What is precocious puberty?

In the culture of our country, like many others in the region and Latin America, the importance that this specific stage of life deserves in the development of the human being is not given the importance that, as well as the neonatal stage and the geriatric who deserve a sub specialized medical attention the pubertal stage is no exception.

A very high percentage of parents do not know at what age their children’s puberty should begin, neither when it is early nor when it is late and it is extremely important to know it because it is the parents who will alert the pediatrician and the endocrinologist of the onset or not of signs of sexual development.

So in this article we want to present the most relevant tips so that parents have the ability to identify and can recognize if their children are affected by precocious puberty, we will also indicate in a general way the treatment and its follow-up.

Precocious puberty is defined as the appearance of signs of sexual development before the age of 8 in girls and before the age of 9 in boys, it is worth noting that there is no predetermined order in the appearance of signs of sexual development.

The signs of sexual development are in girls: enlargement of the mammary gland, appearance of pubic hair, increased growth rate, appearance of armpit hair and adult-type odor sweat as the most important signs. In boys, it manifests itself in increased testicular volume, appearance of pubic hair, adult-type odor sweat, and increased growth rate.

As we mentioned, there is no pattern of order of appearance of these signs, nor can they all be present.

If the parents notice some of these signs before the indicated ages, the diagnosis is made and they should consult with a children’s endocrinologist to complement the cabinet studies and determine the treatment.

If it is the case of a girl, the endocrinologist will confirm the clinical signs and proceed to classify precocious puberty as central or peripheral and to perform complementary studies such as hormonal studies of gonatropin and estradiol and imaging studies such as bone age, chair visualization Turkish and gonad and uterus volumes, could also extend the study to other hormonal axes if deemed appropriate, such as thyroid and / or growth studies.

In the case of children, testosterone should be studied additionally instead of estradiol.

When obtaining the results, it will be considered whether restraint with gonadotropin-releasing hormone analogs is appropriate depending on the prognosis of height, hormonal levels and imaging studies.

This and other decisions will depend on each case individually.

It should be followed up on a regular basis to combine a good height prognosis and a suitable pubertal age.

Dr. Raúl Velasco, President of the Association of Endocrinology, Metabolism and Nutrition of Guatemala.

Prompt treatment of precocious puberty prevents long-term irreversible complications, such as short stature.


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