Delayed puberty in girls - DD15 - anyone have any experience / advice?

[basilbrush]

[Have also posted this on Teenagers board]

DD15 is distraught as she has no breast development (she is nearly totally flat, the nipples are slightly raised, that is it). We think she had her first period in December - there was a very small brownish blood stain on her knickers which she showed me - but nothing since.

She was underweight last year due to stress / anxiety but has worked very hard to put on a stone since then but is very upset that she still has not developed as she she feels she should have. She is very short for her age (4 foot 11) and has always been short.

The GP has just referred her to hospital for an ultrasound - I presume this is to check there is nothing physically wrong with her ovaries / uterus.

Does anyone have any experience with this kind of situation? My gut feeling is that they will just tell her to go home, eat more and be patient. We have been trying this tactic for months but she is increasingly distressed and socially reclusive as she is so embarrassed about her body.

I've read that a short course of hormones can be given to 'jumpstart' puberty in some cases but I don't know whether I should be pushing for this from the doctor or whether this would be potentially irresponsible / dangerous and I should just keep telling her to be patient?

Any insight very grateful received!

Has she got any positive role models for women who have a similar body type to her? For instance most supermodels have a very small chest and are slim. Maybe a petite supermodel, they do exist.

It is really sad to be so self conscious, if it were the opposite and she had a large chest no doubt she would also be self conscious and sticking to baggy clothes.

Hang on in there, it all feels very intense at this age but things will calm down eventually.

Yeah, I agree, does she not see the many women out there who are built athletically or are more angular and flat-chested, but who are beautiful and feminine? Failing that - a padded bra might make her feel more "normal" for now? If she's genuinely hiding away and not pursuing normal activities because of this, then I think it's time for good old psychological help, because that's an extreme reaction.

Please work on getting her into the healthy bmi range. She should be at least 7 stone. It’s worrying that she isn’t showing many signs of puberty. I have always been underweight/borderline underweight despite not restricting calories (it’s genetic). I started my period at 11. If I lose a few pounds then my period disappears. Most women wouldn’t get a period at my weight (I am also short but taller than your Dd).

If she struggles to eat decent adult sized portions or skips meals then make her these shakes. You could also use these shakes as snacks between meals. Aim for 3 meals a day plus snacks. Ensure Plus is an option too. Do you have an example of what she eats in a day?

https://www.healthline.com/nutrition/protein-shake-weight-gain#1.-Chocolate-peanut-butter-shake-with-Greek-yogurt

I was 16 when I started periods and was very flat chested and slim.
So hard for teens girls though to feel distressed about it especially when everyone around is blossoming and becoming womanly. You feel left behind and I did too. And pressure from social media today must be hell (at least for me in the early 90s the skinny, boyish, heroin chic look was all the rage 😝).
Can you start enriching her diet with loads of good fats? Coconut oil/milk, avocado, butter, cream, nuts, seeds, full fat dairy. Oestrogen needs fats. Also maybe a bit of counselling if she’s that upset by it?

You're doing the right thing by getting a referral OP. My DD is similar (now 16) and after various tests at 2 different hospitals is about 9 months into a 12 month course of oestrogen which does seem to be helping a bit. Prom was also a big issue in DD's mind but we've just taken delivery of a custom sized prom dress and today she's trying on heels! She's never going to be the tallest, but she'll get there...

That's really interesting @Bramshott - do you mind me asking if she suffered any unwanted side effects from the oestrogen or whether the consultants warned you that they might be any?

I was put on the pill as a teenager Back in The Day to lighten my heavy periods (as they used to think that was a great idea back then) and I was hit with an onslaught of physical and emotional side effects.

Now I'm terrified of meddling with my daughters hormones and causing similar distress but equally I want to make sure I'm doing what's best for her! The treatment protocol for delayed puberty with just oestrogen might be different from being on the pill... I was put on Microgynon which is a combined pill...

DD doesn't seems to have had any side effects from the oestrogen at all, although mood swings and general grumpiness go along with the puberty we're trying to kick start I guess! Hard to tell what she'd be like without the tablets, but we've not noticed any major differences. All in all it's been a pretty positive experience and DD has been reassured that both we and her doctors are taking seriously something that has a big impact on her life.

Thank you @Bramshott

My daughter was exactly the same at 15 and shopping for a dress for leaver’s was horrendous because so many dresses had cups inbuilt. We did find something but at 16, compared to her friends she looked way behind in the chest department and was head and shoulders above them height wise. Thankfully she stopped worrying about it once I told her to trust me, once her periods start, that’s it, for the next 30+ years. Once they start you will wish you could stop them so make the most of not having to worry about them.

I was a very skinny child (6 stone at age 11/12) but I got periods at 14 and had breasts at 12.

I will say what’s really important is making sure DD has a good diet (include snacks but ensure she has a good lunch especially on weekends) with healthy snacks like hummus and cheese on crackers to build up weight and also exercise, so she’s actually healthy that way.

I was lucky/unlucky that I was a teenager in early to mid 80s so although less bust shaping clothes we didn’t have eg size 6 etc so a size 8 swamped me.

You could get her a wonder bra for her bust. My DM and her DM (nana) both flat chested compared to me, swore by them when they were younger.

I’ve got a friend who’s got a DD similar to yours, but adopted. She had periods but for years clothes shopping for her was a pain as she was a size 4 and short (5ft). She’s now a size 6 and 22 but still very petite.

I was very slim as a child. My first bra at age 13 was a 28AA and I persuaded my mum to buy me one as I was the only one in my friendship group still wearing a vest(this was in the mid 70s).I had my first period when I was 14 yrs old,5ft 6 and weighed 6 st 7lbs.

FWIW I think there's "small" (some of the stats PPs are quoting above) and then there's "something's not quite right here". For reference DD (16) after the 9 months of oestrogen is now 145cm tall, possibly just starting puberty and mostly wearing age 10-11 clothes. However, that's a significant improvement on where she was at 2 years ago.

@Bramshott I get your point! My DD15 is not that "bad" - she is 149 cm in height (although hasn't grown upwards for 2 years), she wears age 11-12 clothes or a size 4, depending on the brand

Sorry - that wasn't directed at you @basilbrush!

Being so underweight is her main barrier. See what the ultrasound says, and then ask to be referred to a consultant. But you may be partly dismissed until the weight issue is addressed.

Her chronic anxiety and low self esteem need addressing first. For her to turn down parties etc is so sad. Can you look at this aspect?

I was 13 when I had my first period but they were sporadic and by 17 I'd had 5 or 6. I went for a scan and was diagnosed with PCOS. I'm 30 now and my last period was over a year ago. It is what it is.

As for my boobs, they never arrived despite coming from a family of very busty women. I ended up having a boob job when I was 21 and i still have the smallest boobs on both sides of the family. Im ok with it. Im a 34C and they're still perky. I can smile and sympathise with my younger cousins moaning about the sagging while secretly being happy about my small boobs.

Oh I forgot to mention that I was put on Dianette when they diagnosed PCOS. Google suggested my boobs might come in but it didn't happen.

I would see a doctor I've always been very slim. I started my periods at 13 I was probably just over 5ft and wouldn't have weighed much more than 6 stone. I remember my breasts developing at around 11/12. I've only ever been an A-B cup and my hips widened. My friend was 17 when she started and had a much more normal body weight, she had developed breasts though and was really tall nearly 6ft so all signs of puberty were there. I think that because of the lack of signs of puberty I'd see a GP.

I didn’t start until well after 15. At 16 after GCSEs I suddenly grew breasts over the summer. I hated being the tiniest girl in school and I was very short for ages too.

rest assured OP she will be fine. I’m 5’7” & I now have 36FF bra and 3 teenagers

My Dd was tiny and had a hormone deficiency so took growth hormone injections for about 4/5 years. I would agree its weight that is holding her periods back. Once they have done the ultrasound hopefully she will be reassured ( my Dd had one and they could see the ovaries were developing eggs and getting ready to start ovulating). She has just stopped the hormones as she is now about 18 months post period starting and that's when they stop their major growth spurt. She is still going to be quite short (will probably stay at 5ft 1) but that is way better than she would have been without the hormones.

Her delayed puberty is probably due to being too underweight. A dietician may help with coming up with a diet plan to gain weight. In the meantime make sure she eats decent portions for meals and has high calorie shakes between meals. I wouldn’t look at hormone treatment until she is a healthy bmi because an increase in weight might kickstart puberty.

As a side note, doctors still think it’s a good idea to treat very heavy periods with the pill. I have extremely heavy periods (change a night time pad every hour), but I refuse to go back on the pill.