Evaluation of 451 danish boys with delayed puberty: diagnostic use of a new puberty nomogram and effects of oral testosterone therapy. Lawaetz JG1, Hagen CP, Mieritz MG, Blomberg Jensen M, Petersen JH, Juul A. J Clin Endocrinol Metab. 2015 Apr;100(4):1376-85.

Few data exist on the diagnostic criteria, and on the effects of puberty induction, in boys with constitutional delay in growth and puberty (CDGP). To evaluate the different diagnostic criteria and the effect of oral testosterone undecanoate (TU) in boys with CDGP. The authors performed a cross-sectional and longitudinal study of Danish boys with normal pubertal development and a retrospective observational study of 451 boys evaluated for delayed puberty between 1990 and 2013.
Seventy-eight (27%) of the 287 boys had delayed pubertal onset according to the classical criteria, whereas 173 (60%) of the 287 boys had impaired pubertal progression according to the puberty nomogram. Ninety-six (56%) of these 173 boys were treated with oral TU for 0.8 years (0.5; 1.3) [median (25th; 75th percentiles)], which resulted in beneficial effects on pubertal progression. Height increased from -1.9 SD (-2.5; -1.2) to -1.5 SD (-2.1; -0.7) (P < .001), and PAH increased from 172.3 cm (170.3; 182.8) to 178.1 cm (171.4; 191.7) (P = .001) following one year of treatment.

The puberty nomogram evaluates both delayed pubertal onset as well as delayed pubertal progression and allows separation of normal versus abnormal pubertal development. Oral TU treatment was followed by pubertal induction and progression and short-term growth without  compromising final height.