About the Adrenal and Puberty Center

Having your child diagnosed with an adrenal disorder or condition that affects your child’s sexual development can be distressing. Because these disorders can have a lasting impact on your child’s overall health and well-being, it’s important to find an experienced team of specialists that can create a customized care plan to treat your child.

The Adrenal and Puberty Center (APC) at The Children’s Hospital of Philadelphia (CHOP) provides streamlined, coordinated care for children and adolescents with adrenal disorders and conditions that may affect puberty and gonadal function. The program brings together experts from several pediatric specialties who tailor your child’s treatment to his unique needs. Our goal is to provide comprehensive, integrated care as your child grows and develops.

Conditions we treat

The Adrenal and Puberty Center at CHOP cares for children and adolescents with:

  • Disorders of the adrenal glands, which produce hormones that are essential to life, such as cortisol and aldosterone.
  • Disorders related to puberty that may affect your child’s sexual development and growth.

Adrenal disorders

Puberty disorders

  • Amenorrhea (absence of menstruation)
  • Delayed puberty
  • Disorders of sex development (DSD)
  • Precocious puberty — this may include early breast development (thelarche) or early development of pubic hair, body odor or axillary hair (adrenarche)
  • Genetic disorders associated with early or delayed puberty
  • Gonadal disorders
  • Hypogonadism
  • Kallman syndrome
  • Klinefelter syndrome
  • Lack of menstruation and puberty problems associated with anorexia nervosa, eating disorders or other chronic disorders such as Crohn's disease or inflammatory bowel disease
  • Puberty problems associated with McCune-Albright syndrome
  • Children born with ambiguous genitalia

Our Programs and Services

The APC offers both inpatient and outpatient services to help manage these complex conditions.

Our programs and services include:

  • Comprehensive care program for patients and families with congenital adrenal hyperplasia
  • Comprehensive care program for patients and families with Klinefelter’s syndrome
  • Medical management of children with adrenal or gonadal disorders
  • Program for children with steroid-induced adrenal insufficiency. Many children with an underlying disease that requires treatment with high doses of steroids, such as prednisone or hydrocortisone, may develop adrenal suppression. Our team works with the patients’ primary medical team to taper patients off steroids and ensure normal adrenal function as patients improve and are weaned off steroids. 
  • Surgical consultations and treatment for genital reconstruction.
  • Psychosocial support, including social work services and family counseling.
  • Nutritional counseling and weight management.
  • Genetic counseling to help with future family planning.
  • Transition to adult care and referrals to adult specialists to address any health challenges that arise as your child grows and develops (i.e. reproductive issues and fertility preservation).


In the Adrenal and Puberty Center is dedicated to research and expanding the knowledge base of all the conditions that we treat. Our team is continuously involved in several research activities. Current research involvement includes several clinical trials for treatment of congenital adrenal hyperplasia (CAH):

  • Efficacy and Safety of Tildacerfont in adults: CAHMELIA 203 and 204 studies
  • Efficacy and Safety of Crinecerfont in adults: CAHtalyst study
  • Efficacy and Safety of Crinecerfont in children: CAHtalyst study
  • Efficacy and Safety of Crinecerfont in children: CAHlibrate study

The Center collaborates with researchers and partners to study information needs in children with gonadal disorders and sex and gender development and assess neurodevelopment in infants and children with sex chromosome trisomy.