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Teenagers

Parenting teenagers has its ups and downs. Get advice from Mumsnetters here.

Original poster

Constitutional growth delay DS 15

81 replies

Letshaveablackcelebration22 · 28/12/2022 08:51

DS 15 has just been diagnosed with late puberty with the option of testosterone treatment but we don’t know what to do. Consultant thinks wait for a few months as he’s showing some signs of testicular growth but genital are pre- pubescent. She wants to do genetic testing too. He has bone age 2 years younger.

We are quite concerned generally so wondering if anyone had any experience of it? He’s just 15 in november. Should we just opt for the testosterone now? He’s going to have blood tests in a few weeks

OP posts:
AwayFromTheNoise · 30/12/2022 10:31

@Remmy123 does your son tell you he’s upset or can you just tell he is?

From all the replies to the OP I’ve decided to try and book the soonest GP appointment for a general checkup

Original poster
Letshaveablackcelebration22 · 30/12/2022 13:33

The consultant said to us that because DS had some testicular growth, it meant something was happening but that’s it. I have decided to contact her next week and explore starting the testosterone I think as it’s making him literally miserable. He’s having tests for hormone levels in 3 weeks & genetic tests too so we will know more then.

His bone scan was that of a 13 year old and his hormone function tests were normal

OP posts:
Original poster
Letshaveablackcelebration22 · 30/12/2022 13:34

@AwayFromTheNoise It can take up to a year for endocrinology referrals so worth getting him in the system now tbh

OP posts:
Remmy123 · 30/12/2022 15:11

@AwayFromTheNoise we noticed and he bought it up many occasions himself

we went private to see a endocrinologist who said things may happen in the summer but they didn't! His mates came over the other day and there is a big difference .. more height than looks

nolongersurprised · 31/12/2022 02:21

It’s a normal growth variant, 95% of boys have some pubertal development by 14, which means that 5% of healthy boys don’t.

The delayed bone age is good, because it means their bones will “catch up” with their growth. It definitely runs in families.

Boys grow a certain amount per year from growth (and other) hormones but their huge spurt kicks in once they start making testosterone, growth plates fuse once testosterone levels are high. The increase in testicular volume is the first sign, that means testosterone is being made and the other signs of puberty follow.

Unless it isnt just constitutional delay, puberty will happen and growth will occur later but until an older age than peers. They are the boys who are tiny at 14/15 but still growing until much later teens. There do need to be tests to make sure there’s not an underlying hormonal or medical issue.

The risk of giving exogenous testosterone is that final height may be impacted (growth plates fusing too early) with this weighted against the social impact of later puberty.

123woop · 31/12/2022 02:26

Didn't want to read and run as I know how tough this can be. I had two friends who went through this themselves as teenagers and going to the doctors etc was really mortifying for them and made it into a "thing" though I understand now why their parents did it and were concerned. Both refused treatment and one is now a strapping 6'3" guy who had an enormous growth spurt at 18, and the other is now a perfectly average 5'4" girl - both were just slow to grow! Hope this puts your mind at ease X

hopeishere · 31/12/2022 09:21

That's really helpful @nolongersurprised.

gogohmm · 31/12/2022 09:28

It's within normal range! 16 is the upper age to start, yes its concerning (I have DD's and dd2 was 16 for her first period, an outlier these days but still normal) and do see the gp after about 25 for reassurance but I wouldn't consider medication unless beyond the normal range. My dd had been referred to gynae at 16 but started before the appointment (3 months later)

Appletreefarmyard · 31/12/2022 09:42

I suggest you talk to the specialists about your confusion/ doubts . They deal with this day in and day out. They can discuss and explain the risks/benefits of treatment versus 'watchful waiting'.

Namechangedfortodayspost · 03/01/2023 11:17

This is really interesting, as I have a 12 yr DS who is very small and slight compared to peers. Actually, he has a lot of small boy friends but he's still smaller than the smallest.

DS was a late developer. Doesn't know when and parents also can't remember (!), but late. He's 5ft 8 now, which is respectable etc

But my question is about testosterone. If that is the only option, but it can cap height at a small height, what's the benefit of taking it?

I feel so worried that my son is on a difficult path, or what if there are other issues? DH reluctant to shine any light on it (i.e. take him to doctor) as he doesn't want to make a thing about it or make DS feel something is wrong. I get all of that, but of course underlying fears make me want to check

Startoftheyear2023 · 03/01/2023 11:27

My son entered puberty late and was much smaller than his peers aged15/16. He had testosterone for a few months and puberty started. He had the bone scan so we knew his bone age was young.
He was pleased to have a chance to do something proactive. No idea if it helped but he's now 5'7"/5'8" and it's a total non issue.

Namechangedfortodayspost · 03/01/2023 12:02

Startoftheyear2023 · 03/01/2023 11:27

My son entered puberty late and was much smaller than his peers aged15/16. He had testosterone for a few months and puberty started. He had the bone scan so we knew his bone age was young.
He was pleased to have a chance to do something proactive. No idea if it helped but he's now 5'7"/5'8" and it's a total non issue.

This is encouraging, thanks. What age did he have testosterone?

hopeishere · 03/01/2023 12:45

Startoftheyear2023 · 03/01/2023 11:27

My son entered puberty late and was much smaller than his peers aged15/16. He had testosterone for a few months and puberty started. He had the bone scan so we knew his bone age was young.
He was pleased to have a chance to do something proactive. No idea if it helped but he's now 5'7"/5'8" and it's a total non issue.

Does the testosterone "cap" his growth though?

nolongersurprised · 03/01/2023 22:21

Namechangedfortodayspost · 03/01/2023 11:17

This is really interesting, as I have a 12 yr DS who is very small and slight compared to peers. Actually, he has a lot of small boy friends but he's still smaller than the smallest.

DS was a late developer. Doesn't know when and parents also can't remember (!), but late. He's 5ft 8 now, which is respectable etc

But my question is about testosterone. If that is the only option, but it can cap height at a small height, what's the benefit of taking it?

I feel so worried that my son is on a difficult path, or what if there are other issues? DH reluctant to shine any light on it (i.e. take him to doctor) as he doesn't want to make a thing about it or make DS feel something is wrong. I get all of that, but of course underlying fears make me want to check

Where I live in Australia no one would do anything at 12, with the local guidelines being that of lack of puberty at 15 years, with a bone age at least 2 years behind. And social distress, obviously.

Assuming no medical issues including undiagnosed coeliac disease a major predictor of growth and timing of puberty is family history.

i think a child who is smaller than they “should” be, based on genetics and family growth patterns should be checked out. Undiagnosed coeliac disease can result in growth failure with only around 40% of children having obvious symptoms.

However, if a boy’s dad and two paternal uncles were small, started puberty at 14-15 and grew till 18-19 years then that’s more suggestive of a (normal) familial growth pattern.

nolongersurprised · 03/01/2023 22:28

Local information booklet

Here is our local booklet, for parents, about delayed puberty, including the bit on Constitutional Delay. It just states that care needs to be taken to ensure that exogenous testosterone doesn’t accelerate the bone age (this will reduce final height).

Original poster
Letshaveablackcelebration22 · 04/01/2023 06:13

@nolongersurprised that’s a very useful and interesting booklet- thanks for sharing

OP posts:
BabyST · 08/01/2023 21:30

@Letshaveablackcelebration22 I have popped you a long message. I have been thought this with my son aged 14/5-15 now 21. Happy to answer any potential questions you've got

Remmy123 · 09/01/2023 10:50

Why wouid the testosterone injections cap height?

the consultant said no risk of them etc so wondering if that is fact?

My 11 year old now has undrrhair growth but my 14 year old has nothing! I was going to contact the consultant to start injections but I'm still hanging out for it to happen without intervention.

BabyST · 09/01/2023 12:10

There’s lots of risks with testosterone treatments one of which can cause cardiovascular problems as it can cause the blood to thicken. Also increases possible cancer cells. For my son we have decided not to go for it

Remmy123 · 09/01/2023 12:29

@BabyST thanks - how do you know this? Did the consultant go though side effects with you or google?

the consultant I spoke to didn't say any of this as it's such a minimal amount but I'd rather know.

BabyST · 09/01/2023 17:51

Yes the consultant went though it as my dad has cardiovascular issues so we don’t want to increase the risks. I am also medical so I have access to more than just google and have also looked at research papers behind this

hopeishere · 09/01/2023 18:11

We actually had another (private) appointment today. My son has grown 3cm but apparently the velocity has dropped even lower. So he had blood tests and we await the results of those. He also looked at his armpits and measured his testicles.

Crazycrazylady · 09/01/2023 18:53

Regardless of what treatment people decide to pursue or not. It's always worth checking these things out. It is very rare that there is a actual problem but in in the event there is , it's always better to address it at an earlier stage.
The vast majority of these boys develop on their own according to their genetic makeup albeit later than the average but I always think a full check up is reassuring to both the teen and their parents.
My niece had this abs decided to pursue hormone injections but she was one of the unlucky ones that had an issue . She still won't be tall at 5ft but she's dainty all over and it suits her and the treatment gave us a couple of all important inches .

Winewednesday · 09/01/2023 19:16

My son is 14 and in the same position. He has seen endocrine and has had growth hormone tests but they have come back "normal" He is really struggling being mich Aller than his peers. They checked his testicular size and said he was pre puberty growth stage. No hair, and no body odour. He is 141cm. His consultant has said that there is no growth hormone disorder and therefore will discharge him from the outpatient clinic. The consultant hasn't mentioned testosterone so I think I will mention this to her. Not sure what else to do at this stage.

hopeishere · 09/01/2023 19:24

@Winewednesday are they basically saying it will kick in at some point?