Not to medically treat my DD

[StayingHere]

My DD is 8.5. We are overseas in an Asian country that relies on medical insurance, I think this might be relevant later. This time last year she started showing signs of puberty (a little under arm hair and adult body odor). For reassurance I took her to an endocrinologist who insisted that she had precocious puberty and as soon as she developed signs of Estrogen (ie breast buds) that she should be treated with puberty blockers for a couple of years. Her bone age scan showed 1 yr and 11 months ahead which he said would have an impact on her adult height. I consulted another doctor in the UK via zoom who said her results showed early adrenarche (adrenal hormones setting off a bit early), not precocious puberty and that she is really more likely to be 'just' an early developer - her development is not rapid and shows no signs of the hormone you need to trigger breast development followed by periods a couple of years later. She doubted that her full adult height would be wildly effected even with the advanced bone age. Based on her family history she is unlikely to be a 91st centile adult anyway so we wouldn't expect her to follow that line forever.
A year later and she has no breast buds, she has pretty much the same amount of under arm hair and she has stayed on her growth line. She is happy and healthy and aside from a little spray of deodorant on PE days her life is the same as any other 8 year old girl. The underarm hair is light and no one seems to have ever noticed.
I do not particularly want to treat her even if she does develop breast buds whilst she is still 8 or early end of 9. I am not convinced that puberty blockers are a good thing unless puberty is very precocious (ie 5 or 6) and I understand that there is usually 2 years or so between breast buds and periods which means even if that all started now she would be 10.5 (I was 11 and in primary school and I survived). I also don't think her predicted height of 5'3-5'4 would make her life particularly bad! I was a very tall child and early to my period and topped out at 5'6 which I find totally fine.

I guess I am worried that I am doing her a disservice and I should treat her. Will she resent me if she ends up short or has her period early? Or would she be more likely to resent me if I put her through puberty blocker injections every 2-3 months - I would have hated that. DH falls firmly on the side of not treating her - I very much lean that way too but want to do the right thing by her and not make her childhood difficult.

[StayingHere]

I didn't take her to GOSH I had a zoom chat with a specialist there. DD was fast asleep!

[Roonerspismed]

I wouldn’t be treating this. You started earlier yourself - surely this is normal genetics?

This is my neighbour’s daughter - same as yours and my neighbour was also early. I was a later person snd my elder daughter is still behind hers.

These are surely all just norms on a curve.

What are the downsides of puberty blockers? I don’t know but I’m generally very wary of medication unless it’s absolutely necessary because of side effects that come out later that they didn’t know about at the time

[Mummyoflittledragon]

@StayingHere

Thanks Embracingthechaos. My consultation was with a doctor at GOSH - she did suggest that when we arrive back in the UK (soon) that we have her bone age/height/development reviewed.
I guess part of my concern is that the endocrinologist here has a lot to gain financially by treating my daughter - my insurance company would pay. I don't want to put her through anything unnecessary if she's going to end up an average height with a early-side-of-normal period. I think I will consult one more doctor but wait till we're back in the UK. Thank you!

But aren’t you intending to do this in the future? That’s what I was referring to. What kind of tests would they perform?

[EarringsandLipstick]

S*tayingHere
*
Also Caucasian children are a minority here - most children are of a different ethnicity and I think 8/9 would be very early for the girls of this ethnicity but not so much for mine

I think you've nailed it with this. It sounds likely from what you've said that ethnicity differences are at play here.

I think you've been really sensible about this, getting it checked out & a second opinion from a reliable source.

The option of puberty blockers, with the potential side effects, seems so extreme, that I think your gut instinct is avoid, is correct.

The plan to follow up with GOSH for physical checks to be sure, sounds like a good plan.

I also don't think you've been causing your DD any anxiety & a follow up with GOSH would be appropriately handled I'm sure.

It's a bit alarming isn't it - you obviously checked it out & sought a suitable second opinion, but another parent might not have & gone straight to the nuclear option of puberty blockers.

[Mummy1608]

Just another anecdotal story to add, I started developing breasts age 9 (I'm half asian), which I remember being earlier than some of my classmates but not all, and I had dark body hair (leg, armpit and public hair) before I was 10. But I didn't get my period till I was 12. I do think age 9 isn't crazy early, if you look at any P5 or P6 class there will be some girls who look a bit more mature than others. It might be a bit early but not to require intervention surely? Your instinct says don't, go with your instinct!

[EarringsandLipstick]

@Mummyoflittledragon

This is what the GOSH consultant recommended:

she did suggest that when we arrive back in the UK (soon) that we have her bone age/height/development reviewed.

That's hardly anything extreme, or likely to involve much poking or prodding. It just sounds sensible.

Why are you making such a big deal about this?

[Palaver1]

I can talk about both sides of this discussion but I won’t .from personal experience.
You have been given the advice needed and very good advice by the consultant .
Get back to the UK and follow through with the advice.
There is no reason for you to work yourself up .

[Wallywobbles]

All 3 of our DDs had BO by 7. Youngest got her periods at 9/10. Stopped growing by 12. She is very small but genetically from a very small family.

Others got periods at 12 and 13 I think.

Most children won't get periods until they are 50kg and we have found that to be true.

[Clymene]

I would follow the advice you've had from GOSH and leave your daughter to develop normally. Her development is within normal bounds.

[EasterEggBelly]

In the circumstances you describe I would not give her any medication.

[MumUndone]

I got my period at 9 and stopped growing at 12. I'm 5'5. I think your daughter's development is within the normal range and you'd be mad to treat with puberty blockers!

[IHateCoronavirus]

My Dd had hair under her arms at 8/9 now at 11/12 she is just starting to get breast buds.

My friends’ Dds were of a similar age although their breast development has started a little earlier than DD’s. I wouldn’t say it was that unusual op. Follow your gut.

[chipsndippy]

I know several females who had the body odour and some underarm hair at 8. None of them went on to get their period any earlier than normal, or developed any quicker apart from that. None of them had medical intervention either.

[Sceptre86]

I has some armpit hair at that age, started periods at 10 and had smallish breaststroke by then too. I stopped growing at 12 and am 5ft 3in
The height doesn't bother me and didn't then, the periods did.

[Sceptre86]

*smallish breasts by then

[rainingdogs1977]

Hi , I could have written your original post . My daughter is 9 and has been diagnosed with exactly the same around the age of 8. No treatment required . Shes is 98th percentile for height as my husband is tall. She does have breast buds now .

I know it's a worry but I was told that it wasn't early puberty and her periods won't come any earlier than normal .

[daftoldbat]

@stayinghere .I was told (UK) that it,s not precocious puberty unless the menarche occurs before 8. Ours was a "long burn". Hairy and stinky and spotty at 7.several considerable growth spurts. Menarche at 12.6. I understand ethnicity has a part to play in what's considered normal time range for puberty.

[StayingHere]

Wow so many helpful responses, thank you. I agree with whoever said the Asian doctor put the spooks in me is right, because he gave me a horror story about her bone age advancing even more and her starting her period any minute now. But that was a year ago and shes barely changed.
I find it hard being under an insurance system because whatever you do you get medication whether you need it or not so it's hard to figure out when its needed. I am glad I consulted with the lovely doctor at GOSH and I am sure DD will develop at the rate she is meant to over the next few years. And anecdotal or not the stories are reassuring!

[Cccc1111]

Pubic hair from age 2. Then periods started at 16. But no lasting problems from the precocious puberty, I’m 5ft8, fertility ok managed to have a child. I had it early 80’s when they knew so much less about it, the uk dr’s are much more clued up on it now. And like someone said above, only problems it caused me were bullying in the communal changing room on swimming day at school.

[RosesAndHellebores]

Sounds just like my dd who is now 22. Periods at 10.5, always one of the tallest throughout primary school. Stopped growing at 12. She's only 5'3" but I am extraordinarily tall for my side of the family at 5'7".

I'd say do nothing.

[katiedidnt]

What's her ethnicity?

I think 8 is perfectly normal for a white British girl, especially if she's on the chubby side.

Race, weight and family history all come into play here. Depending on which Asian country you're in, your child may just be an exception to the norm based on having a minority background. Doesn't make it alarming.

[mogtheexcellent]

Dd 6 has just had her 2nd injection. Her only signs were breast buds. My understanding is once breasts start to bud it is entering full puberty and once periods come adult height has been reached.

DD is not nearly adult height. Bone age is 7 yrs 11 months but she is still so young so we decided to do the injections. These will probably be until she is 8.5 or 9.

In your daughters situation I probably wouldn't treat with drugs.

[StayingHere]

@katiedidnt yeah shes Caucasian. 91st centil height and just above 50 weight, same since birth!

@mogtheexcellent sounds absolutely right in your DDs case hope the treatment all goes smoothly

[tentimesaday]

My DD developed adult body odor and some underarm hair at age 7. Did not get periods until 13! Leave her be.

[ihearttc]

I has body hair and breasts at 9-10, I started my periods at 11. I stopped growing then and only reached 4ft 10 however my mum and my grandmother are also short so I was never going to be massive. Even at my short height I can do anything everyone else can (apart from reach shelves in supermarkets!). I’ve also produced a 6ft 1 16 year old!

Just to say to the poster who said that hospitals can be scary and traumatic places for children, I think that is a load of rubbish. The only reason children feel like that is if the parents show their concern and worry. My youngest DS has had countless consultations, procedures and operations including ones at GOSH and has never or will never be upset or traumatised by the experience. In fact he thinks it’s fun because I’ve never made a fuss about it.