Precocious Puberty

Precocious Puberty. Signs and Treatments

In recent years, experts and parents have noticed that early puberty, especially in girls, often begins around the ages of 6 to 7 years old.  We spoke with expert endocrinologist Dr. Aristotle Panagiotopoulos, Director of the Department of Pediatric Lipid Disorders at Athens Medical Group, to learn more about a topic many parents are concerned about – early puberty and how we can support our children when their bodies show signs of it. Dr. Panagiotopoulos explains what parents need tο know and how they can take the right steps if their children observe the signs of  early puberty. 

What is precocious puberty?

Precocious puberty is when a child's body starts showing signs of sexual development earlier than usual, often before the age of 8 in girls and 9 in boys.

How can I tell if my child might have precocious puberty?

Look out for early signs like breast development in girls, testicle growth in boys, rapid height increase, body odor, acne, or early menstruation in girls.

What causes precocious puberty?

It can be due to various reasons, like hormonal imbalances, brain issues, genetics, or rarely, other medical conditions. Many times the cause is not clear.

How will the doctor check for precocious puberty?

The Pediatric Endocrinologist will give your child a thorough evaluation which includes:

• Medical History: Provider will ask about the child's medical history, including any family history of early puberty or other relevant medical conditions.
• Review of Growth Charts: The child's growth history and patterns will be reviewed to identify any abnormal growth patterns that may be associated with precocious puberty.
• Physical Examination: Assess the child's overall health and to look for signs of early puberty. This includes “Tanner Staging”, which assesses the stage of sexual development in children and adolescents. It involves evaluating characteristics like breast development, pubic hair growth, and genital development.
• Bone Age X-ray: Helps assess whether bone development is progressing too rapidly.
• Blood Tests: These may include hormone level assessments
• LHRH Stimulation Test: Additional hormone tests that are done if initial testing is not conclusive and further information is needed.

• Brain Imaging: In some cases imaging studies like an MRI may be ordered to assess the brain's structures.

Will this affect my child in the long run?

There might be some emotional and social challenges, and it can lead to shorter stature. However, with the right care and support, most kids can lead healthy lives.

How does it interfere with the child Psychosocially?

Precocious puberty can have psychosocial effects on children, which means it can influence their emotions, social interactions, and overall well-being. Here are some ways precocious puberty can impact a child psychosocially:

• Body Image and Self-Esteem: Children experiencing precocious puberty may feel self- conscious about their physical development, especially if it differs significantly from their peers.
• Peer Relationships: If a child is physically more mature than their peers, they may have difficulty relating to them, potentially leading to social challenges or feelings of isolation.
• Emotional Well-being: Early puberty can be emotionally challenging for children. They may experience a range of emotions, including confusion, anxiety, or frustration about the changes happening to their bodies.
• Parent-Child Relationships: Parents may need to navigate conversations about puberty earlier than anticipated. It's important for parents to provide support, understanding, and open communication during this time.

Are there treatments for precocious puberty?

Yes.. The right treatment depends on what's causing it. It might involve medication to slow things down or address hormone levels.

Gonadotropin-Releasing Hormone (GnRH) agonist is the most common treatment for precocious puberty. They are typically administered as injections or implants and work by temporarily "pausing" the development process. In general this treatment option is safe with minimal long-term concerns. It is always best to discuss details of treatment options with your doctor.

Do environmental factors play a role in precocious puberty?

Yes. Certain foods and products contain compounds that can potentially influence hormonal balance and pubertal development. Examples are: Soy Products, Dairy Products, Processed Foods, Pesticides and Endocrine Disrupting Chemicals (EDCs), Bisphenol A (BPA) Plastics, Phthalates, High Glycemic Index Foods.

It's important to note that while some studies suggest associations, the evidence is not always definitive, and individual responses can vary.

Has COVID-19 affected the appearance of precocious puberty?

There hasn't been significant scientific evidence to suggest a direct relationship between COVID-19 and precocious puberty. The main impact of COVID-19 on children has been related to the virus itself, including symptoms, transmission, and potential complications.

However, it's worth noting that the pandemic and associated changes in lifestyle, routines, and access to healthcare could indirectly influence various aspects of children's health, including puberty. For example, disruptions in regular healthcare visits or delays in seeking medical attention for any health concerns could potentially affect the diagnosis and management of precocious puberty.

What specialist should evaluate and manage a child with precocious puberty?

A child with precocious puberty should be evaluated and managed by a pediatric endocrinologist. Pediatric endocrinologists are specially trained to diagnose and treat hormonal disorders in children.

If you suspect that a child is experiencing precocious puberty, it is important to consult your pediatrician, who can then refer you to a pediatric endocrinologist if necessary.

Dr. Aristotle Panayiotopoulos - Pediatric Endocrinologist

Director of the Department of Pediatric Lipid Disorders at Athens Medical Group, Assistant Professor of Pediatrics at Albert Einstein College of Medicine and Zucker School of Medicine, USA