Concerns for mood disorders in children presenting with early menarche is not an indication for pubertal suppression

The aim of this research was to assess the psychological problems of pubertal girls who presented with early menarche. To the best of our knowledge, there is no similar prospective cross-sectional research in the medical literature.

Group I included patients under 10 years old, who presented with menarche. Peripheral causes of puberty were excluded. Group II included 9-10-year-old prepubertal healthy girls. Four mental tests were employed to both groups. Children in Group I was recalled for re-evaluation after 6 months.

A total of 49 girls (Group I, n=28; Group II, n=21) were included. Median ages of the groups were similar (9.7 (0.4) years vs. 9.3 (0.6) years, p=0.06, respectively). Median bone age and the time between first signs of puberty and menarche in girls in Group I were 11.4 (1) years and 12 (0.1) months, respectively. Height age, height, weight, and BMI SD scores were significantly higher in Group 1 (p<0.01). Mental test scores and the frequency of mood disorders were similar among the groups (Group I, n=2, 7 % vs. Group II, n=2 (9 %), p=0.76)). Re-evaluation of 17 patients (60.7 %) in Group 1 revealed no significant differences in test scores and no new cases of psychiatric conditions.

There was no significant difference in psychological and behavioral problem scores between the early menarche and control groups. Gonadotropin releasing hormone (GnRH) analogue therapy should not be based on the assumption that premature pubertal development will cause psychosocial effects and should only be considered after a thorough psychiatric evaluation.