What are the possible side effects and complications?

It's important for your child to stay on schedule with all related medical appointments. Contact your child's doctor if any changes cause you or your child concern.

Possible side effects of GnRH analogue treatment include:

• Injection site swelling
• Weight gain
• Hot flashes
• Headaches

Use of GnRH analogues might also have long-term effects on:

• Growth spurts
• Bone growth and density
• Future fertility — depending on when pubertal blockers are started

Children will likely have their height checked every three months. Your child's doctor might recommend yearly bone density and bone age tests.

If children with male genitalia begin using GnRH analogues early in puberty, they might not develop enough penile and scrotal skin for certain gender affirming genital surgical procedures, such as penile inversion vaginoplasty. Alternative techniques, however, are available.

In addition, delaying puberty beyond one's peers can be stressful. Your child might experience lower self-esteem.