The development of breast buds is one of the first signs of puberty in a girl. The beginning of adult breast development is called thelarche. As the breasts start to develop, a girl will have small, firm lumps under the nipples called breast buds, which may sometimes be tender. In some cases, one breast may start to develop weeks or months before the other. The breast tissue continues to get larger and become less firm over the next few years. It is normal for Caucasian girls to begin developing breast buds as young as seven years old and African American girls could be as young as six years old. It is advised to consult a pediatrician to evaluate breast bud development and check for other signs of puberty.
A girl usually attains menarche (gets her first period) around two years after breast development begins. The average age for girls in the United States to start their periods is anywhere between 9 to 15 years. Girls usually have a similar pattern to their mothers when it comes to beginning their period. If the mother started her period early, the daughter is more likely to start early. However, this is not true for everyone. Nutrition, medical illnesses, long-term medication and other environmental factors can also influence the onset of puberty.
What is precocious puberty?
Precocious puberty is when the signs of puberty begin before the age of seven or eight years in girls and before the age of nine years in boys. When this happens, it is advised to consult a pediatrician to rule out any serious causes and help manage the effects of precocious puberty.
The effects of precocious puberty
Early puberty can affect the child emotionally and socially. Children with precocious puberty may be confused or conscious about the changes in their bodies. They may have changes in emotions and behavior, and they need guidance on how to navigate through these changes. Girls could be concerned about getting periods and can become moody and irritable. Boys may become more aggressive and develop a sex drive inappropriate for their age. Girls who attain puberty early may be at a higher risk of sexual abuse, hence it is important to educate children. It may also be a good idea to seek the help of the teacher at school, a counselor or a psychologist.
Precocious puberty causes a growth spurt in the child, making them taller than their peers. However, their bone growth stops at an earlier age than other kids. They stop growing in height sooner and end up shorter in height than they would have otherwise been.
What are the causes of precocious puberty?
The onset of puberty is triggered by the hypothalamus, an area in the brain that sends signals to the pituitary gland (a small gland at the base of the brain) to release hormones that stimulate the ovaries (in girls) or testicles (in boys) to produce sex hormones.
Precocious puberty in girls is often due to the hypothalamus sending these signals earlier than it should. This may run in families and usually not a medical problem.
Rarely, precocious puberty may occur due to a more serious medical problem, such as a brain tumor or trauma. Thyroid or ovarian disorders can also trigger early puberty. Hence, it is advised to consult a pediatrician to rule out anything serious and help manage precocious puberty in the child.
How is precocious puberty treated?
The treatment goals are to stop or reverse sexual development or stop rapid bone growth and maturation. This growth spurt may lead to short stature as an adult. Depending on the cause of precocious puberty, treatment may involve treating the underlying disease and lowering the high levels of sex hormones with medication to stop sexual development.
Hormone treatment with drugs called luteinizing hormone releasing hormone (LHRH) analogs may be used in precocious puberty. LHRH analogs are synthetic hormones that block the body's production of sex hormones, which cause early puberty. They are typically safe and don’t cause side effects in children. It is also extremely important to address the child’s mental health at this stage. Parents should help them cope with their changes physically and mentally by taking help from family, friends, teachers, a counselor or a psychologist.
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National Health Service. Stages of Puberty: What Happens to Boys and Girls. https://www.nhs.uk/live-well/sexual-health/stages-of-puberty-what-happens-to-boys-and-girls/