What is Precocious Puberty?
Yes. A very fancy name for early puberty. This post will address early puberty in both males and females. So let’s get into all the reasons why puberty may start early, and things to consider if it does happen.
Precocious puberty is the onset of secondary sexual characteristics before the age of eight years in females and nine years in males.
What are secondary sexual characteristics?
We use Tanner Staging to rate sexual development. The studies behind Tanner Staging found that in females, breast development begins first, then pubic hair growth, and the last development is menstruation (or menses, periods, etc). In males, testicular enlargement happens first, followed by penile enlargement, and finally pubic hair growth.
Benign or Normal Variants
Let’s get some easy things out of the way first. There are some normal variations to puberty that can simply be monitored. In females, premature breast development alone (without pubic hair growth or menses) can be a normal variant. In males, pubic hair growth or mild acne can be a normal variant as well. Keeping tabs on these problems, and staying in touch with a primary care provider or pediatrician is still important.
What are the causes of precocious puberty?
Idiopathic - a fancy way of saying a problem has an unknown cause or arose spontaneously. These cases could have a genetic root, but actual genetic abnormalities causing early puberty are not common.
Cysts or Tumors - Both males and females can develop a variety of cysts on the ovaries or the testicles. In females, these could cause menses-like bleeding, discharge from the nipple, and/or pain in the abdomen and pelvis. In males you could see an asymmetrical testicular growth.
Hypothyroidism - This condition could cause premature testicular enlargement, breast development, recurrent vaginal bleeding, or nipple discharge. This can be treated with medication, but should continue to be monitored (probably very long term) by pediatricians and endocrinologists.
Accidental Hormone Exposure - If a parent or caregiver uses any type of topical hormone (like a Testosterone or Estrogen gel/cream/foam), they should be careful with application. We typically recommend areas that will be covered with clothes and not allow for skin to skin contact with others (like the upper thigh). If someone is repeatedly applying this medication to their forearms and wearing short sleeve shirts it could be absorbed by the child who is in direct contact.
Race and Weight - Since Tanner Staging was put into place in 1970, studies in the US have noted changes in puberty. Children who are obese will go into puberty sooner than other children. And African American children experience puberty the earliest, followed by Hispanic children, and finally White Non-Hispanic children. This can obviously vary worldwide.
Other
Lavender or tea tree oil have been associated with the development of gynecomastia (swollen male breast tissue) in prepubertal males and premature breast development in young girls.
Phthalates (an ingredient used in plastics, and a million other things) has been found in higher concentrations in girls with premature breast development and early puberty. While this evidence is not hard enough to take plastic products off the market, avoidance or reduction of plastic use is probably not a bad idea.
Why is Precocious Puberty a Bad Thing?
Duke Health reports that children who go through early puberty have higher rates of depression, low self-esteem, and substance abuse. As a school aged child, it is normal to want to fit in, and having early puberty does not help. Puberty is a stressful time, even if it is happening at the same time as everyone around you. If your child is experiencing pubertal changes early, it is important to talk about these changes early, often, and consider seeing a professional (like a counselor or therapist).
Sources used for the above article include Duke Health and UpToDate.
