Precocious puberty, understanding it is essential for treatment ··· Symptoms and treatment methods

 

In girls, puberty begins between ages 8 and 9, and in boys, between ages 9 and 10. This is called "precocious puberty" or "precocious sexual development." Globally, the trend shows that girls are starting puberty earlier, making early management increasingly important.

 

Professor Jo Ja-hyang stated, "A Western-style diet centered on meat consumption, along with instant and fast food intake, can influence early puberty," and added, "Excessive consumption of these foods not only increases the risk of obesity but also raises the likelihood of exposure to environmental hormones and endocrine-disrupting substances, which can lead to a quicker onset of puberty."

 

Precocious puberty refers to the early appearance of secondary sexual characteristics. If a child's growth rate is significantly faster than their peers, or during physical examinations, if girls under 8 years old show breast development, or boys under 9 years old exhibit testicular enlargement, precocious puberty should be suspected.

 

It is recommended to check the development of the breasts or testicles at home, but if that is difficult, it is better to monitor your child's growth rate compared to peers and visit a hospital. Refer to growth charts published by the Pediatric Society or Pediatric Endocrinology Society, and if the growth is too large or too small, appropriate measures should be taken.

 

Precocious puberty is classified into true precocious puberty and pseudoprecocious puberty based on the activity of sex hormones. True precocious puberty occurs when the hypothalamic-pituitary axis is activated, stimulating the ovaries or testes to secrete large amounts of sex hormones. Gonadotropin-dependent precocious puberty can be caused by tumors of the central nervous system or encephalitis. In most cases, there is no specific cause.

 

On the other hand, pseudo precocious puberty refers to cases where the hypothalamic-pituitary activation occurs due to causes other than the process of the ovaries or testes secreting hormones. Congenital adrenal hyperplasia, ovarian cysts, and McCune-Albright syndrome are relevant. In such suspected cases, it is necessary to identify the underlying cause through brain MRI scans or abdominal, pelvic, and testicular ultrasound examinations and to initiate prompt treatment.

 

When diagnosing precocious puberty, it is necessary to check the timing of secondary sexual characteristics, the progression rate, the underlying disease, and the presence or absence of sex hormone exposure. Physical examination is used to assess growth rate and the degree of pubertal development. Radiographs are taken to measure bone age, and hormone tests are also performed.

When a specific disease suspected as the cause is mentioned above, brain MRI or ultrasound examinations of the abdomen, pelvis, and testicles may be necessary. Even if the initial examination did not require treatment, it can progress to a stage requiring treatment within a few months, so regular check-ups are needed.

 

If diagnosed with precocious puberty, appropriate treatment according to the condition is necessary. First, precocious puberty negatively affects height growth. If puberty begins early in a young child, it may seem like they are growing well at first, but because bone age advances, their adult height may be shorter compared to children who start puberty normally.

 

Secondly, the early onset of secondary sexual characteristics at a very young age and the different growth rate compared to peers can cause the child to feel anxiety or stress. Lastly, early secretion of sex hormones can increase the risk of hormone-related diseases such as breast cancer and ovarian cancer. Treating precocious puberty can regulate the accelerated bone age, prevent a decrease in adult height, and stop the progression of puberty.

 

In cases of idiopathic precocious puberty that occur without a specific underlying disease, patients visit the hospital every 3 to 4 weeks to receive injections of gonadotropin-releasing hormone agonists (hormone suppressants), which are medications that inhibit the progression of puberty.

 

The key to treating precocious puberty is the timing of treatment. Professor Jo Ja-hyang states, "As with all diseases, in the case of rapidly growing children, early diagnosis and prompt treatment of precocious puberty are essential to improve treatment outcomes." Girls can receive health insurance benefits if treatment begins before the age of 8, and boys before the age of 9.

 

Consistent treatment is important, but irregular treatment can actually stimulate the onset of puberty, so caution is needed. The treatment duration is usually 2 to 5 years, and the length of treatment varies depending on the age at diagnosis and the progression of bone age. The typical end point of treatment is around 11 years old for girls and around 12 years old for boys, but it is carefully decided by considering various individual factors.

 

To prevent precocious puberty, it is advisable to avoid Western-style diets that are meat-centric, as well as instant and fast foods. Consuming a balanced diet rich in fiber, low in fat, and high in protein, along with a balanced intake of nutrients, is important. Proper weight management through aerobic exercise, maintaining regular lifestyle habits, and early sleep schedules are also crucial.