A paediatrician answers questions about precocious puberty: definition, causes, examination, and prevention. Many parents believe early development isn't a major issue, but it can sometimes indicate underlying illnesses. Conditions causing precocious puberty symptoms, such as breast development in girls before age 8 or testicular development in boys before age 9, can result in hormone levels exceeding the standard, leading to accelerated bone age progression. This leads to a growth spurt during childhood, meaning they will be shorter than average as adults. Therefore, if symptoms are noticed, parents are advised to seek medical examination and treatment as soon as possible.
Precocious puberty definition
When adolescents enter puberty, their sex hormone levels increase, causing a series of physical and psychological changes in their bodies. Early puberty refers to the onset of puberty earlier than in other adolescents of the same age.
Precocious puberty symptoms
- Regarding girls: In the very early stages of development, we first look at secondary sexual characteristics. Breast development will happen first. If we find that breast development starts before they are 7-8 years old, or menstruation begins before they are 9 years old, this can be considered early puberty.
- In boys, the second sex characteristic is the development of the testicles, which will start to enlarge. If this happens before the age of 9, it is highly likely that they are entering precocious puberty.
Disadvantages/Risks of precocious puberty
Many families might think early puberty isn't a big issue, merely that it leads to growing taller sooner, but that's not the case. This is because early puberty can potentially suggest that there might be underlying illnesses causing precocious symptoms. Therefore, if parents truly notice signs of precocious puberty in their children, such as breast enlargement before the age of eight or testicular development before the age of nine, they are advised to see a doctor as soon as possible to investigate the underlying causes.
Additionally, regarding height, it's generally thought that early development and early growth spurts have the potential to lead to greater height. In reality, at the ends of our bones, there are growth plates. The reason for growing taller more rapidly during puberty is usually because hormones stimulate these growth plates to grow quickly. At the same time, if puberty occurs early, these growth plates will also close early. Once the growth plates close, they will no longer increase in height. If individuals do mature early, their initial height will be taller than their peers, but often by the time they reach adulthood, their height will be relatively shorter.
The situation of precocious puberty should not be underestimated at all; it may also affect the child's mental development. Many times, they will find that their appearance is different from that of other children their age, which may make them feel embarrassed or inferior, leading to unhappiness. This can potentially affect their social interaction and even their learning.
Causes of precocious puberty
- Central precocious pubertyThis affects our central nervous system, specifically the superior colliculus of the brain and the pituitary gland, causing premature secretion of developmental hormones. This then stimulates our ovaries/testes, leading them to release hormones such as oestrogen and androgens, which causes the appearance of secondary sexual characteristics and the development of gonads. What could be the reason for this? For females, 80-90% of cases have no specific cause. However, for males, it's the opposite, with only 30-40% potentially having no identifiable cause. Possible reasons could include a brain tumour, a severe past inflammation, or even a genetic mutation.
- Peripheral precocious pubertyThe reason is that surrounding organs release hormones prematurely. Whether it's androgens/oestrogen or cortisol, this can also lead to children developing secondary sexual characteristics; What is the reason for that? It could be becauseChildren's thyroid dysfunction, or if there are adrenal gland issues, there's also a chance of tumours in the girl's ovaries, tumours in the boy's testicles, or some internal tumours. It's important to know that peripheral precocious puberty is unrelated to the developmental hormones secreted by our central nervous system's superior colliculus and pituitary gland.
Precocious puberty diagnosis
Every time doctors encounter cases of suspected precocious puberty, they conduct detailed examinations and assessments. They will evaluate whether the child's development has truly entered puberty prematurely, as well as assess the child's overall developmental milestones. They also need to understand the family medical history to determine if there is a predisposition to precocious puberty. In certain cases, we will arrange blood tests / X-rays to assess bone age / for females, it may be arrangedPelvic ultrasound, If central precocious puberty is suspected, a blood hormone stimulation test or a brain imaging scan may be arranged.
Treatment of precocious puberty
The primary aim is to stop or inhibit precocious puberty, as it can cause anxiety and worry for children and parents. At the same time, it is hoped that a child's height can be controlled, as precocious puberty can lead to stunted growth. If treated, height can increase normally.
But not every individual case requires treatment. The decision will be made depending on the child's condition and the doctor's judgment.
How to ensure children have healthy and normal developmental stages
- Balanced nutritional intake
- Sufficient rest
- Appropriate exercise
- Parents try their best to prevent children from coming into contact with external sex hormones, especially avoiding containers, toys, and everyday items containing plasticisers.
Preventing precocious puberty can be done this way!
- Avoid foods high in sugar, fat, calories, and additives.
- Reduce intake of meat from short-term farming or health supplements with unknown origins
- Avoid contact with environmental hormones
- Wash your hands frequently
- Regularly clean your home environment
- Preventing children from staying up late
