Precocious Puberty

The difference between Precocious Puberty and puberty itself is Precocious Puberty is normally found in children between the ages 8 and 11. While puberty normally does not hit children till around age 11-14. The Mayo Clinic best describes Precocious Puberty as: “Precocious Puberty is when the body changes from that of a child into an adult. It includes rapid growth of bones, teeth and muscles; changes in body shape and size; and development of the body's ability to reproduce. Precocious Puberty normally begins in girls between ages 8 and 12 and in boys between ages 9 and 14.

The cause of precocious puberty often cannot be found. ” Rarely, conditions such as infections, hormone disorders, tumors, brain abnormalities or injuries may cause precocious puberty. Treatment for precocious puberty typically includes medication to delay further development. There are 5 different types of Precocious Puberty. Gonadotropin-dependent precocious puberty is very common and affects mostly girls and half of the boys. This is a disorder which is triggered by premature secretion of puberty controlling hormones or higher levels of gonadotropins.

Gonadotropin-independent precocious puberty mostly affects boys with low gonadotropin levels. Central precocious puberty is not triggered by any underlying reason. It is merely a body response to changes that concern the central nervous system. Isosexual precocious puberty causes the sign of femininity in girls and masculinity in boys. Heterosexual precocious puberty is just opposite of Isosexual precocious puberty which brings the sign of femininity in boys whereas masculinity in girls. Early onset of puberty can cause several problems.

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The early growth spurt initially can cause tall stature, but rapid bone maturation can cause linear growth to cease too early and can result in short adult stature. Most children, boys and girls alike that have Precocious Puberty end up being less than 5 feet tall. According to Kids Health (1995) there are signs to be on the lookout for. For instance, “in girls the telltale signs of precocious puberty include any of the following before 7 or 8 years of age include: breast development, pubic or underarm hair development, rapid height growth, and onset of menstruation.

In boys, the signs of precocious puberty before 9 years of age include: enlargement of the testicles or penis, pubic, underarm, or facial hair development, rapid height growth — a growth "spurt", and voice deepening. ” Both girls and boys will have an onset of acne and adult mature body odor. An 8 year old child having such things causes problems for that child. It’s always difficult to be different, and maturing into an adult-looking body earlier than your peers puts a lot of pressure on children. A child I know, Roberta, is only 7 years old and has Central Precocious Puberty.

The mental affects it has on Roberta is outrageous; she is a second grader having to deal with wearing sanitary napkins, the “smell” associated with periods, the self-image problems of already growing breast, among many more issues. This can really wear on a child, especially one that is so young. Roberta is finding it hard to maintain her friends, once they find out about her already having periods their mom’s want them to not be friends anymore. One little girl had been friends with Roberta since Preschool then the mom found out that Roberta was wearing sanitary napkins and told her daughter she could not be friends with Roberta anymore.

Roberta’s mom went to talk to this lady, and her response was, she was not ready to have “the talk” with her daughter yet. It was better they not be friends to prevent Roberta from telling her daughter anything. It is more difficult for girls than boys. Girls have undeniable signs that are visible to everyone. Boys can hide their growing penis and chest hair from their friends, the only thing they cannot hide is their facial hair if that is coming in early. Both boys and girls can have a tough time when they go through pubertal changes.

Children who go through the changes at the age of 8-11 while their friends do not hit puberty till 11-14, makes it even harder for those early bloomers to cope. Children with Precocious Puberty may be stressed because of physical and hormonal changes; they are just too young to understand all the changes their body is making. These children will be teased and may end up having body image or self-esteem problems. Girls who reach menarche before age 9-10 may become withdrawn and may have difficulty adjusting to wearing and changing sanitary napkins.

Roberta has had problems adjusting to wearing the sanitary napkins and she wants to make sure no one can see them from her pants. It is very confusing and traumatizing for her. Both sexes, boys more often than girls, may have increases in libido leading to increased masturbation or inappropriate sexual behaviors at a young age. Girls with a history of early puberty have a slightly earlier age of initiation of sexual activity. Some girls with Precocious Puberty enter the dating scene much earlier than their classmates.

Early-maturing girls may also have behavior problems and a greater risk for substance abuse and suicide. The best thing for the children struggling through precocious puberty is for someone to be there for them, listen to them, encourage them, let them know there are others who are just like them, and what they are going through is normal. It may not normal for their age, but normal none the less. All children go through adolescences. Those with Precocious Puberty are just going through adolescences sooner. In order to diagnose Precocious Puberty the doctor will perform a work up on the child.

The doctor normally begins by reviewing the medical history of the family, doing a physical exam, reviewing blood work to measure hormone levels, and taking x-rays of the child’s hand and wrist to determine bone age. When diagnosing a child with Precocious Puberty, a doctor will look at the Tanner Stages to determine where the child is at. Tanner Stages is a system that was developed in 1969 it grew out of a two-decade-long study of girls as they transitioned through puberty. “The Tanner staging system is named after Dr. James Tanner, who was a British pediatrician.

He performed a longitudinal study in which the subjects were observed repeatedly over a period of time in the same context. ” (Dr. Greenp 2006) In an experiment; the girls underwent examinations and photographs every three months. Dr. Tanner and his research group studied the progress and developed the 5 Tanner Stages that we use today. The Tanner Stages deal with both breast and genital development. Roberta (the afore mentioned child) has a Breast Tanner Stage 3 and a Pubic Hair Tanner Stage of 4; this happens more times than not for girls to be more advanced in one area over the other.

She is biologically age 7 but her bone age is 11. Girls will have Tanner Stages numbered 1-5; childhood through adulthood. Boys will have only one Tanner Stage, Tanner Stages numbered 1-5; childhood through adulthood. According to the Mayo Clinic (1998) there is treatment for Precocious Puberty. The children can receive a treatment called Gn-RH analogue therapy, usually includes a monthly injection of a medication, such as leuprolide, which stops the HPG axis and delays further development. The child continues to receive this medication until he or she reaches the normal age of puberty.

Once he or she stops receiving the medication, the process of puberty begins again. The goal of treatment for Precocious Puberty is to stop puberty from progressing so the child can have a normal healthy childhood. Treatment will also depend on the type of Precocious Puberty and the underlying cause, if known. According to Health of Children, there are several drugs that have been developed for treatment: histerlin, nafarelin, synthetic gonadotropin-releasing hormone agonist, deslorelin, ethylamide, triptorelin, and leuprolide.

If parents opt to have treatment, there is some after care that is required. The child will have follow up visits every 3-6 months to ensure that progression of puberty has been slowed or halted altogether. Normalization of accelerated growth, reduction in size of breasts and suppression of gonadotropin levels after receiving Gn-RH. Monitor bone age yearly to confirm that the rapid advancement seen in the untreated state has slowed typically to a half year of bone age per year or less.

If parents opt to not have treatment, the child might need therapy to help with self-esteem issues, high anxiety, irritability or even withdrawal. Some studies have shown that not treating children has no effect on them at all with the exception to early adolescences. The best thing a parent can do is to discuss the ends and outs with the Endocrinologist about which treatment if any will be best for their child. Precocious Puberty is something a child can live with. Most importantly, there is help out there if they want it.

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