Mrs. Chan's daughter, Zip-ching, is seven years old. Zip-ching told her mother that her left breast had been intermittently sore and swollen for a few days. Mrs. Chan found a lump on her daughter's left nipple and, very worried that her daughter might have breast cancer, took her to see a doctor. After a thorough examination, the conclusion was that Zip-ching was starting puberty.
Whether to decide if childrenPrecocious pubertyFirstly, it is important to understand what constitutes normal development. The first sign that a girl is entering puberty is breast development; the nipples will become prominent first, followed by a gradual enlargement of the areolae and breasts. This usually occurs between the ages of 8 and 10.Around 3% of girls may begin this process as early as the age of 7, which is still considered normal. Shortly afterwards, pubic hair begins to grow and vaginal discharge increases.Height also increases rapidly, with girls growing by 8–10 cm per year. Approximately 2–2.5 years after breast development begins, the first menstrual period will occur. The average age for the onset of menstruation is around 11–12 years.
In boys, puberty is marked by the enlargement of the testicles, which generally begins between the ages of 9 and 11. This is followed by the development of the scrotum, pigmentation, and the penis. Pubic hair, underarm hair, and acne will also appear subsequently. Voice changes in boys can occur at any point during puberty, but are most common between 12 and 13 years of age. In the middle of puberty, the growth spurt in boys can reach 10-14cm per year. Over the course of puberty, girls can grow by approximately 20-25cm, while boys can grow by about 25-28cm.
According to the Hong Kong Department of Health, precocious puberty is generally defined as the appearance of puberty symptoms in boys before the age of 9, and in girls as breast enlargement before the age of 7 or menstruation before the age of 9. Conversely, delayed puberty is defined as the absence of any pubertal signs in girls after the age of 13, or in boys after the age of 14.
Precocious puberty is not uncommon and is showing a global trend, with cases of precocious puberty being more prevalent in girls than in boys. There are many causes of precocious puberty, including pathological factors such as tumours and brain diseases, but the most common reasons are related to genetics, dietary habits, and environmental factors. Children who develop early will initially be taller than their peers, but their final adult height will be relatively shorter. In addition to height, precocious puberty can also affect children's mental health. When they realise their bodies are different from other children, they may experience feelings of anxiety and unease. Furthermore, studies have shown that precocious puberty increases the risk of developing various gynaecological diseases later in life, such as breast cancer.
Therefore, precocious puberty is a problem that cannot be ignored. If parents discover that their children are showing secondary sexual characteristics too early, they must take their child to a paediatrician as soon as possible to find out the cause.
