Helping Your “Late Bloomer” Teen Cope with the Challenges of Delayed Puberty

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Medically reviewed by Lynn Keenan, MD

A few weeks ago, we discussed the phenomenon of precocious puberty, and strategies for helping the “early bloomer” in your life deal with some of the struggles that can accompany early physical development. This week, we’re discussing strategies for helping the “late bloomer” in your life navigate the challenges that can come with delayed puberty. 

When I was 14, I found a small amount of spotting in my underwear. I was excited, and thought “Oh, I’m getting my first period!” The timing felt right—I’d heard other girls at school talking about their periods. I felt like I’d finally hit a milestone and had joined some sort of club—the woman club! But my membership in the women’s club was short-lived. I eventually realized that I wasn’t getting a period at all. Months went by, and still I had only seen that small bit of bleeding and no more. 

Around this time—about 8th grade—I also decided I was fat. Though I was tall and already naturally thin, I was also very insecure. I began obsessing about how much fat and how many calories I consumed, and I lost 15 pounds over the next several months. Looking at pictures of myself during that time, I can see how underweight I was. It should have been clear to those around me that I was, in fact, struggling with the beginnings of an eating disorder. 

It’s obvious to me now that my eating disorder likely contributed to my late puberty, and the additional feelings of insecurity that accompanied that. Although being a late bloomer never stressed me out excessively, I do remember distinct moments of feeling left out and very naïve compared to my peers. 

Feeling left out of “the club”

One time, another girl was dealing with her unexpected period and asked me if I had a tampon. “I have a pad,” I said, thinking of one of my mom’s maxi pads I’d been carrying around in my backpack for a couple years, in preparation (hope) that I would soon be joining “the club.”

“No thanks. I need a tampon,” she replied. She was going to volleyball practice and needed something she could be active in. This was something I knew nothing about.

Unfortunately, I coped with being a late bloomer the same way I coped with my other body insecurities: by not talking to anyone about it, especially with other girls my age. I always had this fear in the back of my mind that something was permanently wrong with my body. What if I couldn’t have children someday?

I always had this fear in the back of my mind that something was permanently wrong with my body. What if I couldn’t have children someday?

In fact, it was precisely this fear that shook me out of my eating disorder. When I saw that spotting in my underwear, I truly thought that my body was trying to cycle, but after 4-5 months of not getting anything that resembled a period, I realized that maybe I was hurting my body with the way I was eating. What if I wasn’t getting a period because I was too thin and not feeding my body enough? What if I couldn’t have children someday because of what I was doing to myself? Fortunately, this was a wake-up call for me, and it helped me shift my focus to eating a balanced and healthy diet rather than simply restricting calories. Despite its difficulties, this dark time in my life did produce a lifelong interest in me for healthy eating and maintaining a healthy lifestyle.  

At age 16, I finally got a real period and breathed a sigh of relief. I wasn’t doomed to be childless, and could now feel like a normal teen girl.

Now, as an adult with daughters of my own, I found out only a few years ago that being a late bloomer runs in my family. My sister, my mom, and my mom’s sisters also didn’t have their first periods until age 16, either. Looking back, I wish they had talked more openly with me about this, which I believe would have made me feel a lot less “alone” and fearful that something was wrong with me. It’s part of why I am already talking to my daughters about periods and fertility in age-appropriate ways. 

Possible causes of delayed puberty

It’s in your genes 

There are a variety of reasons puberty can start late for a young person. The most common reason for delayed puberty is simply because it’s hereditary. There is no medical problem and treatment probably isn’t necessary. Simply being aware that late puberty runs in the family should put everyone’s mind at ease and reassure your late bloomer that she’ll eventually start puberty on her own, and that when it does start, it should progress normally until she’s caught up with her friends.   

Stressors on the body: Low body fat, chronic medical conditions, hormone or chromosomal abnormalities

The other (and less common) causes of delayed puberty are usually stresses on the body that somehow inhibit hormone production or body growth. 

Girls with very little body fat are more likely to have delayed puberty. A 1985 study showed that a minimum body-fat percentage of 17% was necessary for menarche [1]. Girls who are very active in sports like dancing, swimming, or running often have the lean body type that could delay puberty. Also at risk for being underweight and having delayed puberty are girls with eating disorders such as anorexia or bulimia. 

Less common reasons for delayed puberty are a large number of chronic medical conditions such as diabetes, autoimmune diseases, or even cancer treatments that stress the body and suppress the hormones necessary for puberty. Also to be considered are thyroid or pituitary issues, or even chromosomal abnormalities.

When to be concerned about delayed puberty

The normal age for the start of puberty is 8-13 for girls, and it begins with breast development, which is termed thelarche. In boys, puberty normally begins at age 9-14, and the first sign is testicular growth. 

Puberty is considered delayed in girls if any of the following occur: 

  • Breasts development has not began by age 13
  • There’s a delay of over 4 years between thelarche and menarche (first period)
  • Lack of menarche by age 16

Puberty is considered delayed in boys if any of the following occur: 

  • Lack of testicular enlargement by age 14
  • There’s a delay of over 5 years between testicular enlargement and completion of puberty

How to help your late bloomer

If you find yourself with a teen whose body isn’t maturing like all of her friends, there are a few steps you can take to first, determine if there’s a medical or lifestyle issue that needs to be addressed, and second, to reassure your late bloomer that it will all be okay.

  1. Evaluate her lifestyle and behaviors. Is your late bloomer very physically active? Is she underweight or show signs of having an eating disorder? 
  2. See a doctor if you’re concerned. If she shows signs of being underweight, undernourished or has a medical condition that could be stressing her body, see a doctor to get help and adjust her lifestyle if necessary.

If she passes the test in the first two steps:

  1. Reassure your late bloomer that nothing is wrong with her. If possible, let her know when menarche commonly occurs in your family. Remind her that puberty happens at different times for each person and her body will develop at the right time for her.
  2. Allow her to do normal teen things. Let your late bloomer wear a bra, use deodorant, shave her legs and carry a period kit in her backpack (even if she doesn’t necessarily need to). It will help her fit in and feel like a normal teen.
  3. Ask her how she’s feeling about herself. Tweens and teens get stressed easily and it often revolves around their own insecurities and comparisons to their peers. Parents need to give their children openings to discuss their worries. Shy or introverted kids (like myself) may never express their concerns to anyone unless they are prompted. Parents who suspect their child is holding onto emotional stress may need to start a conversation and simply start talking about their own adolescent emotions, insecurities, and experiences to normalize their teen’s experience, and to help their teen feel comfortable enough to voice their feelings.

Quite often, a stressed out late bloomer only needs to hear that she is normal and her body will develop and catch up with her friends soon. After all, puberty is usually a question of when, not if.

References:

Baker ER. Body weight and the initiation of puberty. Clin Obstet Gynecol. 1985 Sep;28(3):573-9. doi: 10.1097/00003081-198528030-00013. PMID: 4053451.

Additional Reading:

Signs that your daughter will be getting her first period soon—and how to prepare her for it

Why I’m teaching my daughters how to chart their menstrual cycles

Busting the 4 Biggest Myths about Teens and Fertility Education

Study Shows Link Between Teen Birth Control Use and Adult Depression

The Links between Irregular Cycles, Birth Control, and Early Death

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