Usually, puberty or the appearance of secondary sexual characteristics begins at 10 years of age in girls and at 11 years of age in boys. In recent times, this age has been falling steadily, so some girls experience these changes as early as 8 years old, and boys as early as 9.
This is especially evident in girls, as the psychologist Lenin E. Salmon has written, because their bodies begin to develop in uncoordination with their infantile mentality and intelligence, which exposes them to risks that they cannot understand without the help and protection of the family.
In girls, the most obvious sign is the growth of the mammary gland. In boys, increased testicular volume. But not all cases are precocious puberty; There are situations that are considered variants of normality, explains pediatric endocrinology specialist Marjorie Morales Bazurto, and this is determined by the sum of the developmental characteristics that each child presents.
Morales indicates that there are no figures in Ecuador about the alterations of puberty and that, in the absence of specific diagnoses, doctors must use the closest criteria to be able to create and close a clinical history. For example, the age range does not consider the possibility that a 9-year-old girl has started menstruating. This may invalidate statistical data.
Even so, “there has been a phenomenon in the last five or six years: the number of patients with precocious puberty has increased,” says Morales, adding that this point of view may also be due to the increase in pediatric endocrinologists in the country that, at present, the family goes more to the consultation. Some of these patients are late, when they do not require treatment, only accompaniment. Most are girls.
“The Ecuadorian Society of Pediatric Endocrinology is about to publish a follow-up protocol for patients with precocious puberty; a guide for paediatricians, family doctors and adult endocrinologists, to monitor patients with early puberty and all its variants”, adds the specialist.
The various types of precocious puberty and their causes
The most common form is central precocious puberty, which originates in the pituitary gland, where trophic hormones are generated, which in this case are activated prematurely. What is the cause? History such as premature births with low birth weight, type of diet, lifestyle, genetic factors (early maturing parents) and certain medical treatments make up this list.
There are also secondary and tertiary causes, such as the activity of the adrenal gland or tumors in the central nervous system or in the pituitary gland.
Therefore, the pediatric endocrinologist Alexandra Vimos highlights the importance of pregnancy controls, balanced nutrition and free of ultra-processed foods, but, above all, regular pediatric controls.
Treatment will depend on the cause: in the case of central precocious puberty, it can be treated with hormonal inhibitors; but this will be different if it is a congenital disease of the adrenal gland or a tumor in the central nervous system.
Obesity is one of the factors that promote earlier development. “Before the pandemic, the statistic was known that four children out of ten had obesity in Ecuador; Currently, I would say that it will be about five out of every ten: the consultation for obesity has increased, ”says Vimos. “A sedentary lifestyle and inadequate nutrition are factors that have contributed to increasing the prevalence of this disease,” he adds.
Risks of precocious puberty for girls and boys
Having an early puberty carries certain physical risks. One of them is the final size or adult size, which in these cases falls short of expectations, indicates Dr. Morales. “There are specific hormones that are going to act on the growth plate, and this cartilage starts to proliferate sooner and faster, until there is a closure and the boys stop growing in height.”
Dr. Vimos notes that, initially, precocious puberty can cause both boys and girls to have hypergrowth or tall stature. The family does not consult the doctor, because they see being bigger and heavier than other children as something positive, while what causes concern is a small size.
But this early development causes the bones to mature much faster, leaving them less time to develop. “So, one of the novelties is that the final size will probably be low,” reports Vimos. “For this reason, pediatric control is important, to determine the different diagnoses in a timely manner”, and not wait for major developments, such as pubic and axillary hair or body odor before time, for example.
Then come the psychosocial and emotional risks. “It is difficult for them to include themselves socially, because they do not understand these changes, they are not the same as their peers, and they feel out of place,” says Morales. There are also changes in behavior, early infatuation, earlier sexual activity and, with it, teenage pregnancy and sexually transmitted diseases. “The chain of risks is very high”, so psychological intervention can help the family understand and better manage the situation.
But not all children who show excessive curiosity before their time can be included. Precocious puberty should not be confused with early adolescence, in which there are not necessarily physical changes, and that the Master in Family Sciences María Helena Manrique has described as a suspension of the process of infancy and childhood to skip to the next stage without being prepared. In this case, the children are distressed, and this does not originate in their bodies, but in the behavior of the adults who are close to them: sexual abuse, physical or psychological violence, continuous disqualification, disinterest. (F)
Source: Eluniverso
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