Precocious Puberty

What is puberty?

Puberty is the period during which the capability of sexual reproduction is attained.  Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the sexual organs. This usually happens between ages 10 and 14 for girls and ages 12 and 16 for boys.

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Precocious puberty is development of the following characteristics before age 8 year in girls and before age 9 year in boys.

Signs and symptoms in girls include:

  • Growth of breasts.
  • First period (menarche)

Signs and symptoms in boys include:

  • Enlarged testicles and penis
  • Facial hair (usually grows first on the upper lip)
  • Deepening of voice

Signs and symptoms that can occur in boys and girls include:

  • Pubic or underarm hair
  • Rapid growth
  • Acne

Precocious puberty is classified as central and peripheral.

 In central, gonadotrophin dependent, when it results primarily from early hypothalamic-pituitary maturation. Central Precocious Puberty represents 80% of cases of Precocious Puberty and occurs more commonly in girls, with a female to male ratio of at least 3:1.

In peripheral, gonadotrophin-independent puberty, the primary event is increased secretion of adrenal or gonadal sex steroids or exposure to exogenous steroids. Some forms of peripheral Precocious Puberty occur in boys, such as chorionic gonadotrophin secreting tumors and familial gonadotrophin-independent peripheral Precocious Puberty resulting in constitutive activation of the LH receptor and hence testosterone production. [Symposium on Growth and Its Disorders-II, Growth in Precocious Puberty. Justin J. Brown and Garry L. Warne ]

Possible complications of precocious puberty include:

  • Short heightChildren with precocious puberty may grow quickly at first and be tall, compared with their peers. But, because their bones mature more quickly than normal, they often stop growing earlier than usual. This can cause them to be shorter than average in the long run.
  • Social and emotional problemsGirls and boys who begin puberty long before their peers may be extremely self-conscious about the changes occurring in their bodies. This may affect self-esteem, increased stress and increase the risk of depression.
  • Early menstruation can be very disturbing for girls who are of age 8 or younger who are not able to take care of themselves in those days. Parents can help by educating their child about what physical changes are occurring to them, how to take self care.
  • Decreased concentration, poor scholastic performance, bullying, teasing at school. Child may refuse to go to school.
  • Parents may have trouble dealing with child’s early development or worry regarding kids sexual interests but there’s no strong evidence that kids with early puberty are likelier to be sexually active at a younger age

Make an appointment with your child’s doctor if your child has any of the signs or symptoms of precocious puberty. Treatment of this is available. If you, your child are having difficulty coping, seek counseling. Psychological counseling can help your family better understand and handle the emotions, issues and challenges that accompany precocious puberty.

Dr. Aprateem Mukherjee

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