Puberty is the period when a young person begins the process of sexual maturation that will result in the ability to reproduce. Puberty involves accelerated growth and the development of secondary sexual characteristics. These bodily changes occur at various ages, usually between 9 and 14 years of age for girls and 12 and 16 years of age for boys, and are associated with psychological changes as well. Precocious puberty occurs when the process of sexual maturation begins at an abnormally young age.
Causes of Precocious Puberty
Puberty normally begins in the brain and pituitary hormones are released that stimulate the production of sex hormones. Once the sex hormones, estrogen and testosterone, are produced, physical changes occur. Causes of puberty beginning prematurely are varied, and may or may not be serious.
Central Precocious Puberty
In cases of central precocious puberty, the process of sexual maturation begins prematurely, but otherwise proceeds normally. Most children in this category do not suffer from any underlying disorder and there is no reason for medical intervention. In some cases, there may be a family history of precocious puberty with no underlying problems.
More rarely, central precocious puberty may be caused by:
- Birth defect, such as hydrocephalus of benign tumor
- Radiation to, or injury of, the brain or spinal cord
Other possible causes of central precocious puberty are genetic diseases, such as congenital adrenal hyperplasia or McCune-Albright syndrome.
Peripheral Precocious Puberty
Peripheral precocious puberty does not originate in the brain, but rather in the direct release of estrogen or testosterone in the child's body. This premature release of sex hormones may occur because of:
- Dysfunctions of the ovaries or testicles
- Problems with the adrenal or pituitary glands
- Ovarian cysts or tumors in girls
- Tumor of sperm-producing cells (Leydig cells) in boys
- Rare genetic mutation in boys
Peripheral precocious puberty may also be the result of exposure to external sources of estrogen or testosterone.
Risk Factors for Precocious Puberty
While incidents of precocious puberty may appear randomly, certain factors increase the risk that an individual child will develop the problem. These include:
- Being female
- Being African-American
- Being obese
- Having certain medical conditions
- Having undergone radiation therapy of the nervous system
- Having been exposed to medication containing sex hormones
- Having been sexually abused
It is important that children be kept away from any adult medications containing sex hormones because these medications, whether taken orally or topically, can be the cause of precocious puberty.
Signs of Precocious Puberty
The signs of precocious puberty in children of both sexes include physical growth spurts, growth of hair under the arms and in the pubic area, and possible acne. Other signs vary according to gender.
Female Signs of Precocious Puberty
Signs that a girl is undergoing puberty include the following when they occur before age 9:
- Breast growth
- First menstrual period
- Maturation of the vagina
Male Signs of Precocious Puberty
In boys, precocious puberty is when any of the following develop before age 12:
- Facial hair, often first on upper lip
- Growth of the testes and penis
- Muscular development
- Voice deepening
Children undergoing precocious puberty may also exhibit mood swings and irritability commonly found in adolescents.
Diagnosis of Precocious Puberty
Precocious puberty may first be noticed by the child or parents or may first be detected during a routine medical examination. Once discovered, the doctor will probably administer blood tests to check hormone levels. Diagnostic imaging tests, such as CT or MRI scans may also be performed to rule out tumors or other abnormalities.
Treatment of Precocious Puberty
In many cases, precocious puberty may be no cause for alarm, considered simply a variation from the statistical norm. In other cases, where the cause of the problem is found to be exposure to medications with sex hormones, it may be enough to remove the offending products. If a more serious underlying cause for the problem is found, however, the child may require treatment with medications that will prevent any further release of sexual hormones in the body or surgery to remove the tumor responsible for the condition.
Possible Complications of Precocious Puberty
Precocious puberty may complicate a child's physical and emotional life. If left untreated, a child who goes through puberty prematurely may never reach full height since, once the period of puberty is over the growth process will stop. Children whose sexual development comes too early may also feel isolated because of differences with their peers, both in terms of physical appearance and in terms of emotional and sexual feelings. It is important that children receive medical, parental and psychological support during this possibly troublesome time. Children who undergo puberty at an early age may be more prone to teasing or sexual harassment.