Delayed puberty treatment

[EatforEngland]

DS will be 15 in a few weeks and has been diagnosed with delayed puberty after lots of investigations. He has been prescribed testosterone injections of Sustanon 250 and had the first one today. Does anyone have experience of this and can tell me how long it will take to see/feel changes? The second reason I'm posting is because there is very little information online about getting a diagnosis/what's involved - I spent hours Googling without a great deal of success and I thought it might help other people. If anyone has any questions about it feel free to ask!

My son had testosterone injections for this reason and at this age. He was on them for about a year, by which time they had kick-started puberty. He was really keen to have the injections because he felt so self-conscious about looking young for his age. The treatment didn't have any negative side effects and I think it worked quite quickly. The first thing we noticed was that his voice broke, which really cheered him up. He also started to get taller.

Nearly three years on, he still looks younger than he is (he is 17, going on 18, but looks about 15), but at least he is going through puberty now and he'll catch up with his peers in time.

I hope everything goes well for your son.

Hi i’m in your situation from a few years ago. would you mind telling me how long it took for your son to start changing?

@HeikeMum - it's difficult to remember now, but I think he started changing within a few months of starting the monthly jabs. There were no side effects and he was relieved to be catching up with his peers.

(I realise you may have been directing your question at the OP, but thought I'd reply anyway in case it helps).

Thanks @Toffeewhirl. My son has had a course of 6 injections. Some changes but no great increase in height yet (but luckily he’s not much shorter than his peers as both his Dad and I are fairly tall. Most importantly (for him) his voice hasn’t broken. There is so little information online and we have to wait a good few months for the endocrinologist follow up. My son is so miserable about it… he’s not being bullied but he’s had enough comments from teachers as well as pupils to make him feel pretty rubbish. We’re pretty late starting hormone treatment (he’s now 15 1/2), when i first took him to the GP when he was 14 the GP said there’s nothing you can do about it, I heard from a friend about the sustanon injections, saw another GP and he was referred to an endocrinologist who told me off for waiting so long!

It was 5 years ago now so I can't be certain, but I think his voice broke relatively quickly (maybe 3 or 4 months). He did grow taller, but we had been warned that the injections wouldn't increase the height he would have naturally achieved without the injections and men in our family tend to be short. He's now 20 and 5ft 9, which he's been since around a year after starting treatment. Hope that helps!

@HeikeMum - your poor son. You were unlucky with that first GP - he/she should have known better.

I can't remember how soon after starting the injections that my son's voice broke, I'm afraid. He had a year of monthly injections and by the end of that year puberty was well underway and the injections were deemed unnecessary. I would expect your son's voice to start breaking fairly soon, as he's done several months of injections already.

Does the endocrinologist have a secretary you can contact? You might be able to get an answer to your concerns that way.

The teachers who've commented on your son's late puberty should be ashamed of themselves.

it does thanks so much for your replies @Toffeewhirl and @EatforEngland it does help to know other people have been through it… quite agree the teachers that mention it are horrible but i guess if you go through puberty at the ‘normal’ time you just don’t realise that it’s no joke!
Fingers crossed it all works soon!

@HeikeMum - do come back and update. Hope things improve very soon.

Weird - I can't seen any posts from teachers.... maybe they removed them 🤔

@HeikeMum @Toffeewhirl sorry, just re-read the post and see it was the teachers commenting in class, not on this thread 🙈 The first endocrinologist (NHS) we saw was very dismissive so we paid for a private appt in the end and the new lady we saw was horrified that we hadn't been taken seriously and said the potential effects on mental health most certainly warrant treatment, so there is no doubt you did/are doing the right thing.

I'm worried my son is going to have a late puberty also. He is 10 but small and looks younger and is only just lost 4 baby teeth. my brother also went through a very late puberty he's now early 50s so it was back in the 80s and he was offered hormone treatment but our parents refused as were told he could have a higher risk of cancer etc. This was back in the 80s though so things have moved on and improved since then.
My brother had an horrendous time with bullying at school as a result of still looking like a little boy at 15 even at 18 his voice hadn't yet broke and he looked so strange and like a little boy driving a car sitting on cushions when he passed his driving test at 18. He got through puberty eventually but it as a tough time for him looking like the little boy next to his 6ft strapping school friends. I'm hoping my son doesn't suffer the same but glad to hear there is help for boys now. isn't it funny how you never here of girls having late puberty?

@99redballoonsgobyy - definitely see the GP if your son isn't showing signs of puberty by 14 as it will take time for any appointment to come through. I would suggest earlier, but I'm not sure a GP would refer before then. Although you might be able to persuade them if you provide the family history of late puberty.

Appointments with an endocrinologist will involve an intimate exam, which is obviously a bit embarrassing for a young boy. And then there's a monthly jab in the buttocks to deal with. But that's nothing compared to the embarrassment of being the only 'boy' left in your peer group. My son was able to be quite matter of fact about all this because he really wanted the end result and was so relieved when he started puberty.

@Toffeewhirl thank you. I think puberty changes or lack of are so much more noticeable for boys aswell when they small and still a high pitched voice it's hard to hide kind of less noticeable with girls, suppose I was also a slightly late developer in comparison with my peers not starting my periods whilst almost 15 where friends were all aged 11-12. Yes so I think there definitely is some family history. Other kids already comment that my son doesn't look like a 10 year old. if no signs by 13 I will see gp if my son wishes. the signs that he's not loosing milk teeth at the average rage is a sign that he will have a late puberty. According to his dentist tooth loss in kids coincides with their growth spurts. who knows maybe he'll surprise us and have one big growth spurt all of a sudden. I kind of like him being my cute little boy at the moment though! Glad things worked out for your son.

My brother and I both had fairly late puberty. I started my periods at 16. I was still growing after I left school, and didn’t have much body hair either until 18/19.
My mother had a late puberty, so wasn’t worried about me, but it seems it was more common in her age group anyway.
Brother grew to over six foot , just a bit later than his peers. No intervention but probably because he wasn’t quite as late as some of your ds already mentioned upthread. He was v small at 15, but started growing then, his voice broke at nearly 16, and like me he probably stopped growing at around 19.

This is interesting to read. DS is 14 1/2 and still showing zero signs of starting puberty. He is tiny compared to his peers in Year 10, no signs of any body hair, voice breaking or growth spurts. I am concerned and have considered going to the GP for a while. This thread has confirmed to me that we need to take him.

The reasons why we haven’t so far are:

• DH went through puberty very late himself. He thinks he was late 15/16 before he showed any signs
• DS has ADHD and is on medication. It is thought that children with ADHD can often be around 3 years behind developmentally so this could be a factor. He certainly is around 2/3 years behind in terms of mental and emotional maturity. DS’s ADHD consultant paediatrician has never suggested that we should get him checked out for delayed puberty.

DS isn’t being bullied and doesn’t seem hugely concerned although he does comment occasionally things like he wonders when he’s going to grow. I’m torn because part of me thinks that us taking him to the GP will make him think that there is something wrong with him when he doesn’t seem that worried currently. But then if there is a problem then obviously we want to know about it.

I didn’t realise that not starting puberty by 14 was definitely considered concerning and now I’m feeling like we have been remiss abd should have got DS checked out earlier.

@99redballoonsgobyy so sorry to hear your brother had such a hard time, and agree it’s such a non issue as a girl compared to boys. On my trawl through the internet looking for info I read an article by a professor of sports psychology on how it affected his self esteem well into adulthood.@Rollergirl11 @MrJi i would say see a GP sooner rather than later. It wasn’t such an issue for my son when I first contacted the GP and was then fobbed off. By the time I tried again 6 months later my son was one of two boys in year 10 whose voices hadn’t broken and by that time it really bothered him. It also takes so long to get seen by an NHS endocrinologist, meanwhile their confidence is plummeting. I’d say even if ADHD will ultimately delay puberty, if you know it in advance, you can come up with a plan with how you might deal with any issues…it’s difficult when you’re trying to be sensible and rational but you have a miserable kid to deal with at the same time.

I completely agree that any growth issue should be checked out, I wasn’t trying to dismiss anyone’s concerns so I hope it didn’t come across that way . I hoped to say something reassuring, in that later puberty can run in families, for any average there will be the ones at either end, and so it isn’t always a worry in terms of not catching up with peers. Brother and I are both taller than average and each taller than our same-sex parent by four inches.
I do think in terms of self esteem it perhaps has more of an impact on boys. I was the last of my friends by quite a way, but actually I felt happy about that. I feel that I had time to be a bit more mature emotionally before my periods started. I have never asked my db how he felt, it may well have been different for him. Boys might get teased more ? I wasn’t teased at all.
Also when I was a teenager it seemed not uncommon for boys at 14-15 to not have broken voices, but now that age does seem to have dropped, as with girls and periods. So perhaps more of a big deal for boys now ?

What signs of puberty should boys have at 14? Mine has just had his birthday and is smaller than his peers and hasn't had a growth spurt or broken his voice. I've not worried until reading this thread!

No history of adhd in my family but still a history of delayed puberty in our family so can still happen with or without additional but it is interesting to hear about the link do they know why adhd is likely to lead to delayed puberty?
Also we all tend to be very slim in our family so I think having a lower body weight doesn't trigger puberty as early my son is so skinny.
I'm sure I read once that overweight children, girls especially start puberty earlier.

that should've read adhd not additional, bloody autocorrect!

What specific tests did they do to confirm delayed puberty?

thanks

Ps my son is almost 14 and hasn't started puberty / no growth spurt

@Remmy123 - my son had stopped growing and wasn't showing any signs of puberty - no body hair, no breaking voice - so was referred to an endocrinologist. He had a blood test which looked at hormone levels and he also had a hand X-ray to assess his bone age. Then he had to have an examination by the consultant, poor boy.

Injections of testosterone kickstarted puberty and once it was underway the injections were stopped.

@Remmy123
Yes we’ve had the same experience. Blood tests to show the testosterone level (you never know things might be happening now naturally and a blood test might reassure you), but if the hormone levels are lower than average for age the boys have to have their testicles measured to see what stage of puberty they’re at (you can google it it’s called tanner stages of puberty)…. it’s mortifying, but worth it to get the injections.
Hopefully things will start happening naturally for you soon, it’s amazing how puberty seems to happen overnight for the majority of kids. But if he’s a bit behind in development it’s worth going to the GP. It’s my only regret, that I didn’t research it earlier, as if they need some help to kick start puberty the earlier the better!