Symptoms & Treatment

PRECOCIOUS PUBERTY: CAUSES, RISKS, IMPLICATIONS & CONSEQUENCES

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What is Precocious Puberty?

Precocious puberty (early onset puberty) happens when girls and boys show signs of sexual maturity before 8-9 years of age (which is the average age of puberty) and is not considered normal. This condition occurs in approximately 1:1500 children.

Types

  1. Central Precocious Puberty: The more common type, it is much like common puberty, characterised by early onset of puberty.
  2. Peripheral Precocious Puberty: Also called pseudopuberty, because estrogen and testosterone hormones get triggered into over secreting, without stimulation from the secretion of gonadotropins from the pituitary gland.

Causes & Symptoms

  • Family history: This could be one of the causes of early puberty. If a woman starts menstruation early (before the age of 10-11 years), then it is highly likely that her daughter would also start menstruating early. Genetic disorders/ mutation may also be an underlying cause.
  • Hormonal imbalance: The pituitary and adrenal glands secrete hormones which determine sexual development and function. For unknown reasons, gonadotropins — the hormones secreted by the pituitary gland which determine the development and function of the sexual organs and characteristics – further stimulate the secretion of testosterone and estrogen in both girls and boys. Testosterone is responsible for facial, underarm and pubic hair, height gain, acne, and voice thickening in boys, and estrogen is responsible for breast development in girls.
  • Underactive thyroid function (Hypothyroidism) is also one of the causes.
  • Obesity: Overweight and obesity is linked to early puberty in boys and girls and early onset of menstruation in girls.
  • Female sex is 10 times more likely to suffer from precocious puberty, than the male sex.
  • Pre-existence of medical issues like ovarian cysts in girls, tumours, congenital adrenal hyperplasia, exposure to radiation treatment, brain injury, infection and inflammation in the brain can trigger precocious puberty.

Complications

  • Short height: Sudden initial spurt in height (as compared to peers) is observed: but because of this initial spurt, bones mature faster and stop growing, resulting in shorter average height (as compared to peers).   
  • Emotional & psychological issues of self-esteem and being self-conscious among peers may increase the risk of depression and substance abuse.

Diagnosis & Treatment

  • Physical examination by a paediatric endocrinologist is required to screen and pinpoint the underlying cause of precocious puberty, and recommend appropriate tests and treatment.
  • Blood tests:
  • GnRH (Gonadotropin releasing Hormone)stimulation test: the doctor administers it to the child-patient and then observes their hormone response by conducting a series of tests over a period of time. Thereafter, he may recommend GnRH Analog Therapy as treatment, to halt the development in the child patient. This treatment lasts until the suitable age for attaining puberty is reached.
  • Thyroid profile is done to screen for hypothyroidism.

MRI (Magnetec Resonance Imaging) to rule out any abnormalities in the brain function of the child patient.

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