Analysis of pubertal height gain in post-menarche girls

Menarche significantly affects linear growth, and the extent of height gain after menarche remains a key clinical concern. This study aimed to analyze the relationship between menarche timing and pubertal height gain, determine the extent of height gain after menarche, and assess whether treatment is required in cases of early puberty with advanced bone age (BA). A retrospective chart review of 43 patients aged 12 to 16 years with precocious or early puberty was conducted between January and June 2022. Eight patients were excluded due to treatment with recombinant growth hormone. The remaining 35 patients were divided into 2 groups based on whether they received gonadotropin-releasing hormone (GnRH) agonists. Of the 35 patients, 27 (77.1%) were treated with GnRH agonists. The mean age at menarche was delayed (11.5 ± 1.0 vs 12.1 ± 1.7, respectively). The mean predicted adult height (PAH) before menarche was lower in the untreated than in the treated group (156.7 ± 1.8 and 160.0 ± 1.8 cm, respectively, P < .05) in the treated group. After menarche, mean PAH was 157.0 ± 0.7 cm in the untreated group and 160.5 ± 0.9 cm in the GnRH agonist group (P = .04). Height gain after menarche was greater in the untreated group, 6.6 ± 3.9 versus 4.9 ± 3.0 cm, though it was not statistically significant. Importantly, the final height increase after menarche was negatively correlated with advanced BA before menarche (r = -0.092, P < .001). The mean age at menarche was delayed in the GnRH agonist group, and the final PAH was higher than that in the untreated group. However, a later age at menarche was associated with lower pubertal height gain. An increase in PAH after treatment can be anticipated in patients with an advanced BA.