• precocious puberty
• growth
• gonadotrophin releasing hormone analogue

We are writing as parents of a young girl who “suffers” from precocious puberty and we use the word suffers without reservation despite the fact that:

• Puberty is a normal process

• No underlying cause triggering her puberty has been determined.

Our daughter started to show physical signs of development, for example, breast development combined with pubic hair, at 6½ years, and within a year experienced her first period. We were devastated by this event, as our local general practitioner had told us that there was nothing to worry about, and that we were imagining and exaggerating things. Our ongoing concerns for an explanation and regular visits to the surgery were seen as pushy and demanding. Surely confronted with this period, an obvious sign of female maturity arriving very early, we would get help and support. Regrettably, it didn't get any easier.

The good news was that the general paediatrician to whom we were first referred was really helpful. He confirmed that he had rarely encountered the condition before but would organise particular tests to discount any underlying causes for this early growth, such as cranial or ovarian tumours. Our shock with these possibilities was diminished by the speed of his tests and his effectiveness in communicating to the three of us as results came in. Fortunately no underlying cause was identified and we were referred to a paediatric endocrinologist. Confusion was about to reign again.

The specialist recommended that our daughter, who has “central precocious puberty”, should receive analogue treatment (with gonadotrophin releasing hormone analogue) to suppress her accelerated development and enhance her height potential. Growing up early, he explains, will result in compromised final height. Before commencing this treatment we seek a second opinion from another paediatric endocrinologist. We find that an insufficient range …