Understanding Early Puberty: Causes and Consequences

Precocious puberty is the early appearance of signs of pubertal development before 8 years of age in girls and before 9 years of age in boys.

Puberty is the process in which the child becomes an adult and reaches reproductive capacity. It manifests itself with the appearance of menstruation in girls and the ability to produce sperm in boys. Along with these changes, there is an acceleration of growth and a maturation of the bones with the progressive closure of the growth plates.

It is characterized by the presence of three factors:

• Appearance of sexual characteristics: in girls breast development begins (thelarchy) and in boys the increase in testicular volume.
• Acceleration of bone growth and maturation.
• Decrease in final adult height due to early closure of the bones.

Causes

Precocious puberty can be classified into three types according to its origin:

• Central or true: this type depends on the hormones that regulate puberty (for example: tumors of the central nervous system)
• Peripheral or pseudo puberty: not dependent on gonadotrophic hormones (for example, ovarian or testicular tumors)
• Idiopathic: the cause of puberty is unknown

The most frequent form is precocious puberty of central origin. In many cases, the cause of the early onset of puberty cannot be known.

To make a good diagnosis, pubertal changes in children should be observed, a hormonal analysis and an X-ray of the bones of the hand should be carried out to assess bone age. In some cases, larger studies with CT or MRI of the brain may be necessary.

Treatment

Treatment should be evaluated by a pediatric endocrinologist and treatment of the cause should be considered, if any.

The treatment of central precocious puberty is based on the administration of drugs that slow down the hormones responsible for the onset of puberty, so that they slow down bone maturation and growth rate. Hormonal treatment should be given in those cases where the final height may be affected or if the onset is very early.