Precocious Puberty

"In the treatment of precocious puberty, the psychological circumstances of the child, as well as his or her age, must be taken into account".

DR. CRISTINA AZCONA SAN JULIÁN
SPECIALIST. PEDIATRICS DEPARTMENT

Precocious puberty is defined as the appearance of secondary sexual characteristics (breast development, pubic hair and armpit hair) before the age of 8 in the girl and 9 in the boy.

If they appear between the ages of 8 and 9, it is called early puberty, which is the lower part of the normal distribution.

In the physiological development in the girl usually appears first, the mammary button, second, the pubic hair (although in one of each 6 girls it appears before), third, the hair axillary and finally the rule.

However, this order can be altered, above all, in cases where precocious puberty does not depend on the secretion of pituitary hormones (central precocious puberty or gonadotropin-dependent), but is triggered by the autonomous production of estrogen in the ovary (peripheral precocious puberty or independent gonadotropin).

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What are the symptoms of precocious puberty?

The progression of the clinical picture leads to an accelerated bone maturation and therefore to an early closing of the growth cartilages and a low final size and to the early appearance of menarche (first rule).

In addition, both boys and girls may have psychological problems when they see that their development is different from that of their peers.

Most common symptoms:

  • Early appearance of the first period.
  • Development of the breast button.
  • Low size.

Does your child have any of these symptoms?

You may suffer from precocious puberty

How is precocious puberty diagnosed?

The diagnosis is made by means of a physical examination of the child, which can be complemented with hormonal analysis.

A hand x-ray will be done to know the degree of bone maturation.

The parents should play down the importance of the problem and explain, according to the pediatrician's indications, why this pubertal advancement has occurred and how it should be treated.

How is precocious puberty treated?

In the treatment of precocious puberty, the psychological circumstances of the girl, as well as her age, must be taken into account.

The treatment for precocious puberty consists of the administration of monthly injections that block the pituitary receptors (GnRH receptors) whose function is to stimulate the secretion of hormones that stimulate the production of estrogen.

When these receptors are blocked, the production of these hormones is stopped and therefore the stimulation of the ovary by the same, achieving as a final effect the suppression of estrogens or testosterone and with it, the pubertal development.

It is necessary to evaluate if the treatment is going to be effective in improving the girl's final size, because the problem that occurs in precocious puberty is that, when the bone age is advanced, the final size can be compromised.

In the event that an organic alteration is detected that affects the pituitary gland, the appropriate treatment must be carried out.

Where do we treat it?

IN NAVARRA AND MADRID

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