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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Delayed Puberty

hi, im a 13 year old girl who hasnt started her period or got any boobs. i have trouble with my waterworks since i was 8 and still wet the bed and get continuous water infections. i am referred to Birmingham childrens hospital and they arent doing much. i feel like i dont have anyone to talk to and it really uopsets me because my 3 sisters dont listen and dont like me. my parents dont really understand and i dont feel like i can talk to friends about this. it really upsets me
Thu, 9 Jun 2016
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Endocrinologist,  's  Response
Hello,
I have gone through your querries.
If you have not started developing breasts (thelarche) by this age , then you need to get evaluated for your delayed puberty.
You can get FSH/LH done 4 hrs after a tryptorelin injection (tryptorelin stiumlation test) and if it is more than 4 IU/L , it is more suggestive of constitutional delay in growth and puberty (CDGP). (we would like to know whether you are tall or short compared to your peers)
A bone age (x ray of wrist) help you in assessing your growth. If it tallies with your height age (mean age according to height which is measured by plotting your height on a growth chart)
if it is CDGP, we can consider low dose estradiol to trigger the puberty
Kindly discuss the matter with your treating endocrinologist and get more clarity regarding the present situation. Give us more details so that we shall help you further.
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Suggest Treatment For Delayed Puberty

Hello, I have gone through your querries. If you have not started developing breasts (thelarche) by this age , then you need to get evaluated for your delayed puberty. You can get FSH/LH done 4 hrs after a tryptorelin injection (tryptorelin stiumlation test) and if it is more than 4 IU/L , it is more suggestive of constitutional delay in growth and puberty (CDGP). (we would like to know whether you are tall or short compared to your peers) A bone age (x ray of wrist) help you in assessing your growth. If it tallies with your height age (mean age according to height which is measured by plotting your height on a growth chart) if it is CDGP, we can consider low dose estradiol to trigger the puberty Kindly discuss the matter with your treating endocrinologist and get more clarity regarding the present situation. Give us more details so that we shall help you further.