Normal puberty begins between the ages 8 and 13 in girls and 10 and 15 in boys. It can be a bit later or a bit earlier that this, but when it happens very early, sometimes beginning as early as SIX MONTHS of age, it is called precocious puberty. Puberty is defined as sexual maturation. The child experiences physical, hormonal and sexual changes and the appearance of secondary sexual characteristics.
In Girls, the following happens:
Breasts begin to develop
Armpit and public hair begins to grow
In Boys, the following happens:
Testicles and penis enlargement
Armpit and public hair begins to develop
Facial hair begins
Precocious puberty is premature development of these physical characteristics. It is a rare condition and occurs ten times more often in girls than in boys. Many times, the cause is not known, but rarely it may be due to abnormalities of the brain or hormone-secreting humors.
If puberty occurs before the age of six, other causes may be ovarian cysts, thyroid problems or external sources of estrogen. Another condition, McCune-Albright’s Polyostotic Fibrous Dysplasia could also be the cause. Please watch for my article on McCune-Albright’s syndrome. Go to the link at the end of this article.
Sometimes, young girls (under age 9) begin to have isolated breast development which does not progress to the rest of the signs of puberty. This is called premature thelarche and is a different, benign condition, and not precocious puberty.
Early onset maturation in girls has two main categories: Rapidly progressive and slowly progressive. Most girls who begin puberty before the age of 6 have the rapidly progressive type. They progress through the stages of puberty very quickly and the growth plates of the bones close prematurely. About 1/3 of these girls will end up being much shorter than normal height.
Most of the girls who begin puberty after the age of seven do begin early, but will go through the stages at a more typical pace. They will continue to grow until their bones reach final maturity around the age of 16.
Some of the problems associated with precocious puberty can be serious. Girls who have their first period before the age of 12 have a higher lifetime risk for breast cancer. Their prolonged estrogen exposure is thought to be the cause of this higher risk. As the child reaches maturity, she needs to be made aware of controllable risk factors for breast cancer such as estrogen-containing birth control bills, a first pregnancy after age 30, high-fat diet, alcohol use, fertility drugs, pesticides and radiation exposure. Each added risk multiplies her accumulated risk.
There are many long-term effects of premature development including short stature, psychological-social problems, self esteem problems, substance abuse problems and depression as well as pathologic conditions with the risk of morbidity and even death. The child needs to be referred to a pediatric endocrinologist for complete diagnosis and treatment. One of the most difficult things for them is finding a peer group. These children, especially the girls, no longer fit entirely into their age group and they need people to help them bridge the gap between being a little girl and being a woman.