Introduction
Precocious puberty (PP) is defined as the development of secondary sexual characteristics before 8 years old in girls and 9 years old in boys. Girls tend to develop earlier than boys.
What exactly is precocious puberty?
Precocious puberty is defined as the early onset of physical changes associated with sexual maturation before the age of 8 years in girls and 9 years in boys. These physical changes may include breast enlargement (in girls), pubic hair growth (in both sexes), and testicular enlargement (in males). In females, these physical changes may include menarche at earlier than average ages. Other symptoms may include accelerated height velocity and bone age advancement.
In addition to physical changes, children who experience early puberty may exhibit behavioral changes including increased aggression, mood swings, and attention problems. Children who experience early puberty may also develop sleep disturbances, headaches, stomachaches, and decreased appetite.
Children who experience early puberty may not always know they are experiencing these changes. Parents should watch their children closely for any unusual behaviors or physical changes. If parents notice anything out of the ordinary, they should consult a pediatrician immediately.
How does precocious puberty develop?
The cause of precocious puberty remains unknown. However, several theories have been proposed including abnormal brain function, endocrine disorders, genetic factors, autoimmunity, environmental influences, and infection.
Causes
There are many reasons why precocious puberty happens. Some of them are genetic, some environmental, and others psychological.
- Genetic: Some cases are caused by a mutation in genes that control the release of hormones. These mutations cause the body to produce too much hormone.
- Environmental: In some cases, it is triggered by certain chemicals found in food or water. For instance, high levels of lead in drinking water can trigger the early onset of puberty.
- Psychological: Sometimes, precocious puberty is due to emotional stress. Children who experience abuse or neglect may become stressed and their bodies react by producing too many sex hormones.
- Hormonal imbalances: There are some hormones that affect the timing of puberty. For instance, the thyroid hormone affects the onset of puberty.
- Brain tumors: A brain tumor can interfere with the normal functioning of the pituitary gland, which controls the release of sex hormones.
- Infections: An infection of the central nervous system can lead to PP.
- Endocrine disorders: Certain endocrine disorders can cause this. Examples include Cushing’s disease, hyperthyroidism, hypothyroidism, and adrenal insufficiency.
- Drugs: Many drugs can cause this, including amphetamines, antidepressants, antihistamines, anticonvulsants, antipsychotics, beta-blockers, calcium channel blockers, corticosteroids, dopamine agonists, estrogen, fluoxetine, flutamide, gonadotropin-releasing hormone analogs, lithium, methyltestosterone, norepinephrine reuptake inhibitors, phenothiazines, progesterone, rifampin, selective serotonin reuptake inhibitors, sertraline, testosterone, thiopurines, trazodone, tretinoin, tricyclics, and zolpidem.
Symptoms
Girls with this condition may notice changes in their breasts, hips, and genitals. They may begin to grow taller and gain weight faster than normal. Boys may start growing facial hair and developing acne.
Some of the symptoms of include:
- Breast enlargement in girls
- Pubic hair growth in boys
- Early voice change in girls
- Increase in body height
- Increase in weight
How to Treat Precocious Puberty?
There are two ways to treat precocious puberty.
Medical Treatments
Medications can be prescribed to treat precocious puberty. These medications work by blocking the release of gonadotropin-releasing hormone (GnRH). GnRH is a chemical messenger that tells the pituitary gland to produce hormones called luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH stimulate the production of sex steroids. The medication blocks the action of GnRH and prevents the production of sex steroid hormones.
Surgical Procedures
If medication fails to halt the advance of puberty, surgery may be necessary. Surgical procedures involve removing parts of the brain involved in regulating puberty. The goal of these surgeries is to prevent further sexual development. Surgery is only recommended after puberty begins and should be considered only after other methods of treating precocious puberty have been tried.
Precocious puberty treatment (PPT) is a medical term used to describe any intervention aimed at treating pp in children. PPT may involve medication, surgery, radiotherapy, or some combination of these treatments.
Parents often seek out alternative methods of treatment, including natural remedies. However, there is no evidence that herbal medicine is effective in treating precocious puberty. There is also little evidence that it causes harm.
The American Academy of Pediatrics recommends that doctors treat precocious puberty using medications only after trying non-drug therapies first. If those fail, then doctors should consider surgical removal of the pituitary gland, which produces hormones that cause this condition. Doctors do not recommend radiation therapy for precocious puberty.
The first step in treating precocious puberty is identifying the type of precocity. Once identified, doctors prescribe medication to treat the problem. Medications may include estrogen blockers, gonadotropin-releasing hormone agonists, antiandrogens, and aromatase inhibitors. Estrogen blockers block the effects of estrogen in the brain.
These medications slow down the production of sex hormones in the brain. Gonadotropin releasers stop the release of luteinizing hormone and follicle-stimulating hormone, which stimulates the ovaries to produce estrogen. Antiandrogens prevent the action of male hormones in the body. Aromatase inhibitors reduce the amount of estrogen produced by the ovaries.
Risks And Complications
There are many side effects associated with these treatments. Side effects vary depending on the medication prescribed. Common side effects include headaches, nausea, vomiting, breast tenderness, decreased appetite, weight gain, mood swings, depression, anxiety, acne, hair loss, and increased risk of bone fractures. Other side effects include changes in menstrual cycles, irregular menstruation, vaginal bleeding, and reduced fertility.
In some cases, surgery is necessary to remove excess tissue in the hypothalamus area of the brain. Surgery involves removing parts of the skull and opening the skull to access the hypothalamus. Doctors then use a laser to destroy the overactive cells in the hypothalamus.
Is precocious puberty dangerous?
Yes! There is no doubt about it. Precocious puberty is a very serious condition and can lead to long-term complications if not properly treated. Girls who experience precocious puberty are more likely to suffer mental retardation, poor school performance, and social problems later in their lives. Boys who experience precocious puberty also face similar risks, although they might not show outwardly obvious symptoms until adolescence.
Are there any preventions for precocious puberty?
Yes! Unfortunately, there isn’t much we can do to prevent precocious puberty. But, there are some things you can do to help reduce its risk. First, make sure your child’s diet contains adequate amounts of protein, iron, zinc, vitamin B12, vitamins A and D, and folic acid. Second, make sure your child gets plenty of exercises. Third, keep track of any illnesses your child experiences throughout his/her childhood. Finally, talk to your doctor about the possibility of treating your child with medication.
What is the Outlook on Precocious Puberty Treatment?
Children with precocious puberty tend to have good outcomes with treatment. Some studies have reported that 95% of treated patients experience improvement in puberty and body growth, including increased height and weight. Although there are still many questions regarding the long-term effects of treating precocious puberty, it seems to have no effect on future fertility.
