Premature puberty in boys and girls has been increasing due to problems such as lifestyle and diet, air pollution, and access to clean food, as well as genetic factors.
Families should follow their children closely in order to overcome the early adolescence process that affects individuals physiologically and psychologically. It is important to be aware of the symptoms and to consult a specialist immediately, if any. Professor of Pediatric Endocrinology Department of Memorial Kayseri Hospital. Dr. Selim Kurtoğlu gave important information about early adolescence in children.
How does normal puberty in children begin?
The period known as 'mini puberty' in the newborn period of boys and girls is evaluated in the normal adolescence process. Mini puberty; It continues until 6-12 months in boys and 1-2 years in girls and the hormones that initiate puberty enter the sleep period. As the age progresses, the adolescence period starts from the age of 10 for girls and 12 for boys and this process is completed within 2-3 years. At the beginning of adolescence in girls, growth accelerates (more than 6 centimeters per year) and breasts grow, hair growth and pimples appear in the armpit and genital area, and the smell of adult sweat is felt under the armpits. In boys, the vertical testicular (ovary) size reaching 2,5 centimeters and the testicular volume exceeding 4 milliliters are indicators of the transition to puberty. Again, as in girls, armpit and genital hair growth in boys is an important symptom of puberty.
Some foods can trigger puberty
The occurrence of secondary sex characteristics before the age of 8 in girls and 9 in boys is considered as precocious puberty. Premature puberty, ie premature puberty due to hair growth, manifests itself in the armpit and genital area. Again, breast growth alone in girls is also an indicator for early puberty. If precocious puberty occurs as a result of activation of the hypothalamus-pituitary-gonad hormone axis, it is diagnosed as 'central adolescence'. While cysts, tumors, abscess, trauma, radiation, acquired children, radiotherapy are considered to be effective in the onset of central early puberty in boys, the cause cannot be revealed in girls. However, mutations can be detected in some genes that regulate puberty.
Endocrine disruptors cause early puberty
Some endocrine disruptors lead to premature puberty because they act like estrogen hormone. Chocolates with an additive called soy lecithin are the main ones. It is also stated that excessive consumption of industrial products such as biscuits, soudjouk, salami, sausage, mayonnaise, ketchup, chips, which contain soy additives cause premature puberty. In addition, direct use of lavender or shower gel containing lavender, shampoo or cosmetic products, cosmetics using tea tree, fennel tea, and corn can cause premature puberty, as the fungus toxin called ZEA is formed. It is thought that playing with play dough a lot and consuming beverages in plastic containers with 'phthalate' material known to be endocrine disruptors after waiting under the sun for a long time are thought to trigger early puberty.
Hormones should be checked for early puberty diagnosis
In order to diagnose early puberty, FSH, LH, testosterone in boys and estradiol in girls are measured in addition to physical examination. The left wrist radiography is taken to evaluate whether there is early progression in bone age. In girls, it is determined whether there is growth in the uterus and ovaries with abdominal ultrasonography. The pituitary gland and other regions are evaluated with cranial MRI in cases observed at an early age in girls and in all boys.
Adolescence can be paused with appropriate treatment planning
The process can be paused by making monthly injections to children who enter early adolescence and are checked in 3-month periods. Generally, treatment ends at the age of 11. However, if there are precocious puberty developments not originating from the hypothalamus or pituitary, the diagnosis of 'peripheral puberty precox' is made. Because the secretion of hormones in ovarian cysts, which are the most common in girls, can initiate the process. In 'Mc Cune Albright Syndrome, which has milky coffee stains on the body, ovarian cysts are frequently observed and may cause vaginal bleeding and breast enlargement at an early age. In addition, estrogen-secreting tumors in girls can also create the same picture. In boys, adrenal tumors with testicles that secrete androgen hormone can cause early puberty. Tongenital adrenal hyperplasia, which occurs as a result of the failure of any of the five enzymes required for the formation of cortisol hormone, which the body increases in some cases, may not function properly, if not treated, early puberty may occur. Some tumors may cause premature puberty by secreting hormone that stimulates the testicle. Hypothyroidism, which occurs due to low functioning of the heavy and untreated thyroid gland in both genders, can lead to early puberty.
4 problems that should be separated from early adolescence
Some endocrine developments should be examined except for early puberty.
- Early breast growth in girls is called 'premature alarche'. Breast growth is normal during the newborn period. However, with temporary warnings, there may be breast enlargement or it may be due to estrogenic factors. However, since one study found that 3 out of 1 cases evolved towards early puberty, it is recommended that the cases be monitored at regular intervals.
- Breast enlargement in boys is defined as prepubertal gynecomastia. In obese children, the accumulation of fat tissue around the breast is considered to be breast enlargement. Also, this can be caused by estrogenic tumors, estrogenic foods, estrogenic creams. Treatment should be done depending on the cause.
- In some children, acne, oily hair and adult sweat odor can be detected due to a group of diseases. Congenital adrenal hyperplasia and tumors should be considered in children with premature hair growth. The treatment process should begin with the necessary tests.
- Premature menarche, known as early menstruation in girls, is an indicator of vaginal bleeding before the age of 9,5. This can be caused by ovarian cysts, tumors, foreign bodies, and urinary tract infections. It is important to plan treatment based on the cause.