Is it too late to do anything?

[KST97]

My 11 year old daughter started her period at 10 1/2.  We just had a wrist X-Ray and it stated that her bone age is 13.5.  She is currently 4"10 (97lbs)The pediatrician has said that she might grow to 5"1 or maybe 5"2.  Her growth up to the start of her period was in the 75th percentile and was on track for 5"5.  She is not overweight and very physically active (dances 6 days a week).  I have been reading about all the different treatments and am trying to get into to see a  referred pediatric endo.  Because she is now 11, is there really anything they can do?  I am also concerned as her periods seem to be about 14-18 days apart. I just want to know if there is anything that can be done to help get a few more inches of height.

[Deanna L Aftab Guy, MD]

Early puberty is considered before age 8 in girls and before age 9 in boys, UNLESS you are the mom! However the testing we do is to rule out early pulsing of the pituitary and other causes, the treatment is to stop this pulsing with a medicine (lupron) that basically stops the stimulation to the ovaries and reduces estrogen effect. At 11 she really needs the good estrogen effect and that is for bone density, something she doesn't get as much  of past her teens. I actually stop treating with lupron at age 10 or 11 for this very reason. So at 11 I would not advocate treatment. Irregular menses will happen for the first year but this does not mean that she cannot be evaluated. Have her seen by her pediatrician and they can consider checking thyroid, LH, FSH and estradiol levels as well as insulin, she may have some polycystic ovarian symptoms or anovulatory symptoms, that will show up in her bloodwork. The growth will be completed when her bone age is closer to 16 or 17 so her height is still going but will slow over time.
You can still see a peds endo for her menstrual cycles and also ask about what we talked about but I do not think they will treat with Lupron.