YOUNG-WOMEN Messages for September, 2000: Re: Depolupron for an 8 year old

Re: Depolupron for an 8 year old

From: anonymous@obgyn.net
Tue, 26 Sep 2000 08:26:08 -0500 (CDT)

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In reply to: Kristine: "Depolupron for an 8 year old"

At Tue, 26 Sep 2000, Kristine wrote: >
>Hello,
>I just arrived home from the Dr.'s office and am concerned about my 8
>year old daughter. Three months ago she started having periods. The
>doctor is recommending depolupron injections to try to allow her to grow
>some more and to preserve her childhood. Her x-rays show her bone age
>to be approx 11 years. The doctor is concerned that the bone age may
>already be to great. I definitely would like my daughter to not have to
>put up with periods at this young age however I am worried about long
>term side effects like future childbearing, fertility and birth defects.
>The doctors say it is a very safe drug with only side effects of expense
>and short term vaginal bleeding after injection. Can you please explain
>to me what side effects there are, and what are the long term effects?
>How long has depolupron been in use with children and do we know enough
>about it so say it is safe for her much later childbearing.
>I thank you for your help,
>A concerned mother
>
>--
>Kristine
>

Precocious puberty is of significant concern. In addition to the social problems of being so far in advance of the child's peer group, there are physical consequences as well, the most significant of which may be premature closure of the epiphyseal plates of the long bones, i.e. they stop growing. Women are shorter on average than men because women do not generally grow more than another 2 inches after their first period, while puberty sends boys skyrocketing. Even though your daughter is currently taller than average for her age, she will stop growing without treatment to stop this process, and will not grow significantly taller than she is today.

DepoLupron is a medication that arrests this process, and returns the patient to a prepubertal state. Unlike adults, who have lots of menopausal type side effects with this drug, young girls are simply returning to what they were, and should still be. There appear to be relatively few side effects in this age group. This is also the only treatment that is known to stop the premature closure of the epiphyseal plates. Once the medication is discontinued, puberty proceeds as usual. I don't know for sure how long this has been used for this problem, but I have a text published in 1986 here on my desk as I type this that refers to this as the standard of care.

--
William D. McIntosh, MD, FACOG
Clarksville, TN

This is for educational purposes only, and is not intended to be replacement
or substitute for consultation and examination by an appropriate medical
professional.  Due to time constraints, private e-mails cannot be answered.

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