My understanding is that in Noonan’s puberty can be delayed in boys, but is it the same for girls? My fifteen-and-a-half year old girl is a physically fully developed young woman but hasn’t had her period yet. She is PTPN11 with a pulmonary valve stenosis.

Early studies that looked at the onset of puberty both in boys and in girls showed that puberty is delayed in both boys and girls and perhaps reaching their full potential in terms of height and development just takes that little bit longer. It is more unusual to be physically developed in terms of puberty in all other ways and to have not started periods just yet. If there is a discrepancy between the normal body development and the periods, then this should be looked at more specifically. You can get discrepancies in the process of puberty itself and there are certain orders that we anticipate in children as they move on into adulthood. When those are staggered or disordered in some way there can sometimes be some other underlying endocrine issues.