Precocious puberty - what would you do?

[ThrowawayALotta]

DD9 has been diagnosed with precocious puberty and we've been told to go away and consider Decapeptyl injections to delay her period for a while.

The trouble is her consultant is pretty on the fence and keeps saying its up to us. I prefer to be guided by experts so I'm finding it incredibly difficult and frustrating that I have to make this judgement without the doctor being any help at all!

Her current status is: minor pubic hair, breast buds, no periods. First signs of hair growth age 7 but due to covid we werent seen until she was 8, she's just turned 9.

The doc measured her and said her growth is borderline, they allow for 5-8cm in the normal range (presumably per year) and she has grown 8.5cm so only just over normal.

We have been told she might want the injections to gain more height, her projected final height is 160-170cm so not overly short in my opinion. The doc also said to consider the psychosocial aspects of starting periods early without really giving me much insight into what those might be.

The side effects of the drug are particularly worrying, with depression being considered common (1 in 10). She already has a depressive tendency, with lockdown causing a severe bout for many months and she is still anxious to this day.

On the other hand it doesn't sound easy to be the only girl with boobs, the only one to deal with periods and acne etc. I worry about bullying and sexual interest from older boys etc.

If you've been in this position, what did you do? Do you regret your choice in the end?

Agree with looking at the new tests.

I would also involve the school, I know that might seem like sharing something that is quite private but the school can support her better if they know.

I would have thought that 9 was the earlier side of the normal range?

It's under 8 that's considered young. 8+ is within normal range.

When did breast development start as thats the main indicator of puberty starting? Periods may not start for a couple of years after breast buds.

My DD started her periods at primary school, but it was towards the end of yr6.
You would need to talk to the school as they're not really set up with the expectation of menstruating girls, although I am sure that the teachers will be able to help.
Rather than pads, look into period pants - super easy to use. It might make dealing with the reality of periods at school easier.
I guess the reason for considering height is that there is a growth window once puberty starts and she won't grow much after that, I think it's something like 4-5 years.
You can also get swimsuits like period pants as otherwise things like swimming lessons will need thinking about. Periods do complicate certain activities - maybe being much earlier than your peers is one of the social/psychological aspects.

Periods at nine are unusual but not abnormal. She is NOT early. Think of it as puberty starts somewhere between 8-13 and for girls the average age is 11, but itnis known that this is getting younger as human health improves, and there will be outliers. She is just at one end of the scale.

I have personally seen too much of the NHS’ incompetence to ever let my child have treatment, especially drugs, unless it was overwhelmingly clear that it was medically necessary.

Three girls in DD’s class (yr 4) have breast buds (I only know because their mums told me.) The boys are all getting suddenly hairier too. Hormones shift a lot in yr 4. Maybe keep an eye on her diet and eg shift to organic milk in case she is getting too much hormones in cow milk. But probably she is fine.

Worries about possible future bullying / interest from older boys would not be something I would take into account or think about at all, and if an older boy showed interest in my 8 yr old DD you can bet I would address that ferociously. Limit your decision to medical facts and be aware that quite often the NHS talks nonsense.

OPs dd hasn't started her periods yet though so even more reason not to intervene with injections

9 isn't young, 8-18 is normal range!

I had a friend at school who was 8 and by year 6 several girls in my year had to change in the toilets because they wore bras

Btw my dd is 5'2 and started her periods just before she turned 16 - height is not determined by how late they start otherwise she would be a giant! Her sister was nearly 15

I started my periods at 9, well first one then regular by 10
I'm 5ft 10

I understand that your doctor doesn’t think that there’s much point, but you look at your daughter and see a little girl. Right? It sounds like he’s seeing symptoms. If she stops growing soon, and developing the body of a woman, what will YOU see?
I had my first period at 9. With that came all the emotional crap that nobody is ready for when they’re a teenager. The fact that I had no idea what periods were didn’t help, so I was convinced I had cancer and was dying. My mum assumed that it was a one-off, so just minimised it, and bought me panty liners (useless, as I had tsunami periods from the word go), and of course, I kept having periods at least every months. So… I wasn’t emotionally ready, psychologically ready, and then of cours socially - that was fun too. Nobody was getting periods and I was leaking all over my uniform, sneaking pads out of my schoolbag (primary school didn’t have sanitary waste disposal then.), having to ask for pads, passing out in class, the shame, pimples, being teased about my boobs, being the first to need a bra, etc…

Physically - I stopped growing early. I had been on a trajectory to be quite tall. I stopped at 5ft. I have musculoskeletal deformities. My clavicles are too short which means that I appear to be very round-shouldered and my shoulder blades rub painfully against my rib cage. (Excrutiating shoulder pain is a common symptom of precocious puberty in girls, and this is why.) I have had several surgeries to try and alleviate this pain. None have been successful. I can honestly say I would rather have another c-section than have shoulder surgery again. I have severe osteoarthritis in many of my joints, and have had since my teens.

@dementedpixie

9 isn't young. Not sure I'd do any sort of intervention at that age.

I agree, 9 is completely within the normal range.

Periods at nine are unusual but not abnormal. She is NOT early. Think of it as puberty starts somewhere between 8-13 and for girls the average age is 11, but itnis known that this is getting younger as human health improves, and there will be outliers. She is just at one end of the scale

Really good post.

@gogohm

Btw my dd is 5'2 and started her periods just before she turned 16 - height is not determined by how late they start otherwise she would be a giant! Her sister was nearly 15

@gogohm Out of interest were you quite late too? Wondering about the genetic component.

@Justilou1

I understand that your doctor doesn’t think that there’s much point, but you look at your daughter and see a little girl. Right? It sounds like he’s seeing symptoms. If she stops growing soon, and developing the body of a woman, what will YOU see? I had my first period at 9. With that came all the emotional crap that nobody is ready for when they’re a teenager. The fact that I had no idea what periods were didn’t help, so I was convinced I had cancer and was dying. My mum assumed that it was a one-off, so just minimised it, and bought me panty liners (useless, as I had tsunami periods from the word go), and of course, I kept having periods at least every months. So… I wasn’t emotionally ready, psychologically ready, and then of cours socially - that was fun too. Nobody was getting periods and I was leaking all over my uniform, sneaking pads out of my schoolbag (primary school didn’t have sanitary waste disposal then.), having to ask for pads, passing out in class, the shame, pimples, being teased about my boobs, being the first to need a bra, etc… Physically - I stopped growing early. I had been on a trajectory to be quite tall. I stopped at 5ft. I have musculoskeletal deformities. My clavicles are too short which means that I appear to be very round-shouldered and my shoulder blades rub painfully against my rib cage. (Excrutiating shoulder pain is a common symptom of precocious puberty in girls, and this is why.) I have had several surgeries to try and alleviate this pain. None have been successful. I can honestly say I would rather have another c-section than have shoulder surgery again. I have severe osteoarthritis in many of my joints, and have had since my teens.

It was probably much rarer when you were 9 though. Now loads of girls in primary aged 9 have breasts and pimples. Even my beanpole dd started developing at 10, had a spotty forehead and body odour she was one of the later ones. I know of a couple who started their periods in p6 (yr 5) and im sure there are others I don't know about.

Height can be limited by starting early though.
My DD is several inches shorter than me, has always eaten a good diet and I suspect isn't going to grow much more. She's not tiny but is slightly shorter than average.

Fwiw the girl who started first in DD1's year is now taller than me (and I'm 5'8)

I'm surprised they have even suggested any intervention at the age of nine. It is on the young side but I wouldn't have any injections or medication.

I’m surprised it has been recommended at 9. I wouldn’t, her projected height seems normal. Both my dd’s had breast buds at 9 and one had body hair. One started periods in primary school.

She doesn’t sound much ahead of normal development to me? I think I would leave it if it were me.

My dd who started periods in primary is really tall! Her growth did slow down after starting periods though, it didn’t stop.

I wouldn't give my dc9 injections. I don't think it's that unusual tbh to start puberty at 8 or 9. My dc had pubic and underarm hair at 8. She is 9- 10 in a few months and has been using hair removing cream on her underarms for 6 months. This is her choice, she swims competitively and this was bothering her. From
talking to her friends parents they are also in the early stages of puberty.

Completely agree with those saying refuse injections, focus on whole foods plant based diet and general health - hormone disruption is often a sign of gut dysbiosis (increasingly common, but different people suffer different symptoms). Avoid all seed oils.

A quick search reveals some negative social findings associated with early menarche.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3743290/
I’m from Canada with an average age of menarche being a tiny bit later than the UK with the average 12.9 years vs 12.7.
Family history for me is late starters both my mother, myself and dd 16+.
I’d advocate for a much later start than 9.

I started my period at 9. Im 5’9.

Just because she has hair and breast buds doesn’t necessarily mean her period is imminent either. Dd has had both for at least 18 months/2 years and still no actual period.

@Skysblue

Periods at nine are unusual but not abnormal. She is NOT early. Think of it as puberty starts somewhere between 8-13 and for girls the average age is 11, but itnis known that this is getting younger as human health improves, and there will be outliers. She is just at one end of the scale.

I have personally seen too much of the NHS’ incompetence to ever let my child have treatment, especially drugs, unless it was overwhelmingly clear that it was medically necessary.

Three girls in DD’s class (yr 4) have breast buds (I only know because their mums told me.) The boys are all getting suddenly hairier too. Hormones shift a lot in yr 4. Maybe keep an eye on her diet and eg shift to organic milk in case she is getting too much hormones in cow milk. But probably she is fine.

Worries about possible future bullying / interest from older boys would not be something I would take into account or think about at all, and if an older boy showed interest in my 8 yr old DD you can bet I would address that ferociously. Limit your decision to medical facts and be aware that quite often the NHS talks nonsense.

British milk doesn’t contain artificial hormones but milk in other countries (esp the us) does so organic vs non organic milk won’t make a difference.

@fallfallfall

A quick search reveals some negative social findings associated with early menarche. www.ncbi.nlm.nih.gov/pmc/articles/PMC3743290/ I’m from Canada with an average age of menarche being a tiny bit later than the UK with the average 12.9 years vs 12.7. Family history for me is late starters both my mother, myself and dd 16+. I’d advocate for a much later start than 9.

That doesn't seem to cover the U.K. I don't drink, have a degree and didn't have sex until 16 But it's fine saying push it back but then you have to look at issues that might cause. Mine couldn't be pushed back because I just suddenly started my periods, and my mum started at 10 so 9 wasn't out the norm