Precocious or early puberty is medically identified when the growth or development in a child starts at an unusually early age. It can be diagnosed by simple observation of an abnormal development at a young age. It is not an ailment but can affect psychological development, social behavior and reduce height potential. Boys who show distinguished signs of puberty and its development before age 9 and girls before age 7 are considered precocious.
Causes of puberty can be categorized into three major types:
If the cause can be traced to the hypothalamus or pituitary, the cause is considered central.
Causes of central precocious puberty can include:
- Damage to the inhibitory system of the brain (due to trauma, infection or irradiation),
- Hypothalamic hamartoma produces pulsatile gonadotropin-releasing hormone (GnRH),
- Langerhans cell histiocytosis, or
- McCune–Albright syndrome.
Peripheral precocious puberty causes can be related to secondary sexual development induced by sex steroids from other abnormal sources. It is a severe form of disease with children. Common symptoms are commonly as a sequelae from adrenal, which includes but is not limited to hypotension, hypertension, ambiguous genitalia in females, electrolyte abnormalities, signs of virilization in females. High levels of androgens in blood are detected with low levels of cortisol.
Causes may include
- Endogenous sources
- Gonadal tumors (such as arrhenoblastoma),
- Adrenal tumors
- Germ cell tumor
- Congenital adrenal hyperplasia
- McCune–Albright syndrome
- Exogenous hormones
- Environmental exogenous hormones
- Treatment for different condition
Isosexual and heterosexual
Generally, patients with inappropriate secondary sexual characteristics show precocious puberty. This is called isosexual precocity.
At times, a patient may develop in the opposite direction. For example, a female may develop a deepened voice and facial hair while a male may develop breasts and other feminine characteristics. This is called heterosexual precocity. Heterosexual precocity is not very common in comparison to isosexual precocity and is usually the result of only unusual circumstances. For example, children with a very unique genetic condition called familial hyperestrogenism. In this condition, children usually have exceptionally high levels of estrogen which leads to precocious puberty. Males and females are hyperfeminized by the syndrome.
Common Consequences of Early Puberty
Studies indicate that breast development in girls and the appearance of pubic hair in girls and boys are starting much earlier than in previous decades and generations. As a result, “precocious puberty” in children, particularly girls, as young as 9 and 10 is no more considered an anomaly, although it may be confusing and alarming to parents and can be harmful to children who mature physically in advance compared to their mental maturity.
- Breast development in boys prior to appearance of pubic hair or testicular enlargement,
- Pubic hair or genital enlargement (gonadarche) in boys with onset before 9.5 years,
- Pubic hair before 8 or breast development in girls with onset before 7 years,
- Menstruation (menarche) in girls before the age of 10 years.
Research says gender (usually occurs mostly in girls), genetics, race, international adoption, obesity, family stress and chemical exposures in the environment may also have a role in precocious puberty.