PRECOCIOUS PUBERTY: WHAT IT IS AND WHAT ARE THE SYMPTOMS IN GIRLS AND BOYS

Puberty is the transition period between childhood and adulthood. And we know that a child has reached this stage when sexual signs begin to appear (such as breast or testicular enlargement) and faster growth to adulthood.

It is considered a normal evolution between the ages of eight and 13 in girls, and between nine and 14 in boys. But what happens if it occurs early? When do you talk about precocious puberty? What are your symptoms? Do you have any risk for the health of our daughters to have menstruation early?

What is considered precocious puberty?

It is normal for puberty to begin between 8 and 13 years old in girls and between 9 and 14 years old in boys. This wide range of ages is conditioned, to a large extent, by genetic factors, responsible for around 75-80% of this variability.

But also environmental factors, such as nutrition, exercise or socioeconomic status, they can alter the rate of maturation of children and cause them to develop early.

If sexual signs appear before the age of eight in girls and nine in boys, there is talk of precocious puberty.

While when development has not started at 13-14 years, there is talk of pubertal delay and it is essential to study the different causes of hypogonadism.

This is explained by Dr. Antonio Conejo, head of the pediatric service of the Vithas Xanit International Hospital, who solves some of the most common doubts about premature sexual development and the risks that it may entail.

What are the symptoms of precocious puberty?

Girls. Progressive breast development, growth acceleration and first early menstruation (menarche). Usually, the first menstruation occurs between one and three years after the appearance of the breasts. If it arrives earlier, it could be a sign of precocious puberty.
Children. Increase in the size of the testicles and penis, muscle and body hair, growth acceleration and voice change.

Most of the time they will be isolated signs that do not imply true precocious puberty and do not require treatment.

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And the rule?

The first period or menstruation appears between a year and a half and three years after starting to increase the breast. It is common that, a few months before it appears, the girls notice that they have an increase in vaginal discharge.

This is explained by the Spanish Association of Pediatrics, which adds that it is common for the period to be irregular in the first months, but that it will be regulated as the body matures.

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Between the appearance of the rest of the pre-pubertal signals and the rule, there is reaction time, so it can be stopped if the pediatrician considers it necessary.

However, before any of these symptoms in a girl under eight years old, you have to go to the pediatrician, so you can detect as soon as possible an early puberty. Perform the appropriate tests and assess whether or not to stop the evolution of puberty.

What causes precocious puberty?

Most of the time it is simply due to a streamlining of the normal process, by genetics or environmental factors.
Other times because of an abnormality in the pituitary gland or in the hypothalamus, the area of the brain that controls it. Is called central precocious puberty, PPC.
Another possibility, although very rare, is that the glands that produce sex hormones (the ovaries in girls and the testicles in boys), begin to function on their own, earlier than normal. It is called peripheral precocious puberty, PPP.
It may also be that the small gland located above the kidneys begins to produce weak male hormones (androgens) before the age of eight. This can cause pubic or axillary hair growth and body odor, in both boys and girls. Is called adrenaquia and does not usually require treatment.

How is it diagnosed?

The pediatrician or child endocrine can perform:

An analysis of the growth graph.
A blood test to evaluate the pituitary and sexual hormones that control puberty. If they reveal that the child has PPC, an MRI of the brain will be done to make sure there is no underlying abnormality.
An x-ray of the hand and the left wrist, to assess bone age and thus determine how far puberty is progressing, how it advances and how it could affect the child's final height.

When should precocious puberty be treated?

The main risk of the so-called central precocious puberty (PPC) is to cause short stature in adulthood, as growth stops too early. Although it does not always happen, proper treatment can help the child have more time to grow.

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Hence, the main objective of pharmacological treatment is to stop the production of hormones involved in the pituitary gland, and deactivate sex steroids. This will stop the appearance of the signs of puberty and delay the beginning of periods in girls.

But as Dr. Antonio Conejo, head of the pediatric service of the Vithas Xanit International Hospital clarifies:

"You have to study each particular case, to see if there really is any anomaly that causes precocious puberty, because most of the time it is completely normal and does not influence the development of children."

But even if our child does not need drug treatment, we have to be vigilant when it "develops early."

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Precocious puberty also produces a psychological maturation that can present problems of maladjustment in school. Suffers physical and emotional changes for those who are not prepared or prepared to manage (such as breast augmentation or the appearance of menstruation). And we have to support them.

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