“Puberty is consider delayed (delayed puberty) if it hasn't occurred by the age of 13 years in girls and 14 years in boys.”

When my daughter was 14 years old I started asking her birth relatives how old they were when they went through puberty. Most of them answered between eleven and thirteen. Her two sisters were both fully developed by the time they turned thirteen years old. At age 14 she had absolutely no signs that her body was going to go into spontaneous puberty.

She was already seeing a pediatric endocrinologist for her growth hormone. Actually he had been asking her every 90 days for the past five years if she had any signs of puberty or any tenderness in her breast. I could tell that she was both embarrassed and annoyed by the consistency of his probing questions. For some reasons, known only to her, she was opposed to the testing that the doctor recommended.

Finally, just a few months before her sixteenth birthday, she agreed to a day of testing in the hospital to see if her body produced any hormones to cause puberty. She and I packed up our drinks, snacks, and a good book to read, prepared to spend the day. I’m not a doctor so I can’t really explain the test, but the bill from the hospital included; FSH, LH Luteinizing Hormone, Estradiol, and Leuprolide ACET. I know that some of the injections were a little painful for her, not really the shot itself, but the medicine that was coursing through her veins.

The results of the testing proved what we already knew. Her body wasn’t going to produce any female hormones. She began taking Premarin, I believe she took that for about a year, and she stopped taking growth hormone so her bones could fuse. We began to see only the slightest changes in her body’s composition. So then she switched to Vivelle Patch and added progesterone. I don’t know if there is any correlation but she also had to begin taking Synthroid around this time too.

The main goal of the Endocrinologist at this point was to force her body to have a menses. He said that her body needed to have four menses a year to build her bone density up for life and ward off osteoporosis. Well her body didn’t want to cooperate. I had a suggestion and we tried it and it finally worked. A women’s body doesn’t have even amounts of Estrogen throughout the month, so why should the supplement be even. Finally to achieve a menses she had to use 1.5 of the Vivelle patch for a week, and then cut back to 1.0 for two weeks, then the .5 for a week. It wasn’t exactly the recommended way of dosing, but it worked every time and nothing else would.

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