Puberty problem

 

Puberty is the time in a person's life when his or her body changes from child to adult, accompanied by the process of sexual maturation. Puberty is caused by changes in hormones and includes both physical and emotional growth.

Problems with puberty require the clinical care of a physician or other health care professional. Listed in the directory below are some problems associated with puberty, for which we have provided a brief overview.

 

1. Precocious Puberty

 

What is precocious puberty?

Puberty that happens early is called precocious puberty. This means a child's physical signs of sexual maturity develop too soon. This includes breast growth, pubic hair, and voice changes. These are known as secondary sexual characteristics. Precocious puberty happens before age 8 in girls, and before age 9 in boys. Most children with the disorder grow fast at first. But they also stop growing before reaching their full genetic height potential.

 

What causes precocious puberty?

It may be caused by tumors or growths on the ovaries, adrenal glands, pituitary gland, or brain. Other causes may include central nervous system problems, family history of the disease, or certain rare genetic syndromes. In many cases, no cause can be found for the disorder. There are two types of precocious puberty:

• Gonadotropin-dependent. This is also known as central precocious puberty. This is the most common type of precocious puberty. Most girls and half of boys with precocious puberty have this type. The puberty is started by early secretion of hormones called gonadotropins. Gonadotropins include luteinizing hormone (LH) and follicle stimulation hormone (FSH). In girls, precocious puberty may be caused by the early maturity of the hypothalamus, pituitary glands, and ovaries. But in most cases, no cause can be found.
• Gonadotropin-independent. This is a form of precocious puberty that is not started by the early release of gonadotropins. Instead it’s caused by early secretion of high levels of sex hormones. These include the male androgens and female estrogens.

 

Who is at risk for precocious puberty?

A child is at risk for precocious puberty if he or she has any of these:

• Tumors or growths on the ovaries, testes, adrenal glands, pituitary gland, or brain
• Central nervous system problems
• Family history of the disease
• A rare genetic syndrome

 

What are the symptoms of precocious puberty?

The signs are secondary sexual characteristics that happen early.

 

Common signs in girls can include:

• Breast growth
• Pubic and underarm hair
• Menstruation
• Ovulation

 

Common signs in boys can include:

• Enlarging penis and testicles
• Pubic and underarm hair
• Facial hair
• Spontaneous erections
• Production of sperm
• Acne
• Deepening of the voice

 

Other signs of the disorder include:

• Moodiness
• Increased aggression
• Growing taller earlier than other classmates

The signs of precocious puberty can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

 

How is precocious puberty diagnosed?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam.

Your child may have blood tests to measure levels of hormones such as:

• Luteinizing hormone (LH)
• Follicle stimulation hormone (FSH)
• A form of estrogen called estradiol
• Testosterone
• Thyroid hormones

 

2. Delayed Puberty

 

What is delayed puberty?

Puberty that happens late is called delayed puberty. This means a child's physical signs of sexual maturity don’t appear by age 12 in girls or age 14 in boys. This includes breast or testicle growth, pubic hair, and voice changes. These are known as secondary sexual characteristics.

 

What causes delayed puberty?

Delayed puberty most often has no known cause. In some cases, it may run in families. In other cases, it may be caused by any of these:

• Chromosomal problems
• Genetic disorder
• Chronic illness
• Tumors of the pituitary gland or hypothalamus
• Underactive pituitary gland (hypopituitarism)
• Underactive thyroid (hypothyroidism)
• Abnormal development of the reproductive system
• Inability of the body to use androgen hormones (complete androgen insensitivity syndrome)
• Too much exercise
• Severe lack of eating (anorexia)

 

Who is at risk for delayed puberty?

A child is at risk for delayed puberty if he or she has any of these:

• Parents or siblings with delayed puberty
• Chronic medical conditions
• Congenital syndrome
• An eating disorder

 

What are the symptom of delayed puberty?

The symptoms are a lack of secondary sexual characteristics.

 

Common signs in girls can include:

• No breast growth by age 12
• More than 5 years between first breast growth and first menstrual period
• No menstrual period by age 15

 

Common signs in boys can include:

• No testicular enlargement by age 14
• No pubic hair by age 15
• More than 5 years to complete adult genital growth

The signs of delayed puberty can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

 

How is delayed puberty diagnosed?

In addition to a complete health history and physical exam, diagnosis of delayed puberty may include:

• Blood tests. These are done to check hormone levels, look for chromosomal problems, and check for chronic disorders that may delay puberty. These may include diabetes or anemia.
• X-ray. This test uses a small amount of radiation to make images of tissues inside the body. An X-ray may be done of the left hand and wrist. This can estimate your child's bone age. With precocious puberty, bone age is often older than calendar age. Precocious puberty means your child's body begins changing into that of an adult (puberty) too soon. This change would occur before age 8 in girls and before age 9 in boys.
• CT scan. This test uses a series of X-rays and a computer to make detailed images of the body. A CT scan can show bones, muscles, fat, and organs. CT scans are more detailed than regular X-rays.
• MRI. This test uses a large magnet and a computer to make detailed images of tissues in the body.

 

How we treated delayed puberty?

we will consider his or her age, overall health, and other factors when advising treatment.

Treatment for delayed puberty depends on the cause of the problem. In many cases, when the cause is treated, puberty proceeds normally. If the delayed puberty is inherited, no treatment is usually needed. In some cases, treatment may be done with hormone therapy. This helps to cause secondary sexual characteristics to occur. In other cases, surgery may be done to correct a physical problem.