My menopause patches made my daughter go through puberty at the age of three… I feel so guilty

A mother is warning parents about the risks of accidental exposure to topical hormone gels after her daughter began showing signs of puberty at just three years old – an experience she says caused her child to ‘miss out on being a normal child.’

Samantha Ashworth, 52, said her concerns were initially dismissed when she took her daughter – now five – to the GP after noticing mood swings and physical changes typically associated with puberty. 

Drawing on her professional background as a newborn hearing screener and trained nursery nurse, Ms Ashworth recognised the signs early.

‘I knew what it was, but I didn’t feel like I was being listened to,’ she said.

After a year of ongoing symptoms, missed school due to medical appointments, and switching GPs while seeking answers, her daughter was formally diagnosed with precocious puberty, a rare condition in which puberty begins unusually early, in February last year.

‘It was heartbreaking,’ Ms Ashworth said. ‘By that time, a full year had passed and she could have been receiving treatment. It was a very stressful and emotional time—we just wanted answers.’

Doctors believe the early onset of puberty may have been triggered by accidental contact with Ms Ashworth’s hormone replacement therapy (HRT) gel, which she uses to relieve menopausal symptoms. 

While transference of topical hormone treatments is uncommon, it can occur if application instructions are not carefully followed.

She described the impact on her daughter, who wore clothes aged six to seven at the age of three, as ‘horrendous’.

She said: ‘Watching her struggle with mood swings and not being able to cope with her emotions at such a young age was awful. 

‘Her meltdowns were very hard to manage because it just looked like she was having a tantrum, when in reality, she was dealing with pubescent hormones. 

‘She had uncontrollable outbursts, would take herself off to bed and become very frustrated. 

‘It was a daily battle trying to avoid the meltdowns. Her mood swings were typical of a teenager. She was slamming doors, shouting, crying and not understanding what was going on in her body. 

‘She was suffering greatly, but I couldn’t explain it to her in a way she would understand.’

Professor Jovanna Dahlgren, an expert in paediatric endocrinology at Sahlgrenska University Hospital in Gothenburg, has previously spoken of the dangers that hormone treatments pose to children. 

Talking to the Swedish newspaper Göteborgs-Posten, she said: ‘I don’t think people always understand how potent these treatments are. The parents become completely desperate when they understand what has happened.’

She added that there had been another case where a 10-year-old boy developed breasts after being exposed to a female sex hormone treatment his mother was taking.

The risk of childhood exposure to hormone medications is also known in Britain. In 2023, the UK drug safety regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), received a report of a British child experiencing ‘increased growth and genital enlargement’ after exposure to a testosterone gel their parent was using.

This prompted the MHRA to request that manufacturers include warnings on testosterone gels, advising adults to wash their hands and avoid direct skin-to-skin contact with children. Similar precautions are recommended for women taking hormone-based medications for menopause to prevent accidental exposure.

However, Ms Ashworth said she was never advised to wear gloves when applying her gel, a precaution often recommended to reduce the risk of transference.

‘She could have come into contact with the gel through cuddles with me,’ she said.

Her daughter now attends check-ups every six months to monitor her condition.

The issue comes as more women are accessing HRT treatments. In England, there were 14.7 million HRT items prescribed in 2024/25, an 11 per cent increase from the previous year, according to NHS data.

Estradiol, the primary and most potent form of human estrogen produced by the ovaries during a woman’s reproductive years, is the most common form used in menopausal hormone therapy. 

Estradiol gel, often sold under brand names such as Oestrogel and Sandrena, is a first-line transdermal option for managing menopause symptoms.

According to the NHS Business Services Authority, estradiol gel was the most frequently prescribed HRT item in England in 2024/25, with 1.3 million items dispensed, a 13 per cent increase compared with 2023/24.

Speaking of the link between estrogen gel and early puberty, Dr Deborah Lee of Dr Fox Online Pharmacy told the Daily Mail that because maternal age is rising, precocious puberty is likely to become more common.

‘The incidence of premature puberty has been rising for many reasons, including environmental factors and the current epidemic of childhood obesity,’ she said. 

‘It is a very distressing condition for both the child and the parents, which always needs careful assessment and management by a specialist paediatrician.’

Dr Lee highlights that the Summary of Product Characteristics for Estrogel clearly states there is a small risk of passive transfer of oestradiol when using the gel and children must not come into contact with it. 

She also adds that the gel should be left to dry for five minutes and covered with clothing. 

‘Although the SPC is primarily for medical professionals, it is available online to all and is not intended to be kept away from patients,’ she said. 

‘It’s vital that doctors and nurses pass key information on how to use any medical product to the patient. 

‘In a busy clinic, it’s not possible to cover everything and patients do need to read the PIL and follow instructions carefully.

‘It’s quite possible this case of precocious puberty could have occurred anyway and was nothing to do with the Estrogel. 

‘But there is no way to prove this one way or the other. Women should not fear using Estrogel but must follow the instructions for application and use very carefully.’