5/5/12 I am pretty sure that she started her period today. She has been having blood in her brief from the vaginal area. I need to talk to endocrine about if that means the growth plates have fused, or if we still have a ways to go. I had heard that periods usually don't start for about a year after breast development. Well...we started the estrogen in Jan. She gained 4 pounds in 4 months. Started getting chubby in the breast area in about March. Small amounts of armpit hair in March and now period in beginning of May. That's a lot faster than 1 year.
5/6/12 Endocrinology came by while we were inpatient. They don't think she has breast development yet...just "baby fat". They also don't think that she has started her period. They think that it is just break-through bleeding, possibly due to the fact the onfi make estrogen less effective. So she thinks if we stay on onfi we may have to go up on her estrogen dose. She doesn't think that she is developed enough (in the breast area) to have started menstruating yet. She said periods are usually 2 years after breast development. in typically developing girls the average is 10.5 for breast development and 12.5 for menstruating. She thinks that Dr. Murray (her regular endocrinologist) may want to do a bone age scan. We are not going to make any changes for now. We will just wait and talk to Dr. Murray tomorrow when she gets back in town.
5/8/12 Break through bleeding was not caused by the onfi. But when you are given estrogen the lining of your uterus builds up until it has to slough off. The onfi and the estrogen do not interact with each other. They are processed in different parts of the body (one in the liver and one in another part of the body--I can't remember). Her bone age (from hand x-ray) started at a 10 year old and is now at a 13 year old. He said we only have about 1% left. Meaning her growth plates are almost fused. That is really good news. That means she's almost as big as she is going to get. We should have to do the estrogen for no more than 6 more months (at the very longest). She has not started menstruation. Menstruation does not signify that the growth plates have fused. Normally growth plates fuse at around age 14 for girls. The average period starts at about age 12.5 years. Dr. Murray did send in her recommendations: She wants to increase the estrogen. The increase of estrogen will speed up the remaining process that is left. She also wants to and add progesterone for 10 days every 3 months. This will give her a controlled amount of bleeding (when you give the progesterone). If we just let her continue spotting, then the bleeding would get worse and would just be ongoing. I asked "If she has not started her period yet and we are making her bleed every 3 months, how are we going to know when her actual period starts. He said, "we wont". You could do some blood-work to see.
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