Treating delayed puberty

When puberty is delayed or has stalled because of low sex hormones (hypogonadism — very common in thalassaemia), it can be treated. The aim is to bring on normal development, a good growth spurt, healthy bones and, later, fertility.

In girls, treatment usually starts with low-dose oestrogen, increased gradually, with progesterone added later to establish periods. In boys, low doses of testosterone (as a monthly injection, or a gel) are started and slowly increased. Doses are kept low at first to mimic natural puberty and protect final height.

This is guided by an endocrinologist (hormone specialist), often working with your haematology team. Puberty that doesn’t start on its own is a reason to ask for that referral — it’s very treatable.