In helping a friend of mine prepare her mother-daughter talk about the the birds and the bees, I thought about the timing of this talk with my own CAH child.  Some have reached puberty earlier than the average child. Some shockingly at age 5 to younger. Some the average age, some earlier. It is hard to get an idea of an average puberty starting age from CAH adults since their treatment has changed slightly through the years. (ie: some used urine tests to read their levels instead of blood ect.) Medication changes ect. And of course trying to factor in the CAH types, (ie: my daughter has the 21 hydroxylase deficiency and is a salt waster.) Trying to factor in all this is hard to ask a general question to all CAH adults but if you can give any input it would still help. I just wonder the basic period starting time for all CAH patients. I know I have read that some have started to show early signs and are given lupron shots. How many out there are presently using lupron to hold off puberty, what age did it need to be started and what type of CAH does you or your daughter have? Also I know there are the late onset CAH girls that did not have their CAH detected at birth, started puberty early, early. So my question is....type of CAH, start date of period and or puberty signs to indicate a use for lupron shots, if using lupron presently or HAD to, present age or age bracket if you do not want to share that info. I think this is an important issue even for boys too. I am asking because obvioulsy I have a girl. Perhaps there should be two seperate posts, one for boy puberty questions and one for girls. Post one for the boys for those of you that have questions for your boys. I think this is important because this would mean having the birds and the bees talk a little more earlier than the average child. I want to be prepared. If I get an idea of what some CAH woman have started, I can plan ahead the best I can. My daughter’s endo says that having CAH under good control is VERY important to insure a normal puberty and menstrual cycle. I have an adult in my town that has CAH that I have spoken to and she agrees 100%. (She has three children presently) SO, any input would be helpful to many.