Precocious puberty is a rare condition in which bodily changes associated with adolescence occur at an earlier age than normal. It develops in girls before they turn 8 years old and in boys prior to completing 9 years of age. Also Read: Guide To Understand A Girl’s Transition Into Puberty
The average age at which a child, be it a girl or a boy, begins the transition into maturity, by the growth of reproductive organs and other external changes in appearance, is between 9 to 14 years. Hence, entering this phase of puberty earlier than 9 years is considered abnormal and requires proper medical treatment.
While precocious puberty affects both genders - male and female, it is more common among young girls. Moreover, in some cases, such as having suffered from childhood cancers or neurological tumours, the reason behind precocious puberty can be determined. However, in the majority of instances, the factors leading to earlier onset of puberty cannot be diagnosed.
Causes Of Precocious Puberty
The primary cause of precocious puberty is often difficult to identify. Nevertheless, modifications in the mechanism prompting puberty changes in children are considered to be the main causative factors.
Normally, the brain synthesizes GnRH i.e. Gonadotropin-Releasing Hormone, which encounters and stimulates the pituitary gland to produce estrogen hormone in ovaries of females and testosterone in testicles of males.
It is these two reproductive hormones that regulate the development of sexual characteristics in girls and boys, such as the start of menstruation in females and the deepening of voice in males. This, in turn, ensures their proper transition into puberty and adulthood.
When the functions of GnRH, pituitary gland, ovaries or testicles are affected, it triggers an instance of precocious puberty in young boys and girls.
Types
Central Precocious Puberty:
In this kind of puberty, although the initiation of hormonal changes in young boys and girls occurs much before the appropriate age, the pattern of development in sexual functions is quite normal.
The exact reason remains unknown in central precocious puberty.
Peripheral Precocious Puberty:
In normal individuals, the GnRH (Gonadotropin-Releasing Hormone) is responsible for the onset of puberty.
However, in this scenario, the release of reproductive hormones estrogen or testosterone, due to irregularities in the adrenal gland, ovaries, testicles or pituitary glands, is the main cause of the earlier onset of puberty.
Symptoms
The typical signs of precocious puberty comprise:
In Boys:
- Enlargement of testicles
- Growth in size of the penis
- Deep and hoarse sound in the voice
- Growth of hair on the face
- Overactive sweat glands leading to body odour
In Girls:
- Prominent increase in size and shape of breasts
- Onset of the first menstrual cycle
- Hormonal imbalance resulting in facial and body acne
- Hair growth in the pubic and underarm region
- Very frequent or sporadic periods Also Read: Irregular Periods? Don’t Ignore It, Try These Remedies
Diagnosis
The paediatrician, a doctor specializing in ailments in children, initially conducts a thorough physical exam to look for any outward signs of maturation in the young boy or girl. A full family medical history is also taken, to see if any other close relatives have also had early onset of puberty.
Additionally, blood tests are carried out, to measure hormonal levels in the system and check if they are corresponding with the age of the child or are higher than normal.
A GnRH stimulation test is evaluated in the child, to figure out the type of precocious puberty.
Next, MRI scans for brain defects, X-rays for the rate of bone growth and thyroid function analyses are done, to find out if the organs have developed much more than is expected for a child less than 9 years of age.
An ultrasound scan may be conducted, to look for any cysts in the ovaries due to hormonal fluctuations in girls.
Treatment
Once the diagnosis of precocious puberty is confirmed, the healthcare provider initiates treatment for the young child.
In case the cause for very early onset of puberty cannot be identified and the bodily development along with secondary sexual characteristics progresses at the usual pace, then the medical expert does not provide any specific prescription medicines or therapies. The patient is monitored over many months, to ensure no health anomalies arise later on.
If the child has central precocious puberty that advances very rapidly, then hormonal analogue medications are administered by the physician, in the form of injections or skin implants, to cease the reproductive development in the patient. Once the child attains an age of 9 years or older, these medications are no longer given and puberty is allowed to resume at the right age and in a normal manner.
In seldom cases, when a childhood tumour gives rise to precocious puberty in the young boy or girl, the mass of tissue growth is surgically removed, to stop puberty and guarantee a full recovery of the patient.
