Precocious Puberty (Early Puberty)Pubertad Precoz (Pubertad Temprana)

Precocious Puberty (Early Puberty)

What is precocious puberty (early puberty)?

Abnormally early puberty is called precocious puberty. When this occurs, a child's sexual characteristics develop too soon -- in girls before the age of 8 and in boys before the age of 9. Most children with the disorder grow fast at first, but also finish growing before reaching their full genetic height potential.

What causes precocious puberty?

Early puberty and sexual development may be caused by tumors or growths of the ovaries, adrenal glands, pituitary gland, or brain. Other causes may include central nervous system abnormalities, family history of the disease, or certain rare genetic syndromes. In many cases, no cause can be found for the disorder. Two types of precocious puberty include the following:

  • Gonadotropin-dependent precocious puberty. Also known as central precocious puberty, this form of precocious puberty is the most common. Most girls and half of boys with precocious puberty have this type. The puberty is triggered by premature secretion of the hormones responsible for puberty (gonadotropin). Researchers believe that the premature maturation of the hypothalamus-pituitary-ovarian axis causes this disorder in girls. However, in most cases, no cause can be found.

  • Gonadotropin-independent precocious puberty. This is a form of precocious puberty that is not triggered by the early release of gonadotropin hormones.

What are the symptoms of precocious puberty?

The following are the most common symptoms of precocious puberty. As in normal puberty, symptoms of precocious puberty include the onset of secondary sexual characteristics, including:

  • Girls:

    • Breasts

    • Pubic and underarm hair

    • Menstruation

    • Ovulation

  • Boys:

    • Enlarging penis and testicles

    • Pubic and underarm hair

    • Facial hair

    • Spontaneous erections

    • Production of sperm

    • Development of acne

    • Deepening of the voice

Other characteristics of the disorder include:

  • Typical moodiness associated with the hormonal changes

  • Increased aggression

  • Taller than peers, at first

How is precocious puberty diagnosed?

In addition to a complete medical history and physical exam of your child, other tests may include:

  • X-ray. A bone X-ray may be performed to determine bone age.

  • Measurement of gonadotropins (LH and FSH), estradiol, testosterone, and/or thyroid hormones.

  • Ultrasound (also called sonography) of the adrenal glands and gonads (ovaries and testes). This diagnostic imaging technique uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.

  • Gonadotropin-stimulating hormone (GnRH). Produced by the hypothalamus in the brain, GnRH stimulates the pituitary gland to release gonadotropins, which, in turn, stimulate the production of sex hormones from the gonads. The clinical GnRH test may determine the form of precocious puberty (gonadotropin-dependent or gonadotropin-independent).

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

What is the treatment for precocious puberty?

The goal of treatment for is to stop, and possibly reverse, the onset of early puberty symptoms. Treatment will also depend on the type of precocious puberty and the underlying cause, if known.

New developments in hormone treatments for precocious puberty have led to the successful use of synthetic luteinizing-releasing hormone. This synthetic hormone appears to stop the sexual maturation process brought on by the disorder by halting the pituitary gland from releasing the gonadotropin hormones.

What is the emotional effect of precocious puberty on a child?

Early puberty will cause a child's body to change much sooner than his or her peers. The mood swings and the sense of being different may make your child feel self-conscious. Your child may feel uncomfortable about his or her sexual changes, as well. Helping your child cope with teasing from his or her peers, treating your child appropriately for his or her age, and boosting your child's self-esteem are important steps to help your child adjust more appropriately.

 
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