I have become increasingly concerned....

[fuddleduddledee]

I'm not sure if anyone will know the answer to this question or not. My son is almost 17 years old now. I saw him nekked yesterday and he does not appear to be developing normally. I have never been a male, my brothers didn't share and my husband cannot remember so I'm here to ask the experts. What is normal male development?

When I saw him yesterday, his little man has not grown at all, or very little, since he was a very small child yet, his testes have enlarged. I don't see pubic hair, I don't see underarm hair, and I don't see facial hair. He does sweat some however, cause I can smell him, he doesn't bath often enough but that's a different battle. His voice doesn't appear to have changed much he can still whine in a very high pitch. Finally, he is starting to have pimples.

He is on an awful lot of medications and at fairly high doses and has been for quite some time. Six hundred milligrams of Seroquel, 900 mg of Lithium and 37.5mg of Effexor. Could these be delaying puberty? Or is he developing as he should? What's normal other than a setting on the dryer?

I appreciate all your responses.

 

[crazymama30]

I know everyone matures at different rates, I would call his doctor and ask him.

As far as I know, normal is only a setting on a dryer.

 

[JJJ]

I would take him to a pediatrician for a complete physical. It may be that he is just a late bloomer, it could be that the medications have delayed puberty or it could be something more. A pediatrician could put your mind at ease.

 

[4sumrzn]

I'm with the others.....you should take him to get a full physical. My easy child is 13 & the past 2 physicals.....the doctor checked EVERYTHING out. I will mention my easy child was labeled as "teenie tiny" by his pediatrician when he was a baby. husband & I would joke around a little as he was growing up wondering if IT would ever grow!? I will admit I'm not quite sure how it's progressed, but made sure to mention my concern to the family doctor in private a few years back. easy child checked out "fine" according to the doctor. My guess......they all mature at different paces.

 

[TerryJ2]

I agree. Take him in for a physical. There is a spectrum for puberty but, you want to be sure.
Still, there are other things to look for. Does his adam's apple protrude? That's a classic teen guy thing. And are his shoulders getting more square? As you mentioned, pimples are a good sign of hormonal change.

I have no idea if those medications can interfere with-hormones but it's a good question. You could also ask the dr if s/he sees this in other kids who are on the same medications, just to get him/her thinking about it. It's possible the dr could prescribe some hormones to get things going ... you probably don't want another medication, but if your son is concerned about it, do a trial run for a few months.
Best of luck.

 

[smallworld]

You should definitely take him for a physical with his pediatrician and ask the psychiatrist about your son's delayed puberty. Lithium frequently affects the thyroid (in fact, his thyroid should be checked by blood test every 6 months while taking Lithium), and the hormones secreted by the thyroid can affect puberty. Your son is on the late end of starting puberty, and you should ask for a referral to a pediatric endocrinologist whether thyroid function is normal or not. These doctors monitor puberty aberrations. My own daughters see an endocrinologist for short stature and delayed growth.

 

[Wiped Out]

Ditto on the physical!

 

[klmno]

Ditto- the doctor can probably do something about it, especially since there are signs that puberty has started, it just seems to be a little late. Like the others said, it could be medications or being a late bloomer (maybe husband conveniently doesn't remember- it probably is embaressing), or a combination of both. I would be careful to let the doctor aware of these concerns without difficult child being around to hear it. The signs you see do make me think that he his hormones are trying to kick into gear, so I would think this is "solvable", with a medication change or something.

 

[Marguerite]

We were told to start worrying at age 17 if a GIRL still hadn't got her period. Girls do hit puberty sooner than boys, as a rule (that's why women tend to be shorter - puberty hormones trigger vertical growth to eventually cease). But at 17, I would not be panicking yet, but definitely getting him to the doctor for a check-up. He should do blood hormone levels, to see what is happening. He needs to check not just androgen levels, but also thyroid, gonadotropins and growth hormone. Something else to check if he's stopped growing yet - an X-ray of his joints to see if the epiphyses (the bony plates on the ends of the bones) are closing over yet. Sometimes you get the benefit of this anyway, through various injuries kids have in their teens. easy child 2/difficult child 2 broke her wrist in early 2000 (auditioning for Sydney's Olympics Opening Ceremony!) and the subsequent X-rays incidentally told us that she still had plenty of growing to happen.

How tall is he? How is his mood? How does he feel about all this? I would talk to him, find out if this is worrying him at all.

I had a classmate in school (he was actually school captain, he was well respected by kids and teachers alike) who was smaller than the other guys and who had absolutely no facial hair. His voice - it had deepened a little. We would have been 17 at the time, in our final year of high school in Australia. I cannot speak for his gonadal development (! I wasn't that type of girl!) but he was one of only three of us who went to the same uni. I remember visiting him in his college dorm - we would have both been about 19 - and he was still unsuccessfully trying to grow facial hair.
I remember him at the 20 year school reunion - he was no taller, but he now had a fine but close-cropped beard, that would have been the pride of many a sailor. He's a redhead, so it really looked good. He was married (he actually married a girl from our residential college) and they had kids, so clearly no problems in that department.

I don't know of many reasons for delayed puberty, although I do remember blind kids are often delayed - the pineal gland is involved in triggering puberty, and the lack of exposure to light can delay the pineal's drop in melatonin levels, but never completely. It does get you eventually! So anything that could be keeping melatonin levels constantly stable could be delaying things also. A long shot, probably. I'm very rusty with my endocrinology - sorry. From what I can glean, they think melatonin levels are more relevant for females rather than males, anyway. a sort of hormonal 'boys will be boys'.

But from what you say, he is showing SOME of the signs of puberty, so I'd say melatonin probably is less likely to be relevant.

Maybe his body is just taking its time? But it's always wise to check it out, in case there is a problem which NOW could be easily remedied, but less likely to be so easy when he's 27, for example.

I hope you can get some answers for him.

Marg

 

[fuddleduddledee]

Thank you all for your kind and thoughtful replies. I will book an appoint with the family doctor to get this checked out. It seems I spend my life running with this child to doctors. I would also say, that he has not stopped growing in fact he is almost six feet tall, and wearing a size twelve boot. He truly is a BIG BOY.

 

[Steely]

So interesting - because I had the same thing happen with my difficult child - delayed puberty and he was on Seroquel for many years. We went to all of these doctors, and everything came back normal, and no one could prove or disprove it was the medications.

However, we took him off Seroquel when he had just turned 17, and 3 months later puberty hit full steam. I don't believe it is a coincidence, however, there is not any clinical data to back me up. The change was too dramatic and instant to be anything but some sort of medication reaction.

 

[susiestar]

I concur that a physical is needed. PLEASE ask for a referral to a pediatric endocrinologist while you are at the physical.

I was severely underweight as a teen (79 lbs and 5feet no inches the day I graduated high school). A year later, while away in college, I saw a pediatrician endocrinologist. I was on medications for ankylosing spondylitis (a false diagnosis) but the medication levels were so high they would only have been OK if I were a 300 lb male!! I have had lifelong problems from the years on medications for this false diagnosis. To this VERY DAY I have some problems. Though being female the hormone system "resets" with each pregnancy - 3 docs have told me this. I don't think male hormone systems reset.

I do believe there are things that can be done, if puberty is delayed or interfered with though.

I am sorry your son is having such problems. I took the liberty of asking my bro about this - he said it is a RANGE, but there should be some growth apparent. He also said that if it was after a cold shower it could cause the small size.

Many hugs for your worrying mommy heart!

Susie

 

[fuddleduddledee]

Steely, I also wonder about the Seroquel, he's been on it now since for about 5 years pratically from the time it was first approved in Canada. Matter of fact I think he was the first child his psychiatrist prescribed it for if I recall correctly. I know that Seroquel affects the production of prolactin and prolactin is the hormone that produces breast milk. His psychiatrist does take prolactin levels from time to time and the results always come back within a normal range but, what if the normal range on their tests is too high for puberty?? The dilemma then would become can he function without the Seroquel? I hate the thoughts of even going there, I never want to go back to what once was, it's so terrifying to think of the chaos, the terror, the pain I have endured over the years and he didn't weigh in excess of 200 pounds back then, I could physically restrain him back then. I know I cannot restrain him now. I love this child to the very core and yet, I still, deep within me fear him and the feral animal he can become.

 

[smallworld]

When was the last time his thyroid function was tested? Was it normal?

 

[fuddleduddledee]

Thyroid is normal, we even went to see a specialist to have extra thyroid testing done to see if he was at risk for thyroid problems using the lithium. All came back normal with a resounding should never have problems due to the lithium.

 

[Steely]

Yep. sounds like us indeed. I remember how scared I was to take difficult child off Seroquel, but yet, when I did, it was if nothing changed. It was a very weird phenomenon. The Seroquel had done wonders, but after being on it 3 years, he seemed unphased by it's dismissal. He lost about 50 pounds, started puberty, and seemed to come alive again inside his mind and body. At the same time the psychiatrist started him on Clonidine, and that seemed to quell any rages that came up. Sometimes I just wonder that if, as these kids grow, they don't need the medications they once did. Unfortunately, as parents, it is a constant revolving issue of what medications they do need. As you can see my son is not on any less medications, just different ones.

Good luck! Go with your mommy instinct. These medications are still so new, that little to no research has been done on it.