Early Puberty?

Our daughter, who just turned 8, has a significant amount of hair growth under each arm (along with BO).  I noticed the start of hair growth 2 years ago.  One year ago, at her last annual physical, her pediatrician took notice and ordered a thyroid test, and an x-ray of her hand.  Both results came back within normal limits.  We are going back to her pediatrician for her annual physical in 2 weeks, and I would like to know if I should ask for additional tests, if any, are necessary.  Maybe a visit to an endocrinologist is in order?  She does not show any other obvious signs of puberty.  Also, her paternal grandmother got her period when she was age 11, and was short in stature, which leads me to believe she reached puberty at a very young age.  My other concerns are for the control of the obvious BO.  Would an anti-perspirant be in order, or should I stick to just deoderant.  I am also considering laser hair removal for her, as she is becoming sensative to this issue, and I think she is too young to be concerned about shaving.  Would the laser hair removal be safe for a youngster?  What do you think about all this?  Thank you for your input.  Lisa

[Kevin Pho, MD]

A referral to an endocrinologist can be considered for precocious puberty.  Typically, tests to consider would be the measurements of serum LH (luteinizing hormone), both basally and after administration of GnRH (gonadotrophin-releasing hormone).  I would also test for the other adrenal hormones, such as testosterone, to ensure there isn't any suggestion of overproduction.

I would ensure there isn't any virilizing disorder first before worrying about shaving and hair removal.  This likely would require a referral to an endocrinologist for further evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[ozark]

my daughter had the same thing....i forget the endocrine workup she had done but she was diagnosed with premature adrenarche which is a benign condition......she had the bo and armpit hair...also had some labial hair, not pubic....no other secondary traits,...she had the wrist xray too that was normal....she started this around 6 yrs old...she is now 12...she has yet to have her period, jsut breast buds and now pubic hair....she is big for her age, always has been....look up the adrenarche symptoms on line and see if she has the symptoms and then ask the pediatrician to check her for this......good luck

[lmroswell]

Thanks to the doc and to you for your response.  I had never heard of premature adrenarche, but it looks like that might be the case here.  I noticed hair starting to grow under her arms at age 6, or even a little before.  And the body odor could put you away at times! I will mention this to her pediatrician, and see what he thinks.  And I just thought it was because she is Italian!  Thanks again...Lisa

[ozark]

hi lisa   by the way, my daughter started to shave her armpits and use deodorant at 9 yrs of age,,,she didnt like the armpit hair when she had a bathing suit on ....she noticed the other kids didnt have it and she was embarrassed...also the i used deodorant as soon as she had the bo from her pits.....good luck

[lmroswell]

Thanks for the info.  My daughter uses deoderant now, but I was wondering if an anti-perspirant would be okay to use also.  As I understand, the deoderant just covers up the BO, but an anti-perspirant actually prevents the sweat from emerging.  I myself, prefer the latter, but was wondering if that is okay for a young girl.  Once we get this matter settled, she will probably shave, but I still can't believe my 8 year old will have to do this!  They grow up waaayy to fast...Thanks again...Lisa

[ozark]

actually, it was an antiperspirant...i used a stick one but then i changed it to a roll on..i really dont think it matters,,,i thought all were both deodorant/antiperspirant....if you go to the md soon, let me know how you make out    good luck

[lmroswell]

We go June 2.  Will keep you posted.  Thanks...

[ozark]

Hi lisa,  i was wondering how your daughter made out at the doctors

[lmroswell]

Went to the pediatrician Wed. and he now advises that a visit to a pediatric endocrinologist is the next step.  Her height and weight has been below average now for two years, so he just wants her to get checked out.  I have yet to hear from the specialist's office about an appointment.  Just started the process yesterday.  You know how that goes...Thank you for your concern and information.  I will let you know when we get there.  Lisa

[lmroswell]

Appointment with pediatric endo is in the beginning of September.  That is the earliest they could see her.  So, if this subject is still here, I will gladly post the results.  :)

[ozark]

lisa, glad you got an appt altho wish it was sooner for your peace of mind....just to let you know,  i noticed my daughter who will be 13 next week, has a fine line moustache which i noticed a month or so ago....she has a physical in 2 days so i'll have to discuss this with her md....she also just got her period for the first time, she developed some facial acne too.....now i'm wondering if there is more to this than they think ...i'm going to ask for some repeat blood work and ask him if she could have polycystic ovarian syndrome of some sort...the more i investigate the more info i get and the more suspect i am......i'll let you know how we make out........mary

[lmroswell]

Hopefully, it's just the normal rush of hormones they get, but I would insist on bloodwork, but I am not sure what test to suggest.  Good luck at the doctor's office.  We had two small incidents yesterday (the kind where your heart jumps into your throat) where both of my daughters, at separate times, were doing backbends (new to this) and fell on their heads.  Yikes!  Needless to say, I didn't sleep too well last night, but they are fine.  Just a little sore.  It's a good thing they have hard heads.  Keep in touch.  Lisa

[ozark]

Lisa
  hi again,,we went to the pediatrician and he feels it's all related to calories, her weight has increased again.......he doesnt think its due toany endocrine problems...said he spoke to a liver dr regarding some liver tessts  that were a little abnormal and he said he wouldnt repeat them until there was a significant weight loss......so here i am again..but i hope you can find out some info for your dgt when you see the endocrinologist soon.......good luck  hope to hear how things go

[lmroswell]

Had a bone age x-ray done which was normal for her age, so that's good.  Now waiting for an endo workup, to see if the hormones are in check.  Have a good 4th...

[lmroswell]

Well, we finally had our appointment yesterday, 3 days after hurricane Frances.  I almost cancelled the appointment, because we have been without power for 5 days, but they talked me into keeping it.  The doc ordered blood work for all kinds of hormones, but thinks that she may have premature adrenarchy, as you had mentioned.  She is not in a rush for the blood work, and actually wants to see us in 3 months and have the blood work done the week before her next appointment.  But, the doc listened to my little one's heart, and noted a murmur and a very irregular heart beat.  I was shocked, because this kid has always been pretty healthy.  I took her pulse and it does indeed skip a beat after beating 4 beats or so.  So, another thing to worry about.  Her pediatrician is seeing her tomorrow for that.  I am hoping that it is due to her drinking lots of water.  I call her a little water buffalo.  That is pretty much all she drinks, and that she has flushed too much potassium and electrolytes out of her system.  Needless to say, with this hurricane, our diets have not been great in the last week.  And everyone has been drinking water!  I made her eat a banana today, and drink Gatoraide.  She cried because she thinks I will not allow her to drink anymore water!  I told her not to worry, she can still have her water.  So, we'll see.  I keep you posted...Lisa

[ozark]

i'm glad they re checking her out for that.....my dughter had few episodes of irregular heart beats last year and she says she still gets them once in a while...she had a monitor and of course they never showed up!....tey jus assume theyre pvcs....not dangerous....but she has her period and this month it was very heavy...i still think there is something horomonal to her but we'll see....ill just have to keep an eye on her......well good luck and i hope all is well  keep me posted   mary