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Need advice on late puberty.

1701 Views 7 Replies 6 Participants Last post by  mamaverdi
DS will be 13 in 6 weeks, and he has not started puberty yet. Currently he is scheduled to start testosterone shots the day after he turns 13.

This past January we had him taken in for a full physical, and they did blood work, bone x ray, and a testicular ultrasound on him. When the results came back his chronological bone age was 9-10, and that there was no signs of puberty (no pubic hair, no testicular enlargement) or significant traces of growth hormones, his previous doctor recommended that he have the same battery of tests done in 1 year (Jan 07) and make a suggestion from there. They said the ultrasound showed his testicles to be approximately 1.1ml in volume, but healthy. He is 5' and 100lbs. He is petrified about starting high school in the fall of 2007 without having pubic hair, so I had him taken to another doctor that I know personally, who gave him a physical examination and looked over the old lab results. Both doctors said he has the approximate sexual development of a 6-7 year old. She recommended that he start a light testosterone therapy starting when he turned 13. I agreed with this and convinced the DH to agree, now we are setup with an appointment to do so.

DH is uncomfortable with this and wants to wait until DS is 14 to start any therapy. I am wondering what other people here think about it, and what we should expect if we continue on our course that we have laid out. DS will be 14 and 3 month when he starts HS, he currently claims that over 75% of the kids in his current grade (7th) have pubic hair (because they have to shower after PE), and his elder friend who is in 8th grade says that there is only 1 other boy who does not have pubic hair, so DS is worried that he will be picked on and made fun of because of his maturity. He already has been twice this school year.

His new doctor says that it is unlikely that he will develop fast enough on the hormone therapy to see pubic hair by the time he reaches high school regardless, he has 5-6 years of catching up to do by her estimation, but feels that the therapy will help him emotionally as much, or more than as helping him physically catch up as the dosage she is willing to give him is very small.

My questions then is..
What have other people experienced with this?
Could I ask his doctor to give him an even lower dosage so that he keeps the emotional benefits?
Should we _insist_ that he waits until he is 14 like his father says, even after making the appointments?
Should we ask that he receive the full treatment so that he catches up quickly and advances into puberty quickly?

Other background:
I started puberty about 11, and my husband says he started at 11 also. My husband knows that his younger brother at 12, had started puberty.
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Interesting! I didn't realize the puberty schedule was that early for boys.

Off to read up on it.
I know next to nothing about growth hormone deficiencies (which is what it sounds like your DS has) But if he were my Son, I would be taking him to a specialist that deals with endocrine issues such as this.

I would also be talking to the school about the showers in gym rule (I always thought it was ridiculous in highschool that the boys were required to shower after PE as part of their grade but the girls were not)

Do whatever you think would be helpful for your DS's transition to Highschool
Quote:

Originally Posted by ombra*luna
Interesting! I didn't realize the puberty schedule was that early for boys.

Off to read up on it.
Pubic hair is not the first signs of puberty remember, that comes 6 months to a year or latter after the first signs.
I am not (obviously) a male person, but I just wanted to share my experience. I was a very late bloomer. I was short in stature, very thin, and athletic. I did not start to develop breasts until age 14 and even then not very much. I didn't get pubic hair until age 15 and I started menses at age 15.5. I was very close to being put on the pill to jump start my period. Today I am a very healthy person who has had two children. When I was winning races in high school by a large margin I was accused of being a boy. Nope, not a boy! lol! Just a late blooming girl. I still have small breasts. I didn't get my womanly figure until I had my second baby (yeah! Finally have some hips!). But I'm healthy.

Some people are just late bloomers. I would not let social stigma play a part in your decisions one way or another. Some people just develop on their own schedule. If he does have some legitimate hormone issues going on, what are the risks or benefits of waiting to start treatment in a year instead of now? If puberty is delayed another year will it effect his long-term fertility or development into a man?

I know there are risks and side effects of having too much testosterone. I'm sure the doctors will monitor that carefully in his case, but will the test it often? If he starts to make his own testosterone, will they know that and cut back on the injections?

My dh, whom I met when he was 22, had very little pubic hair even at that age. He is now 34 and has a fair amount. I would not let pubic hair be the only determining factor here.


((HUGS)) It sounds like a very difficult situation to be in as a mother. Good luck with your decision.
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Quote:

Originally Posted by USAmma
I know there are risks and side effects of having too much testosterone. I'm sure the doctors will monitor that carefully in his case, but will the test it often? If he starts to make his own testosterone, will they know that and cut back on the injections?
He currently is scheduled to have a short physical examination once a month and have 2 shots per month. He will also have a small sample of blood work taken each month.

Quote:

Originally Posted by USAmma

My dh, whom I met when he was 22, had very little pubic hair even at that age. He is now 34 and has a fair amount. I would not let pubic hair be the only determining factor here.


((HUGS)) It sounds like a very difficult situation to be in as a mother. Good luck with your decision.
We are not looking at pubic hair alone, his testicles have not started to develop past that of a 5-6 year olds. _THAT_ is the problem that I see. When he let me look at him, and when i watched the doctor examine him it was clear that the issue was not just 'pubic hair', while that is 'his' concern because that is what he sees.
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IMO toying with hormones gets scary. I wouldn't even consider it unless at least 3 drs. all agreed that it was the best course of action and could explain why and show me the research to back it up.

-Angela
He needs to see an Endocrinologist. And then another and another. I would not let a general ped/doc take care of this. At all. At all. At all. Did I mention, at all.

mv
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