Early Puberty in Girls

4 February 2015, BKK Kids

The habit of consuming junk food today means that many girls eat a less healthy diet than in the past, and this can sometimes result in earlier puberty, also called precocious puberty. Concerned parents often come to us with a whole range of questions, such as: “Will early puberty make my daughter shorter?” and “Will my daughter’s growth stop after she starts menstruation?” Below are some FAQs about early puberty in girls.

Q: What is precocious puberty?

A: Precocious puberty in girls is the appearance at an early age of signs of pubertal development, such as enlarged breasts before the age of 8.

Q: What are the signs of precocious puberty in girls?

A: Girls undergoing precocious puberty will have enlarged and swollen nipples, typically about 1-2 cm. They will also have an increased appetite and grow more rapidly than their peers.

Q: What are the causes of precocious puberty?

A: While precocious puberty occurs when hormones are released from a pituitary gland situated underneath the brain at an early age, the causes are unknown in most cases. However, some genetic factors are associated with precocious puberty and girls with a family history of precocious puberty are more likely to experience this condition. Precocious puberty is also more prevalent in overweight children, so diet is a contributing factor.

Q: What are the physical changes that occur in girls during adolescence?

A: Puberty usually starts in girls between the ages of 8-13. The first evidence of puberty is breast development. Most girls usually start their periods within 1½-2 years after their breasts begin to develop. It is common for girls to have irregular periods during the first 1-2 years as their bodies adjust to the regular cycle of menstruation. Most girls usually start their periods between the ages of 12-13 with some variances due to ethnicity.

Q: What are the problems caused by precocious puberty in girls?

A: Precocious puberty can cause 2 major problems for girls due to the early release of the female sex hormones, including:

Short Adult Stature: During childhood and adolescence, girls grow rapidly due to the female sex hormones. Girls experiencing precocious puberty are generally taller than their peers at an early age as a result of rapid bone maturation. However, this also causes them to stop growing at an earlier age resulting in them being relatively short in height as adults.

Emotional Problems: Girls with precocious puberty have a mature body, but immature mind. They may be embarrassed about their enlarged breasts while their peers have no physical changes. This combination of a mature body but immature mind can lead to earlier sexual encounters. It could also be more difficult for some girls to take care of their personal hygiene.

Q: What is the treatment for precocious puberty?

A: The treatment for precocious puberty depends on the cause. The doctor will look at the girl’s eating habits as well as growth history during the past 1-2 years to identify any signs of rapid growth. The doctor may also use an x-ray of the hand to evaluate growth. If necessary, a pelvic ultrasound or MRI brain scan may also be used, and the doctor will follow up with the patient if any abnormalities are found.

If the cause of the precocious puberty is not known, a physical examination may be performed to test the level of hormones released from the pituitary gland. If these hormone levels are high, the synthetic hormone GnRH analogue can be injected into a muscle to slow down the onset of puberty. This medication blocks the hormones being released from the pituitary gland. It is given at intervals of every 4 weeks until the girl reaches the age of 12-14 years.

Q: What are the goals of treatment for precocious puberty in girls?

A: The goals of treatment for precocious puberty in girls are to stop or slow down advanced bone aging, so that the girl will become taller when fully grown; and to reduce
the emotional and behavioral problems associated with precocious puberty.

By Dr. Pavintara Harinsoot Somnuke and Dr. Anuttara Pothikamjorn, paediatricians specialized in paediatric growth, endocrinology and diabetes at the Children’s (Pediatric) Center, Bumrungrad Hospital

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