Parents may feel concerned if they see their child entering puberty before she is expected to. They may not be sure whether or not this is normal, and whether or not they should consult a doctor. An assessment by a doctor will help to confirm whether a child may need to receive treatment as, in some cases, if a child is entering puberty too early and does not receive treatment in time, there can be serious consequences to her health. Luckily, this early sexual development can be prevented through proper treatment.
How is Precocious Puberty Diagnosed?
Physical signs that a young girl is entering into early puberty will be present, for example, the growth of breasts, leucorrhoea (vaginal discharge), an increase in height, genital hair growth, and acne. If your daughter has any of these symptoms, then this is indicative of precocious puberty.
Causes of Precocious Puberty in Girls
There are two main causes of precocious puberty in girls:
- Central precocious puberty – This is when the pituitary gland in the brain releases gonadotropin hormones, which in turn, stimulate estrogen production in the ovaries. In most cases, it is still unknown what the specific cause of this early hormone release is. However, there are a minority of cases which appear to be caused by a brain tumor, by another illness within the brain that stimulates hormone release, or as the result of the brain experiencing some type of head trauma.
- Peripheral precocious puberty – this is when the ovaries produce estrogen earlier than usual, without any stimulation from the brain. This is much less common than central precocious puberty, and could be caused by an issue with the ovaries, the adrenal gland, or the thyroid gland, or a type of tumor which stimulates sex hormone growth.
Other than these two main causes, precocious puberty can be hereditary or can be caused by various types of medication, for example, a cream containing estrogen which may cause early breast development in girls.
Potential Risks for Precocious Puberty in Girls
Precocious puberty can cause a range of body issues, from problems with self-care during menstruation to short stature. Regarding short stature, although the child may be taller than his or her peers during the onset of precocious puberty, their bone structure and development will eventually suffer, causing them to be shorter than average in adult life.
Girls who experience puberty early also have a higher risk of developing breast cancer later in life, as many studies suggest.
Lastly, girls who go through precocious puberty often experience teasing from their peers, due to their difference in appearance.
Diagnosis and Treatment
The doctor will look into the child’s medical history and will carry out a detailed physical examination in order to find the cause of the precocious puberty, so as to evaluate the appropriate course of treatment for that specific cause. The doctor will likely conduct an x-ray to determine bone age, perform a blood test, and in some instances, may carry out an ultrasound on the ovaries or an MRI scan on the brain to determine whether there is an ovarian tumor or a problem within the brain. If the doctor is unable to determine the cause, but still detects abnormal hormone production, the doctor will work to limit the on-set of early puberty by giving medications (injections) which can prevent the brain from releasing the hormones that causes children to develop early, and allowing the child to develop and grow at an appropriate rate. This injected medication must be administered monthly until the child’s bone age corresponds to his or her real age, and the child is at an appropriate age to begin puberty. When this treatment is discontinued, the production of hormones will resume as normal.
Should Precocious Puberty Be Treated after Menstruation has Occurred
On average, girls gain an additional 4-6 cm in height after beginning menstruation. For the aforementioned reasons, treatment with medicine at this stage can result in negative results, as the bones have already developed considerably; additionally, if the bones have already fully developed, the treatment will not work. As such, treatment for precocious puberty in girls who are already experiencing menstruation should be judged on a case-by-case basis at the discretion of a medical professional who will be able to determine which patients are suitable for treatment — and which patients could benefit from treatment.
Side Effects of Medication
Medication is safe and effective when used at the appropriate stage, with very few people experiencing any allergies from the medication. However, caution should be taken when using the medication at an unsuitable age, as it may affect the strength of the bone structure. Treatment and length of use should be determined by a trained physician in order to maximize results and minimize side-effects.
Prevention of Precocious Puberty
There is some evidence to suggest that hormones in food may contribute to the occurrence of precocious puberty. However, there is currently insufficient data to determine whether this is in fact the case; there may be no need to avoid any specific types of meat. What is important is that parents ensure their child is eating a varied and nutritionally balanced diet from all the 5 food groups, and getting plenty of exercise and rest to ensure good health and strong hormonal development.