Getting to know precocious puberty

Puberty is when a child's body begins to develop and change transitioning into adulthood.

Normally, girls start puberty between the ages of 8-13 while boys do between the ages of 9-14. Precocious puberty happens before age 8 in girls, and before age 9 in boys.;

What kind of signs or symptoms suggest that your child may have precocious puberty?

Mostly in girls, the first sign of precocious puberty is the development of breast buds, tender lumps felt in the area under the nipples before they turn 8 years old.

For boys, the first sign of precocious puberty is the enlargement of testicles before they turn 9 years old.

Other changes during puberty include the following:

Girls: growth spurt, vaginal discharge, pubic and armpit hair growth, body odor, menstruation

Boys: growth spurt, pubic and armpit hair growth, growing genitals, acne, body odor, and the crackling of the voice later on

Causes

Normally, hormonal changes in the body trigger the start of puberty starting from those in the brain telling the ovaries in girls and the testes in boys to make certain hormones.

• No clear cause has been found in 80-90% of girls with precocious puberty. In some girls with a family history of precocious puberty, it may be inherited.
• It can also be due to the pathology of the brain, ovaries (girls), testes (boys) or adrenal glands.

Negative consequences of precocious puberty

Physically: short stature as adult

• At the beginning, children with precocious puberty often experience growth spurt, making them appear to grow taller faster than same-age peers (who have not started puberty). Then sex hormones can cause advanced bone age and early closure of growth plates. As a result, they stop growing taller earlier than their peers and eventually become adults of short stature due to the shorter period of development compared to their peers going through puberty typically.

Diagnosis

• The doctor will take history and perform a physical examination. If precocious puberty is suspected, the doctor will take an X-ray of the hand and wrist to determine bone age and a blood test to check hormone levels to diagnose precocious puberty.
• In the cases where it is suspected that precocious puberty is due to the pathology of the brain or sex glands (ovaries/testes), the patient may need additional tests such as an MRI brain scan or an abdominal ultrasound.

Treatment

• If a cause is found, it is treated accordingly.
• If there is no clear cause, the doctor may consider injections to delay puberty and the closure of growth plates. The goal is for the patient to grow to adult height. Treatment is most effective if the patient is treated early. So if a child begins to show signs of puberty early, diagnosis should be made as soon as possible.

Compiled by Dr. Nipapat Visavachaipan