Primary Amenorrhoea and Delayed Puberty

Female puberty, driven by the hypothalamic–pituitary–ovarian axis (HPO), sees numerous alterations in the body secondary to the rise in oestradiol concentration. Whilst the onset, tempo and sequence will vary between individuals, delay in initiation of events or arrest during the process warrants medical attention. Pubertal transition requires not only an intact HPO axis but also functional reproductive organs.