Case Study: Follicle-Stimulating Hormone Deficiency and its Impact on Puberty Delay

February 15, 2024by Dr. S. F. Czar0

Patient Profile:

Name: Sarah Thompson Age: 15 years old Gender: Female

Presenting Concerns:

Sarah was referred to the endocrinology department by her pediatrician due to concerns about delayed puberty. According to her medical history, Sarah had not yet experienced menstruation, and her secondary sexual characteristics, such as breast development, were underdeveloped compared to her peers. Her parents also expressed concern about her emotional well-being, as Sarah seemed increasingly self-conscious about her physical appearance.

Diagnostic Process:

Upon initial evaluation, a thorough medical history was obtained, and a physical examination was conducted. Blood tests were performed to assess hormonal levels, revealing a significant deficiency in Follicle-Stimulating Hormone (FSH). Further investigations, including imaging studies such as magnetic resonance imaging (MRI), were conducted to identify potential causes for the FSH deficiency.


The imaging studies revealed a small tumor on the pituitary gland, affecting the production of FSH. Sarah was diagnosed with FSH deficiency secondary to a pituitary gland tumor. The tumor was non-cancerous, but its impact on hormonal regulation needed to be addressed to support Sarah’s puberty and overall reproductive health.

Treatment Plan:

The endocrinology team collaborated with neurosurgeons to develop a comprehensive treatment plan for Sarah. Given the non-cancerous nature of the tumor, surgical removal was deemed the most appropriate course of action. Post-surgery, Sarah was started on hormone replacement therapy (HRT) to address the FSH deficiency and stimulate the normal development of secondary sexual characteristics.

Psychosocial Support:

Recognizing the psychosocial impact of delayed puberty on adolescents, Sarah’s healthcare team implemented a holistic approach. A pediatric psychologist was involved to provide emotional support and counseling, addressing Sarah’s concerns and facilitating communication within the family. Additionally, Sarah and her parents were connected with support groups for families dealing with similar conditions to foster a sense of community and understanding.

Monitoring and Follow-Up:

Regular follow-up appointments were scheduled to monitor Sarah’s hormonal levels, assess her physical development, and address any emerging concerns. Adjustments to the hormone replacement therapy were made as needed, ensuring that Sarah’s hormonal balance was maintained. The psychological support continued to be an integral part of her care plan, addressing the emotional aspects of her journey through puberty.


Post-surgery and with ongoing hormonal therapy, Sarah showed positive progress in her physical development. Her menstrual cycle started, and breast development progressed as expected for her age. The support from the healthcare team, combined with the psychological interventions, helped Sarah navigate the challenges associated with delayed puberty.


Sarah’s case illustrates the complexity of addressing FSH deficiency and its impact on puberty. A multidisciplinary approach involving endocrinologists, neurosurgeons, and psychologists was essential in providing comprehensive care. While surgical intervention addressed the underlying cause, hormone replacement therapy and psychosocial support played crucial roles in ensuring Sarah’s overall well-being. This case underscores the importance of personalized and holistic care in managing conditions affecting puberty and reproductive health.

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