Precocious Puberty
Precocious puberty is an uncommon condition that occurs when puberty begins before the age of eight in girls and before age nine in boys. The signs and symptoms of precocious puberty:
In Girls:
- Development of breasts
- Hair development underarm or in public parts
- Rapid height growth
- Onset of menstruation
- Acne
- Adult body odor
In Boys:
- Enlargement of testicles
- Hair growth in face (usually grows first on the upper lip), public parts /underarm
- Rapid height gain
- Deepening of voice
- Acne
- Adult body odor
In some children 'partial' precocious puberty could be seen. Girls may show breast development that later disappears or may persist without any other physical changes of puberty. Such children with partial precocious puberty should be evaluated by a medical professional to rule out any other health problems. By and large such instances do not require any treatment and usually will show the other expected signs of puberty at the right age.
Causes for Precocious Puberty
Abnormalities in ovary and testicles may contribute to precocious puberty. Problems in the ovaries, thyroid gland disorders can also cause the onset of puberty ahead of schedule. Sometimes precocious puberty is the result of a structural problem in the brain such as a tumor, brain injury due to head trauma, infection such as meningitis that triggers puberty to begin early. In a majority of girls there is no underlying medical problem but they simply start puberty too early for no known reason. Certain types of environmental contamination like environmental toxins could play a role in causing precocious puberty.
Central precocious puberty
- Tumor in the brain or spinal cord
- Infection such as encephalitis or meningitis
- A birth defect in the brain such as hydrocephalus or hamartoma (tumor)
- Radiation to brain or spinal cord
- Injury to brain or spinal cord
- Ischemia
- McCune Albright Syndrome - a genetic disease that affects the bones and skin color and causes hormonal problems
- A group of inherited disorders known as Congenital adrenal hyperplasia which involves abnormal hormone production by the adrenal glands.
- Hypothyroidism
Pediatric Endocrinologist
Pediatric endocrinologists specialize in child related developmental problems. Pediatric endocrinologists are specialists in physical and sexual growth developments in children and specialize in childhood diabetes and other endocrine gland disorders. The most commonly faced endocrine problems in children are Type I diabetes, growth hormone treatment, intersexes disorders, hypoglycemia and puberty problems.
After completion of medical school and internship and after a three-year pediatric residency, a period of three years is spent to specialize in pediatric endocrinology. Pediatric endocrinologists help in:
- Problems related to early or delayed puberty
- Growth problems such as height related problems
- Thyroid problems
- Intersex problems
- Pituitary, Adrenal gland problems
- Ovarian or testicular problems
Ovotestis
Ovotestis is a hermaphroditic gonad, with both testicular and ovarian tissue. The term ovatestis is coined up from ovary and testis. While ovatestes is a normal feature in some animals such as gastropod Helix aspersa, it is an anatomical abnormality in humans associated with gonadal dysgenesis. A hermaphroditic reproductive organ that can produce both sperm and eggs, is found in certain gastropods. Less than 20% of people with true hermaphroditism are diagnosed before 5 years of age and about 75% are diagnosed by age 20. True hermaphroditism is a genetically heterogeneous condition caused by certain phenotypic, gonadal and molecular theoretical factors.
In such gonads the ovaries occupy normal abdominal position although sometimes they may be found at the internal inguinal ring. Many patients with true hermaphroditism have a uterus and internal duct development corresponding to the adjacent gonad. In approximately 50% of ovatestes, there is evidence of ovulation.
Persons with true hermaphroditism have ambiguous genitalia at birth. The majority are reared as males due to the size of the phallus. However, due to the functioning of normal ovarian tissue, most of them experience breast development at puberty and abnormal menstruation cycles. Apart from these syndromes, there are not many other developmental abnormalities in these patients. The mortality rate is also not that alarming for affected individuals. They usually possess average intelligence.
Such true hermaphroditism is a rare condition and they are less than 10% of intersex cases. More than 400 such cases have been reported worldwide. Interestingly geographical variation have been noted and the highest occurrence of such cases is found in the Southern African population.
Bibliography / Reference
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