Is early puberty a matter of concern?

It was another beautiful morning for chirpy-chubby little 8 year old Trishala. All dressed-up for school she sat on the dinning table to start her day with a hearty healthy breakfast. This was when she started feeling a sharp pain in her stomach. She informed her mother to which she said that eating junk food frequently was the reason. (She devoured on a big slice of cheesy pizza and a bowl of noodles last night).

But as soon as she got up from her place for a relief toilet trip, her mother was shocked to see her blood-stained skirt. Flabbergasted, she immediately took hold of the situation and took Trishala to her room and got her changed. Trishala got her first periods!! The situation got so distressing for the mother as she could not understand why it was happening so early for her daughter and largely, how to help Trishala apprehend the changes happening to her! Calming herself down, she booked an appointment with her family pediatrician right away and also took Trishala along.

The situation Trishala and her mother were going through has become a common scenario in recent years, especially post-Covid period. Trishala was going through early pubertal onset or precocious puberty. Let us have an insight into the enriching informative conservation on precocious puberty between Trishala, her mother, Mrs. Pupple and the Doctor Ms. Malti.

Hello Doctor, please help save my daughter! She got her periods just at age8 ! Is she normal, is she sick, is her development normal?

Arrey relax Mrs. Pupple. Come have a seat and take a sip of water, said Dr Malti while calming Mrs. Pupple. Thereafter, Mrs. Pupple explained the situation to Dr. Malti. Dr. Malti then turned to Trishala, gave her a beautiful smile and examined her.

After examining Trishala thoroughly, she asked Mrs Pupple whether she was aware about the physical changes Trishala’s body was undergoing. To this Mrs Pupple said- No Doctor, frankly speaking I did not pay much attention. Why, is there anything that I should take care of Doctor?

Dr. Malti said -Trishala has started developing breasts also. I wonder why you did not notice this! Mrs Pupple said that Trishala has always been a cute chubby girl so she she never attentively noticed the physical changes her body had started undergoing lately.

Ok, Mrs Pupple the prognosis is- Trishala has hit puberty early which is medically known as Precocious puberty.

Q) Doctor, what is Precocious puberty?

Mrs. Pupple, as you must be knowing that puberty is a biological process wherein the body undergoes sexual maturity, i.e. the body prepares itself to enable to carry out reproduction. It is time period when secondary sexual characteristics start appearing like breast development, periods, development of armpit and pubic hairs etc, in girls while penis enlargement, deepening of voice in boys. It generally starts between age 9 to 14 in girls and from age 10-15 in boys. I will email you the following link to have more insight into puberty.

https://biodrivers.in/demystifying-puberty-bodys-transformative-journey-its-changes-challenges/ : Is early puberty a matter of concern?

Precocious puberty happens when the puberty hits young boys and girls much before than the average age i.e. before the age of 9 in girls and before the age of 10 in boys.

Q) What are the symptoms of Precocious puberty?

Symptoms are same physical changes in the body that happens during puberty.

For girls-

• Breast enlargement
• first period i.e. menarche
• growth of pubic and armpit hair
• growth spurt.

For boys-

• Testicles or penis enlargement
• deepening of voice
• growth of pubic and armpit hair
• growth spurt

Q) In general, what happens when the body reaches puberty?

See, in general the onset of puberty is regulated by HPG axis which is hypothalamus-pituitary-gonadal axis. At puberty the axis gets activated. This is when hypothalamus sends signals to your pituitary gland. The pituitary gland, in turn, secretes hormones that when enters blood stream stimulate ovaries (in girls) and testes (in boys) to secrete sex hormones to mark the onset of sexual maturity process.

Again, here is another link that I am going to forward you to read more on puberty onset.

https://biodrivers.in/102-when-does-the-body-hit-puberty/ : Is early puberty a matter of concern?

Q) Why some children have an early onset of puberty?

For most of the children, there is no particular reason that can be zeroed on for an early pubertal onset. It can be genetic i.e. the condition runs in the family, or there may be a brain injury or tumor that may be responsible, exposure to the harmful chemicals in plastics, cosmetics or radiations and problems with sex glands, adrenals or thyroid glands may trigger the early pubertal development.

Also, I would like to add the present day culture of junk food and aerated beverages that when consumed more often can alter the hormone levels which result into obesity, insulin resistance. These altered hormone levels can also cause early start of puberty.

Precocious puberty can be of two types:

Central precocious puberty– It is more common and more frequent in girls. It is also known as GnRH-dependent Precocious puberty wherein the HPG-axis gets activated too early resulting in the release of hormones that stimulate the gonads to secrete sex hormones and exhibit secondary sexual features. In girls, often, there is no underlying cause but in boys pathological reasons like tumors in the brain or injury to central nervous system (CNS), brain infection or exposure to the radiation that may trigger HPG axis early.

Peripheral precocious puberty- It is less frequent. It does not involve HPG axis rather the irregularities associated with sex glands- ovaries & testes, adrenal glands or thyroid gland trigger an early release of testosterone and estrogens in the body. Also, children who suffer from McCune Albright Syndrome (a rare genetic disease that affects bones, skin and endocrine system) may also suffer from precocious puberty.

Q) What are the risk factors associated with precocious puberty?

Puberty is a biological transformation process where the body matures in all aspects to become an adult. And, as a matter of fact, any transformation journey isn’t easy. Puberty brings along a whole-set of challenges both physical and emotional as kids get puzzled with changes happening to their bodies and emotions soaring. With early puberty things definitley get more complicated as the changes begin to happen much earlier. They find difficult to fit-in their peer group and are often hesitant to discuss the changes with their friends and become very skeptical as to why this is happening to them only?

Precocious puberty, thus, can be emotionally draining for kids owning to their tender age. They feel stressed as to why this is happening to them so early or whether they are growing normally. All these questions put them up in a state of mental stress which soon gets transformed to depression and anxiety. A point to be noted here- early puberty takes a toll on mental health of girls more heavily than boys!

Q) How precocious puberty is diagnosed?

There are certain tests available to diagnose early onset of puberty. Physical examination- to externally look out for the body changes in the child like breast development, growth of pubic or armpit hairs etc.

Blood tests can also be run to ascertain the levels of hormones (FSH, LH, GnRH and thyroid) in the child’s body and conclude accordingly. MRI scans can also be done to detect presence of any brain injury or tumor in case of central precocious puberty. X-Rays are also conducted to calculate the bone-age and growth of the kids to mark whether their growth is quicker than their age or normal.

Q) Lastly Doctor, what measures should be undertaken when the child is diagnosed with precocious puberty?

Look Mrs Pupple, puberty is a challenging phase for most kids. Myriad changes happening in the body over a period of 4-5 years can be emotionally more difficult for children to tackle. Kids at this phase of change become doubtful about almost everything happening around them. They have peer pressure, they become conscious of their physical appearances, they have weight issues, acne problems, a fear of being able to fit-in their friend circle, sudden bursts of emotions and how to handle them and also they become curious to know more about sex, substance abuse, etc.

It is, therefore, the primary responsibility of the parents to make them understand about this transition phase of life and the changes it brings along. It is very important to make the kids feel normal when they undergo puberty or if they have an early onset. Explain them everything, make them feel comfortable, and emotionally secured through this phase. I assure you Mrs Pupple when parents have an open word about puberty, its changes, introducing them to sex education, to make them aware of substance abuse, drugs, kids come out to be more confident and emotionally strong.

Besides parents, it is also the primary responsibility of the schools and educational institutions to conduct seminars on regular basis to spread awareness on puberty, periods, sex drive, how to control it and ways to control surging emotions. It is also important to include sex-education in the curriculum to answer their curiosity so that kids do not undertake false or wrong means to know about the same and land up in a shameful situation.

Thank you Dr. Malti. This was really an enlightening session for both me and Trishala. You have answered all my queries and relieved me from all the stress. I hope I do my best to learn more about puberty, its challenges from reliable sources and help Trishala to sail through it smoothly.

Bye Dr Malti.

Bye Mrs Pupple. Take care Trishala. You are very smart and intelligent girl and I hope you will also educate about this to your friends too!

Disclaimer: Articles by Megha Machhar are based on internet sources and should be used for widening knowledge. The reader should seek professional help when diagnosed with any medical condition.