The Whats and Hows Of Early Puberty

Precocious Puberty: The Whats and Hows Of Early Puberty

Definitionally speaking, Precocious Puberty is the process of puberty occurring in a child at an unusually early age, typically before 8 years of age for girls, and before 9 for boys. While Precocious Puberty is not an expected medical condition, it contains the normal effects of puberty in every way, making it an unusual condition solely because of the patients age. Often times Precocious Puberty may refer to some signs of puberty occurring early on, or the entire process itself simply starting at a younger age. In fact, physicians as early as the 19th century have cited early signs of puberty, making Precocious Puberty a well known medical condition. There are a few causes of Precocious Puberty, and they vary from patient to patient, so it is important to cover them all to gain a better understanding.

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Precocious Puberty in Girls

Precocious Puberty in Girls

One day did you observe your 7 year old daughter and discover that her breasts were starting to develop? Obviously, this could be quite worrisome, and you began asking yourself, “could my daughter already be going through puberty?” Well chances are she is.

Precocious Puberty is a term used to refer to the onset of puberty at an abnormally early age. In the United States, a girl is considered to be experiencing precocious puberty if breasts start appearing before the age of 7 years.

If precocious puberty is being experienced by your daughter, is it a reason for you to worry? Probably not because in normal circumstances precocious puberty is common and is just an issue in the variation of normal development among children. However, if it occurs at an unusually early age, it may reflect developmental issues that may demand medical attention. In extremely rare cases, precocious puberty has been linked to brain damage or tumor.

Although seeing your daughter grow to become a woman can be somehow stimulating in normal circumstances, early puberty can have psychological implications upon your daughter, oblivious of the fact that her friends will very soon be following her trail. Precocious puberty can have serious effects on the social behaviors and self consciousness of young girls. In other cases, it has been linked to reduction in adult height potential and may bring about chronic health complications if not properly mitigated. Luckily, if detected early enough, precocious puberty can be successfully mitigated by suppressing the actions of pituitary hormones that triggers the production of sex steroids.

Precocious puberty in girls has caused debates in both social and medical arenas due to its effects of causing early conception among the affected. For example, probably the most noted case resulting of this condition involves Lina Medina, the youngest mother in history give birth at the age of 5 years and 7 months.

The two types of precocious puberty are Central Precocious Puberty (CPP) clinically known as Gonadotrophin-dependent precocious puberty and Peripheral Precocious Pseudopuberty, clinically referred to as Gonadotrophin-independent precocious puberty.

Central Precocious Puberty (CPP) (Gonadotrophin-dependent Precocious Puberty)

Central precocious puberty occurs when Hypothalamic-Pituitary-Gonadal (HPG) axis is prematurely activated. Girls experiencing central precocious puberty may not be victims of any particular abnormality. This condition is caused by infection in the brain or damages in the central nervous system (CNS) due to trauma or possible irradiation. Also, the condition has been linked to hematomas of the hypothalamus, genetic inheritance. Precocious puberty in girls has also been associated with uncontrolled weight gain especially among white girls.

Peripheral Precocious Pseudopuberty, (Gonadotrophin-independent Precocious Puberty)

Peripheral precocious pseudopuberty is quite a rare type and only accounts for 1 out of every 5 cases of precocious puberty. It is usually considered a severe medical complication among children and does not exhibit normal pattern of puberty due to independent maturation of gonads without GnRH stimulation. Causes of precocious pseudopuberty are divided into two; Endogenous causes that includes gonadal tumors, congenital adrenal hyperplasia (CAH) or adrenal tumors and exogenous hormones that may result from the treatment for another diffeent condition.

Diagnostic Criteria

Precocious puberty in girls may exhibit itself in form of thelarche (onset of breast development) or pubarche (onset of pubic hair). Early thelarche may occur in girls less than 3 years but may eventually regress. It is often triggered by maternal oestrogens during the early growth of the child. Although presently it is becoming more difficult to distinguish between normal and abnormal growth, some hints that may help to detect the onset off precocious puberty in girls include menarche (onset of menstruation) below the age of 10 and puberche among girls below 8 years.

As earlier stated, precocious puberty can be treated if detected during its early stages using anastrozole. Therefore, if your daughter has exhibited any of these symptoms, seek medical attention to remedy the situation.

Precocious Puberty in Boys

Most boys between 10 and 14 years old start noticing some changes in their bodies that signify sexual advancements or maturity. These changes are referred to as puberty. They include:

  • Enlargement of the testes and penis
  • Rise in production of testosterone
  • Deepening of the voice
  • Production of sperm
  • Spontaneous erections(hardening of the penis)
  • Broadening of the chest
  • Development of muscles

However, when the above changes occur before the boy is nine years old, that is what is referred to as precocious puberty. It is a rare condition. Puberty is activated by the Gonadotropin releasing hormone(GnRH) which is made in the brain. It is this same hormone that causes precocious puberty.

Classes of precocious puberty in boys

This condition as mentioned above occurs when the GnRH hormone “malfunctions.” There are two categories of precocious puberty:

  • The gonadotropin(GnRH) dependent
  • The gonadotropin(GnRH) independent

Causes of gonadotropin dependent precocious puberty

General causes of this condition are:

  • Tumors in the central nervous system such as optic glioma, cramopharyngioma and astrocytoma.
  • Central nervous system disorders such as arachnoid cyst, hydrocephalus or cranial radiation.

A tumor in the central nervous system is a less common cause of precocious puberty but cannot be disregarded nonetheless. Tumors such as the hypothalamic hamartomas contain sizable GnRH. They may therefore be viewed as ectopic pulse generators of GnRH which have made their way out of the normal inhibitory influences applied during the prepubertal duration on the GnRH secreting centers. These tumors develop slowly and it’s not easy to notice.

Disorders such as neural defects near the hypothalamus may interfere with the inhibition of the hypothalamic, pituitary and gonadal axis by the central nervous system, causing premature puberty.

Causes of gonadotropin independent precocious puberty

This condition occurs when secondary sex characteristics manifest without GnRH stimulation. It can be as a result of isolated gonadal activation, pituitary or the adrenal gland,causing increased secretion of gonadotropins or steroid hormones. High testosterone levels in males may be as a result of tumors in leydig cells.

Effects of precocious puberty

Depression: Boys with this condition may be subject to ridicule by their ‘normal’ peers, causing them high levels of stress and depression.

Low self esteem: Boys want to be similar to their friends and go through the same processes as them. Being ‘different’ makes them feel embarrassed and have a low opinion of themselves.

Stunted growth: Precocious puberty hinders growth and a boy therefore fails to attain his full height.

Drug and alcohol abuse: Severe stress may lead some to seek solace in drugs or opt to drink their sorrows away.

Aggressiveness and shunning of peers: They may feel too old to hang with boys of their age.

Treatment of Precocious puberty

You should seek medical help immediately in case you are suffering from this condition. Release of sexual hormones can be halted by medications. Surgical methods can also be used to remove some tumors.

Hormonal therapy: This can totally cure precocious puberty in some kids. It nay also reverse the effects.

Parental support: As a parent, you should always comfort your affected son. Make him feel important and normal. Talk to him, advise and encourage him throughout the difficult period. This will help him gain self esteem.

What is Precocious Puberty?

What is Precocious Puberty?

Puberty is the time when sexual maturity takes place in children. The medical term, precocious puberty describes the early onset of puberty. In this article, we’ll go over the symptoms, causes and treatment of precocious puberty.

Symptoms of Precocious Puberty

Puberty typically starts for girls from ages 10 to 14. For boys, puberty can begin anywhere from 12 to 16. If puberty starts before 8 for a girl or before 9 for a boy, it is considered precocious puberty.

The symptoms of precocious puberty in girls 8 and younger are:

  • Armpit and pubic hair
  • Menstruation
  • Enlarged breasts
  • Mature outer genitals

The symptoms of precocious puberty in boys 9 and younger are:

  • Armpit, pubic and facial hair
  • Voice changes
  • Muscle growth
  • Growth of testes and penis

A symptom of early puberty common to both girls and boys is a sudden growth spurt where they grow significantly taller. Growth in height stops at the end of puberty. Children who experience puberty early will grow initially taller than their peers, but stop growing sooner. This results in them not reaching their full growth potential and becoming shorter adults that they would have been had they not went though puberty early.

As a result of being taller and more physically mature, children going through puberty early are often treated by others as being older than they are. Others expect them to act more mature than their actual age. Parents can help by reminding family and friends to remember to treat the child based on their real age not their perceived age.

Kids with precocious puberty are most often embarrassed by the physical changes in their bodies and teased by their peers for being different. It’s important for parents to reassure them that they are normal. Parents should reinforce to their kids that they are okay and they should not be ashamed of the changes in their bodies. They should be encouraged to do their regular activities.

What causes Precocious Puberty?

The cause of precocious puberty in most kids is unknown. There are cases where it is caused by other conditions such as, tumors, brain disorders or disorders of the testicles and ovaries. Pituitary and adrenal gland disorders can also be to blame. It’s important to get a clear diagnosis. The doctor will run blood test for hormone levels and possibly order CT scans or MRI’s.

Treatment for Precocious Puberty

If no cause is determined by the diagnostic tests, precocious puberty is treated with hormone blocking medications. Hormones created by the pituitary gland which cause puberty are effectively stopped with the medications. Injections are given monthly until the child is of normal age to start puberty, then injections are stopped and puberty resumes.

If a brain tumor is detected, surgery to remove the tumor will be performed. Radiation treatment will also be done. If tumors or cysts are found in ovaries or testes, they will need to be surgically removed as well. Removal of the tumors or cysts does not guarantee the symptoms will subside. Medications would then be prescribed.

If you notice any of the signs or symptoms of precocious puberty in your child, see the pediatrician right away. Early diagnosis and treatment will ensure the best possible outcome.

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