Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Go to an emergency department for sudden, severe testicular pain or swelling, especially with nausea or vomiting.
This may be testicular torsion, in which the testicle twists and loses its blood supply.
It is not a typical symptom of delayed puberty, but requires emergency treatment.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek prompt medical advice for persistent headaches, changes in vision, repeated vomiting, excessive thirst and urination, or new weakness.
These symptoms do not necessarily indicate a serious hormone problem, but need timely assessment.
Seek urgent mental health support if distress leads to thoughts of self-harm or suicide.
3
Does any of this apply?
Book an appointment
Arrange a routine medical appointment if:
There is no testicular enlargement by age 14
Puberty started but has stopped progressing
Growth has slowed noticeably or weight is falling
Delayed development is causing bullying, anxiety, low mood, or withdrawal
There is a history of undescended testes, cancer treatment, testicular injury, or pituitary disease
Other symptoms suggest a long-term illness
The article also says
Most delayed puberty is not an emergency.
Assessment can usually take place through primary care or a paediatric hormone specialist.
Every sign above is quoted from the sofidex article on Delayed puberty in boys. If you are not sure, err upward — it is always reasonable to be checked.