intervention. Conversely, DP from hypogonadism requires prompt and specific treatment that we summarize in this review. Hormone therapy primarily targets genital maturation, development of secondary sexual characteristics, and the achievement of target height in line with genetic potential, but other key standards of care include body composition and bone mass. Finally, pubertal induction should promote psychosexual development and mitigate both short- and long-term impairments comprising low self-esteem, social withdrawal, depression, and psychosexual difficulties. Different therapeutic options for pubertal induction have been described for both males and females, but we lack the necessary larger randomized trials to define the best approaches for both sexes. We provide an in-depth and updated literature review regarding therapeutic options for inducing puberty in males and females, particularly focusing on recent therapeutic refinements that better encompass the heterogeneity of this population, and underlining key differences in therapeutic timing and goals. We also highlight persistent shortcomings in clinical practice, wherein strategies directed at "the child with delayed puberty of uncertain etiology" risk being misapplied to older adolescents likely to have permanent hypogonadism.

中文翻译：

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性腺机能减退的青春期诱导的新的和综合的治疗选择：文献的深入回顾。

青春期延迟 (DP) 定义了由于下丘脑-垂体-性腺轴激活缺乏/延迟或性腺功能衰竭而导致性成熟开始/进展超过预期年龄的延迟。DP 通常会引起患者及其家人的担忧和不确定性，可能会影响他们直接的心理社会福祉，并造成长期的性心理后遗症。年轻青少年最常见的 DP 形式是自限性的，可能不需要任何干预。相反，性腺机能减退引起的 DP 需要我们在本综述中总结的及时和具体的治疗。激素疗法主要针对生殖器成熟、第二性征发育和达到与遗传潜力相符的目标身高，但其他关键的护理标准包括身体成分和骨量。最后，青春期诱导应该促进性心理的发展，并减轻短期和长期的损害，包括自尊心低、社会退缩、抑郁和性心理困难。已经针对男性和女性描述了青春期诱导的不同治疗选择，但我们缺乏必要的更大规模的随机试验来确定两性的最佳方法。我们提供了关于诱导男性和女性青春期的治疗选择的深入和更新的文献综述，特别关注最近更好地涵盖该人群异质性的治疗改进，并强调治疗时机和目标的关键差异。我们还强调了临床实践中持续存在的缺陷，其中针对“