Puberty (cont.)
What are medical conditions associated with early, or late, puberty?
Precocious puberty
Precocious puberty is the medical term for puberty that
occurs earlier than usual. While medical professionals are not in full agreement
about the age ranges for the definition of precocious puberty, many doctors
believe that a medical evaluation for precocious puberty should be performed if
breast or pubic hair development occurs prior to age 7 in Caucasian girls and
prior to age 6 in African American girls. Boys who show signs of developing
secondary sex characteristics prior to age 9 are also considered to have
precocious puberty. Precocious puberty can be associated with psychological
difficulties that may impact a child's emotional development.
Precocious puberty is much more common in girls than in boys. Many girls
experience precocious puberty in the absence of any disease or condition. In
boys, however, precocious puberty is more likely to be associated with an
underlying medical problem. While in many cases the exact cause of precocious
puberty cannot be determined, a small number of cases are related to
abnormalities of the ovaries or testes, thyroid gland abnormalities or other
hormone problems, genetic conditions, tumors or infections of the brain, and
injury to the brain.
Precocious puberty may be treated by treating the underlying condition that
is responsible for the condition, or by lowering the high levels of sex hormones
with medications (known as GnRH agonists) that block the production of sex
hormones to stop sexual development from progressing.
Delayed puberty
Delayed puberty is the late onset of puberty. Puberty is
usually considered to be delayed when there has been no increase in testicular
volume by 14 years of age in boys and no breast development by
13 and a half years of age in girls. Sometimes, delayed puberty tends to "run in families" and
normal adolescent development proceeds normally after the delay. This is
sometimes called a constitutional delay and is responsible for the vast majority
of cases of delayed puberty. Constitutional delay that affects both growth and
achievement of puberty is much more common in boys than in girls.
Chronic medical conditions, such as diabetes or cystic fibrosis, may also
cause the delayed onset of puberty. Genetic conditions, problems with the
pituitary or thyroid glands, problems with the ovaries or testes, and
malnutrition are other causes of delayed puberty. Many girls who exercise
strenuously have very little body fat and also experience a delay in the onset
of puberty, since a certain amount of body fat appears to be required for the
initiation of puberty. Girls who are competitive athletes may have a delay in
the onset of menstruation of up to one year or more when compared with
nonathletes.
- Puberty is the time of sexual maturation and achievement of fertility.
- The time when puberty begins varies greatly among individuals; however, puberty
usually occurs in girls between the ages of 10 and 14 and between the ages of
12 and 16 in boys.
- Body fat and/or body composition may play a role in
regulating the onset of puberty.
- Puberty is associated with development of
secondary sex characteristics and rapid growth.
- Some medical conditions may
worsen or first become apparent at puberty.
- Precocious puberty is puberty that
occurs earlier than usual. It is more common in girls than in boys.
Last Editorial Review: 8/24/2007
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