Is your child becoming a big kid too soon? Let's learn about Precocious Puberty

Have you ever felt like your daughter or son is growing up a little faster than other children their age? It's normal for some parents to feel a little scared and worried when they see things like a growth spurt, a change in their voice, and perhaps even an adult-like smell of sweat. Is this really something to be afraid of? Today we're going to talk about this issue that many parents think about, which is when a child reaches puberty before the normal age.

Simply put, what is precocious puberty?

Precocious puberty, medically known as precocious puberty , is when a child shows signs of puberty much earlier than the normal age. What usually happens is:

• A girl begins puberty between the ages of 8 and 13.
• A boy begins to go through puberty between the ages of 9 and 14.

So, if a girl shows signs of puberty before these age limits, that is, before the age of 8 for a girl and before the age of 9 for a boy , we call that condition Precocious Puberty.

Let's understand a little, how does this process of becoming an adult happen?

This is like an automatic system in our body. Imagine, there is a main control center in our brain called the Hypothalamus . When the right age is reached, this control center sends a signal to another small gland, the Pituitary Gland . As soon as that signal is received, the Pituitary Gland produces hormones called Gonadotropins and releases them into the blood. These hormones go directly to stimulate the child's gonads.

• In girls, the ovaries produce the hormone estrogen .
• Boys have testicles , which produce the hormone testosterone .

All the physical changes that occur during puberty are due to the action of these hormones. What happens in precocious puberty is that this entire process starts early.

There are two main types of this condition.

This early puberty can be divided into two main types based on how it occurs. This classification is very important to understand the cause.

Why does this happen to a child? What are the reasons?

The reason varies depending on the type we're talking about.

Causes of Central Precocious Puberty (Central Type)

This involves looking for the cause of the brain's control center being activated earlier. But often, especially in girls, a clear cause cannot be found. But sometimes things like this can be the cause:

• Brain injury or accident (Brain Trauma )
• Types of Brain Tumors
• Brain infections
• Certain congenital brain abnormalities
• Undergoing radiation treatment

Causes of Peripheral Precocious Puberty

Since there is no brain involvement here, the cause lies elsewhere in the body.

• Tumors that develop in the ovaries, testicles , or adrenal glands.
• Some genetic conditions (e.g. McCune-Albright syndrome).
• Severe hypothyroidism.
• Adrenal gland diseases (e.g. Congenital Adrenal Hyperplasia).
• Hormones entering the body from outside:This is very important. Imagine if an adult uses a cream or medicine containing estrogen or testosterone and applies it regularly to a small child, it can also cause this condition.

What are the signs we see?

These characteristics are common to both boys and girls, and there are also some that are specific to each. Characteristics that can be seen in both are:

• Acne
• Smelling like an adult's sweat
• Sudden increase in body growth rate (Growth Spurt)

In addition to these common characteristics, sexual characteristics can also be seen.

Are there any other problems that could arise from this?

Yes, this condition can cause the child to face some physical and mental problems. 1. Eventually becoming short: This is something that many parents do not know. Although children who reach puberty early initially gain height, their bone growth stops quickly. This means that as soon as puberty ends, their height also stops growing. So, eventually, they are more likely to be shorter than other children their age. 2. Mental and social problems:This is also very important. Imagine how a child would feel if their body changed before everyone else in the class, if they felt different from the other children?

• Shame and embarrassment
• Being teased by other children
• Conditions like anxiety and depression
• Tendency to behave in a way that is not appropriate for one's age

How do you find this, Doctor?

When you take your child to a doctor, he or she will do a few tests to determine the exact condition. Don't worry, these are not painful for the child.

• Physical examination: First, the doctor will examine the child thoroughly and ask you about your child's health history.
• Bone Age X-ray: A small X-ray of the child's hand and wrist is taken. This is to see how much the child's bones have matured compared to their actual age. Children who reach puberty early have a higher bone age than their actual age.
• Blood tests: A small amount of blood is taken to check hormone levels (especially pituitary hormones like LH and FSH).
• MRI or Ultrasound Scan: Sometimes, if the doctor wants to further investigate the cause, he or she may recommend an MRI of the brain or an ultrasound of the abdomen. These are done to rule out any possible tumors, such as tumors in the brain, ovaries, or adrenal glands. Not all children need these.

After these tests, if necessary, you may be referred to a pediatric endocrinologist .

What are the treatments for this?

Fortunately, there are very effective treatments to control this condition. Treatment depends on the type we discussed earlier (Central or Peripheral) and the cause.

• For Central Precocious Puberty: The main goal here is to temporarily stop the signal from the brain to 'grow up'. A type of medication called a GnRH agonist is used for this. This is an injection that is given once a month or every three months. It's like snoozing the alarm on a clock. Once this treatment starts, the signs of puberty gradually decrease. When the child reaches the right age (usually 11-12), this medication is stopped, and then puberty begins again as normal. This gives the child the opportunity to achieve a normal height and prepare mentally.

• For Peripheral Precocious Puberty:Here, the treatment depends on the cause. If it is a hormone-producing tumor, it will have to be removed surgically. If it is something like an external cream, the problem will go away once you stop using it. The treatment will be decided based on the cause.

When should I go see a doctor?

This is very important. If your child is experiencing any of the following, be sure to see a doctor, especially a pediatrician . Seeking medical advice early can help determine the exact cause, initiate treatment if necessary, and minimize the physical and mental problems that the child may experience. Precocious puberty, premature puberty, precocious puberty sinhala, children's hormones, childhood diseases, puberty, hormonal problems