Delayed puberty

Girls on sex steroid replacement regimes should be told to report the onset of per vaginum bleeding/menarche. Boys on both sex steroid replacement or gonadotrophin replacement regimes should be advised that the onset of axillary hair, voice change, and growth spurt occur in mid- to late puberty. Development of facial hair occurs late in puberty. Men using transdermal preparations of testosterone should not wear clothes over the patch for 10 minutes after application. Showering and swimming should be avoided for 4 hours after gel application. Gel should be applied on the shoulder, upper arm, or abdomen for better absorption.