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tazechip, Board Certified Physician
Category: Endocrinology
Satisfied Customers: 36161
Experience:  Board certified in general practice with years of experience treating diabetics with multiple other medical conditions
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My daughter had a severe case of glandular fever at 14 years

Customer Question

My daughter had a severe case of glandular fever at 14 years old which resulted in depression (on sertraline for 8 months), hair loss, irregular periods and her breasts have stopped developing. We have been to the doctors and they are very dismissive even though she has had 4 blood tests which indicate low levels of eostradial. Could glandular fever cause hypogonadism or a similar problem and in turn stop her breasts from developing to stage 4-5. She is now 16, her periods started when she was 13 and her breasts are only at stage 2-3. Should girls going through puberty have higher levels of estrogen (eostradial) in their blood than mature women? Her blood results are as follows;

83 pmol/l peri ovulatory
289 pmol/l mid cycle
198 pmol/l mid luteal
73 pmol/l mid luteal

Am I right to be concerned and should I take things further, or is the doctor right and are these normal levels for a girl her age?
Thanks Jenny
parent of a very miserable teenager
Submitted: 4 years ago.
Category: Endocrinology
Expert:  Dr. David replied 4 years ago.
This is Dr. David

I just searched the medical literature. I did not find any cases reporting mononucleosis causing delayed puberty or hypogonadism.

no, estrogen levels during puberty are not as high as in mature adult women.

see here

she is still only 16 and still has time to mature and recover from the mono and complete her puberty. I would not rush things. I know you are concerned, but I'm sure with time she will come around and go through puberty fine.

let me know if you have questions.
Expert:  tazechip replied 4 years ago.

Hi. I have a different opinion for you here. First off, your daughter is at the age where she is over the puberty cycle so we shouldn't talk about her completing puberty and somehow improving her condition. As for her breasts, they may have developed as much as they will and she may well just be a young lady with small breasts. That said, she needs to be checked for thyroid and cortisol abnormalities. She also needs an ultrasound of the pelvis to look for polycystic ovarian syndrome. If these areas have not been investigated as yet, that needs to be done. The glandular fever is not connected with her problem.

Customer: replied 4 years ago.

Do you think herbal remedies would help boost her estrogen levels and is this a safe option for a 16 year old?

Expert:  tazechip replied 4 years ago.
Sorry for the delay. Bioidentical hormones--estrogen and progesterone--could help here but that should be under the direction of a gynecologist and that doesn't mean that she shouldn't have the complete workup I mentioned since I think the problem is more than just her estrogen levels.