Is it fine for a 9-year-old girl start her period?

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It is less likely that a girl age 9 years would have started her periods. A detailed evaluation with probably MRI brain (for pituitary status), levels of LH (luteinizing hormone), FSH (follicle-stimulating hormone), TSH (thyroid-stimulating hormone), etc., will be required.

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Periods at the age of 9 years is not common. Hence we will need to check the following:

1. MRI brain (sometimes tumors in the pituitary can cause hormonal imbalance that can lead to early menstruation).

2. FSH and LH (Follicle-stimulating hormone and luteinizing hormone). These hormone levels if high, suggests something may be wrong with the pituitary, either a tumor or a faulty feedback mechanism.

3. Oestrogen and progesterone levels. The levels of these hormones will give us an idea of the menstrual status of the child.

4. Physical examination should be done to look for other signs of puberty. Signs like increase in breast size, pattern of pubic hair, axillary hair pattern need to be seen to judge at what tanner stage the child is in.

I suggest to get the child evaluated physically for the above before testing. This will tell us how to proceed forward with testing.