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Puberty is a process that lasts many years and concerns the transition of the body of boys and girls from childhood to adulthood. In girls, it usually begins after the age of 8 and in boys after the age of 9, however, in recent years it has been observed increasingly often that puberty begins at younger ages.

Pediatric endocrinologist, Dr. Aristotelis Panagiotopoulos, explains what are the signs that parents should pay attention to and gives answers on how to deal with precocious puberty and the impact it can have on a child:

Q: What is precocious puberty?

A: Precocious puberty is when a child’s body begins to show signs of sexual development earlier than usual, often before the age of 8 in girls and 9 in boys.

Q: How can I tell if my child might be experiencing precocious puberty?

A: Watch for early signs such as breast development in girls, testicular enlargement in boys, rapid height gain, body odor, acne, or early menstruation in girls.

Q: What causes precocious puberty?

A: It can be due to a variety of reasons, including hormonal imbalances, brain issues, genetic inheritance, or, rarely, other medical conditions. Many times, the cause is not clear.

Q: How will the doctor check for precocious puberty?

A: The pediatric endocrinologist will perform a thorough evaluation of your child, which may include:

• Medical history: The doctor will ask about the child’s medical history, including any family history of precocious puberty or other related medical conditions.
• Growth chart review: They will check for any abnormal growth patterns that may be related to the child’s precocious puberty.
• Physical examination: Assessing the child’s general health and looking for signs of precocious puberty. This includes the “Tanner Staging”, which assesses the stage of sexual development in children and adolescents. It includes evaluating features such as breast development, pubic hair growth, and genital development.
• Bone age X-ray: Helps assess whether bone growth is progressing rapidly.
• Blood tests: Includes hormone level assessments.
• LHRH stimulation test: Additional hormone tests done if initial tests are inconclusive and further information is needed.
• Brain imaging: In some cases, imaging studies such as MRI may be ordered to evaluate brain structures.

Q: Will this affect my child in the long term?

A: There may be some emotional and social challenges and can lead to shorter stature. However, with the right care and support, most children can live healthy lives.

Q: How does it affect the child psychosocially?

A: Precocious puberty can have psychosocial impacts on children, meaning it can affect their emotions, social interactions and overall well-being. Specifically, it can have an impact on the following areas:

• Body image and self-esteem: Children who experience precocious puberty may feel self-conscious about their physical development, especially if it differs significantly from their peers.
• Peer relationships: If a child is physically more mature than their peers, they may have difficulty relating to them, potentially leading to social challenges or feelings of isolation.
• Emotional well-being: Precocious puberty can be emotionally challenging for children. They may experience a range of emotions, including confusion, anxiety, or frustration about the changes happening to their bodies.
• Parent-child relationships: Parents may need to manage discussions about puberty earlier than expected. It is important for parents to provide support, understanding, and open communication during this time.

Q: Are there treatments for precocious puberty?

A: Yes. The right treatment depends on what is causing it. It may include medication to slow the condition or to treat hormone levels. Gonadotropin-releasing hormone agonists (GnRH) are the most common treatment for precocious puberty. They are usually administered as injections or implants and operate. This treatment option is generally safe with few long-term concerns. It is always best to discuss the details of your treatment options with your doctor.

Q: Do environmental factors play a role in precocious puberty?

A: Yes. Some foods and products contain substances that can potentially affect hormonal balance and pubertal development. Examples include: Soy products, dairy products, processed foods, pesticides and endocrine disrupting chemicals (EDCs), bisphenol A (BPA) plastics, phthalates, foods with a high glycemic index. It is important to note that while some studies suggest associations, the evidence is not always conclusive and individual responses may vary.

Q: Has COVID-19 affected the onset of precocious puberty?

A: There is no significant scientific evidence to suggest a direct link between COVID-19 and precocious puberty. The main impact of COVID-19 on children is related to the virus itself, including symptoms, transmission and potential complications. However, it is worth noting that the pandemic and associated changes in lifestyle, habits and access to healthcare could indirectly affect various aspects of children’s health, including adolescence. For example, disruptions to regular healthcare visits or delays in seeking medical care for health problems could potentially impact the diagnosis and management of early adolescence.

Q: Which specialist should evaluate and manage a child with precocious puberty?

A: A child with precocious puberty should be evaluated and managed by a pediatric endocrinologist. Pediatric endocrinologists are specially trained to diagnose and treat hormonal disorders in children. If you suspect that a child is experiencing precocious puberty, it is important to consult your pediatrician, who can then refer you to a pediatric endocrinologist, if necessary.