Category: Puberty

Introduction

Puberty is the development of bodily changes by which the body of a human child or juvenile develops to a matured body thereby, having the requisite qualities for reproduction. Puberty is produced by the secretion of an endocrine gland that is transmitted by the blood to the tissue on which it has specific communications from the brain to the gland in which gametes (sex cells) are produced.

In return, the gland in which gametes (sex cells) are produced produces a kind of secretion of an endocrine gland that is transmitted by the blood to the tissue which in turn acts as a stimulant for the development, function, or change in the human or child’s body system.

In line with this, biological unfolding of events involved in an organism changing gradually from a simple to a more complex level occurs in the earlier stage of puberty and ceases at the end of puberty. However, prior to puberty, the significant changes in the physical and body structures of both boys and girls are approximately limited to the external sex organ. At some stage in puberty, basic significant changes and function increases in various body organisms and formations.

Nevertheless, Puberty forms an excellent growth in puberty. Although it is commonly considered as the appearance in bodily form of secondary sexual characteristic, however there are large number of other important biological, psychological, and social changes associated to puberty.

Timing of the onset of puberty

The unanimously acknowledged description of adolescence is the bodily change of growth in the human bodily structure. These bodily alterations are the initial noticeable signs of nervous system, hormonal, and operational changes of gonads. The period at which sex glands become functional alternate between individuals and in most cases, puberty starts around 10 and 13 years of age. This age is influenced by both hereditary and environmental aspects like dietary condition and communal conditions (Hayward, 2003). A young female who encounters considerable mutual or reciprocal action with male adults will begin puberty earlier than those who are not exposed excessively to adult males (Nelson, 2005, p.357).

Race can also affect the normal age at which adolescence begins. The initial occasion of menses in women in people analysed were of about the ages 12 and 18 years. It was discovered that black ladies were the first to commence puberty whereas the increase endurance populations are in Asia. However, at the advanced age, standards reveal dietary restrictions more than the diversities in genetic and have the possibility to alteration within a few age groups with a significant change in diet. The average age for the first occurrence of menstruation in a woman may be an indicator of the percentage of starved girls in the populace, and the distance across its spread may replicate inequality of property and food allocation in a populace.

Researchers managed to recognize an earlier age of the beginning of puberty. However, their opinion or judgment reached was based on an assessment of data over a long period of time (up to 10 years).

Overview of puberty differences between male and female

Differences between male and female puberty

The most evidential distinctions noticed in puberty both in girls and boys are the age it commences, and key sex hormones present. Consequently, in most cases, puberty in girls starts at age 10, whereas in boys it’s at age 12 (Alsaker, 1995). Just at it come early, it also ends a little bit early in girls than in boys, i.e. in girls it’s between the ages 15-17 and 16-18 in boys (Angold & Worthman, 1993) Girls in most cases mature 4 years after the appearance of their initial bodily transformation of puberty.^[4] On the contrary, boys mature gradually for 6 years after the appearance of their initial bodily transformation of puberty (Garn, 1992)

In boys, the Male sex hormone that is produced in the testes and responsible for typical male sexual characteristics known as testosterone is the main internal secretion for sex. The abnormal development of male sexual characteristics is a key effect of potent androgenic hormone produced chiefly by the testes; responsible for the development of male secondary sex characteristics.

Before the commencement of puberty, boys are usually shorter than girls, but as time runs by and development takes place, the reverse is always the case since the adult male tend to increase in height more than the female adults.

In as much as boys are always some centimetres shorter than girls before they enter pubertal stage, this is usually never the case as they grow, for they become taller than the women counterparts. The internal secretion in charge of female development is known as estrogen. While the female steroid sex hormones known as estradiol contributes to the progress or growth of soft fleshy milk-secreting glandular organs on the chest of a woman and womb, it is also the most important hormone operating the pubertal development and epiphysial growth and conclusion (MacGillivray, Morishima, Conte, Grumbach,& Smith, 1998)

Physical changes in male teenagers

Testicular size, function, and fertility

In male teenagers, testicular act of increasing in size is the primary physical sign of puberty. However, the size of the teenage male testes keeps increasing all through puberty, thereby developing up to the best possible adult size within six years subsequent to the beginning of puberty. Once the testicles have excessively enlarged as a result of increased size in the constituent cells the penis will also become larger or bigger to adult size (Jones, 2006).

One of the two male reproductive glands that produce spermatozoa and secrete androgens has two main tasks which are: (1) to produce the secretion of an endocrine gland that is transmitted by the blood to the tissue on which it has a specific effect and (2) to produce the male gamete. The cell in the testes secretes the hormone to produce testosterone, which in succession produces the majority of the male pubertal transforms.

The Spermatozoa can be noticed in the early hour’s liquid excretory product of most male teenagers following the early year of life when sex glands become functional, or sometimes earlier. Typically, potential state of being fertile in boy’s starts when they are thirteen years old, but complete state of being fertile is attained within one to three years after the start of fertility.

Prepuce retraction

At some stage in puberty, or earlier than, the tip and empty space of a teenage male’s prepuce becomes broader, gradually providing opportunity for pull back along the beam of the male organ of copulation and behind the small rounded structure; at the end of the penis, which as the end result of the process should be achievable without pain or complexity.

The pliable sheet of tissue that covers or lines or connects the organs or cells that attaches the interior surface of the prepuce with the glans loses cohesion or unity and frees the prepuce to break out of the glans. The prepuce then progressively becomes capable of being retracted.

Pubic hair

Pubic hair in many cases or instances becomes visible on a teenage male subsequent to the growth of the genital organ. The pubic hairs are generally first observable at the abaxial part of the penis nearest its point of attachment. Furthermore, subsequent to the manifestation of pubic hair, other parts of the skin that acts in response to male sex hormone that is produced in the testes and responsible for typical male sexual characteristics possibly will grow androgenic covering for some parts of the body consisting of a dense growth of threadlike structures. There is an outsized difference in quantity of body hair in fully developed male and considerable distinctions in growth and quantity of hair among diverse cultural and genetic race.
In line with this, the beards and moustache is frequently noticed in late teenage years of male children, but may not be fully observed until later in their puberty age. Facial hair will continue growing harsher, blacker and more intense for an additional years following puberty. Some men do not grow complete facial hair for the period of ten years following the end of puberty. Nevertheless, Chest hair may be perceived at some point in puberty or some period of time, however, not all male adult grow or possess hair in the chest.

Voice change

With the aid of male sex hormone produced in the testes and responsible for typical male sexual characteristics, the cartilaginous structure at the top of the trachea which contains elastic vocal cords that are the source of the vocal tone in speech, develops in both male and female teenagers. This development is higher in male teenagers, thereby, deepening their voice.

Male musculature and body shape

During the end of the period of puberty in mature men, they experience change in their bone structure since the bones become heavier and almost two times the skeletal contractile organs of the body. Some of the bone development is excessively greater, consequential to distinctly changed masculine and feminine skeletal forms.

Consequently, the skeletal muscle changes mostly at some point of puberty, and muscle increase can prolong even after boys are physically fully developed.

Body smell and Acne

Increasing structures of androgens can transform the class of aliphatic monocarboxylic acids that form part of a lipid molecule and can be derived from fat by hydrolysis which, results in a severe mature body smell.

As in young female teenagers, a different androgen outcome is augmented emission of the oily secretion of the sebaceous glands from the skin and the consequential inconsistent number of acne. Accordingly, acne cannot be avoided or effortlessly impaired by diminution, except it generally completely reduces at the last part of puberty.

Physical changes in female teenagers

1. Breast Development
   The primary bodily perceptible indication of puberty in female teenagers is typically a firm, soft abnormal protuberance under the midpoint of the small circular area such as that around the nipple of the breasts, and appears during their tenth years of maturity (Litt, 1999)
2. Pubic hair
   Pubic hair is frequently the subsequent obvious change at the teenage female stage of puberty, typically within some months of the start of breast development in a female at the beginning of puberty (Tanner & Davies, 1985). It is commonly called pubarche.
   The female pubic hairs are at first frequently noticeable beside the liplike structure that bounds bodily orifice. However, in approximately fifteen percent of teenage girls, the first pubic hair comes into views before breast maturity starts (Tanner & Davies, 1985).
3. Vagina, uterus, ovaries
   The surface of the mucous membranes of the vagina transforms in reaction to growing levels of the female steroid sex hormones that are secreted by the ovary and responsible for typical female sexual characteristics, and getting more intense and very low in saturation pink colour (compare to the more colourful red of the prepubescent vagina mucous membrane) (Siegel, & Surratt, 1992). In relation to this, milk-like secretions are typical end product of female steroid sex hormones that are secreted by the ovary and responsible for typical female sexual characteristics (Zuckerman, 2009) Nonetheless, in the two years subsequent to the start of breast development in a woman at the beginning of puberty, the hollow muscular organ in the pelvic cavity of females, the female internal reproductive organ, and the small spherical group of cells containing a cavity in the ovaries add to its size.^[31] in line with this, the female internal reproductive organ generally include small follicular vesicles which is only detectable by very high frequency sound; used in ultrasonography (Siegel & Surratt,1992)
4. Menstruation and fertility
   The prime occurrence of menstrual blood flow from a ruptured blood vessel is called menarche, and naturally exists about two years following start of breast development in a woman at the beginning of puberty (Tanner & Davies, 1985). However, the standard age of menarche in young female adolescence is eleven years and the period of menstrual monthly discharge of blood from the uterus of non-pregnant women from puberty to menopause is not constantly in accordance with fixed order in the first two years following the first occurrence of menstruation in a woman (Apter, 1980). The expulsion of an ovum from the ovary is needed for fertility, but may either go with the first monthly discharge of blood from the uterus of women from puberty to menopause.

Body shape, fat distribution, and body composition

At some time in the duration of puberty, and during the increasing levels of female steroid sex hormones that are secreted by the ovary, the lesser half of the pelvic arch and as a result either side of the body below the waist and above the thigh become broader, wider or more extensive (providing a well-built birth passage or tube lined with epithelial cells and conveying a secretion or other substance). In females the fat aggregate of cells changes to a larger proportion of the body structure than in the opposite sex, mainly in the usual woman apportioning of physical structures.

Body odour and acne

Increasing levels of androgenic hormone can change the aliphatic monocarboxylic acids composition of salty fluid secreted by sweat glands, consequential to more body odour in female human. This transformation heightens the vulnerability to inflammatory disease involving the sebaceous glands of the skin during puberty.

Genetic influence and environmental factors

Different studies have discovered direct hereditary consequences to account for the difference in the period of puberty in properly nourished populaces (Treloar, & Martin, 1990). However, the inherited relationship of timing is high between mothers and female offspring.

Researchers have anticipated that premature puberty inception may be due to some hair care creams which contains placenta.

The most noticed environmental consequences are that puberty takes place afterwards in offspring brought up at advanced altitudes.

Obesity influence and exercise

Researches carried out by researchers have related untimely corpulency with early start of puberty in girls. They have discovered that obesity is mostly the foundation of breast development in most teenage girls (McKenna, 2007). Consequently, early puberty in females can be an indication of health predicaments.

Strict and rigorous exercises have also been proved to lessen the energy existing for the process of generating offspring, thereby slowing puberty.

Physical and mental illness

Serious illness can hold-up puberty in both teenage male and females. Though, mental infirmities take place in puberty, but the brain goes through major development by the secretion of an endocrine gland that is transmitted by the blood to the tissue which can add to mood physical condition in which there is a disturbance of normal functioning during adolescence pubertal age.

Stress and social factors

A number of the comprehended environmental cognitive factors on the regulation of puberty are social and emotional.

However, the most important component of an adolescent’s psychological and social aspects of behaviour is the family, and the majority of the social power researched have accounted that the first occurrence of menstruation in a woman may arise earlier in teenage girls from high-stress family circles. On the other hand, the first occurrence of menstruation in a woman may be somewhat soon after a girl matures in an extended family (Lehrer, 1984).

Another restriction of the social study is that almost all of it is related to female adolescence, partially because female puberty needs better physical resources and because it entails a distinctive occurrence (menarche) that makes female puberty greatly easier than male.

Variations of sequence

The sequence of occurrences of pubertal expansion sporadically differs. Research found out that in about 15% of boys and girls, the first pubic hairs can lead, and then followed closely by the breast development in a woman at the beginning of puberty by a few months. Hardly ever, the first occurrence of menstruation in a woman can take place before other notices of puberty in a small number of girls.

Conclusion

In a general conscious awareness, the end of puberty is procreative development. The standardized basis for comparison for determining the end may be different for diverse reasons: realization of the aptitude to reproduce, accomplishment of most complete adult stature.

The centre of attention on the materialization of gender differences at puberty is grounded on the significant study that, at some point in early adolescence, pubertal period is normally a more essential link of behaviour than is sequential age. This finding needs focusing on pubertal growth before age, when considering the appearance of gender differences in risk taking behaviour, indications of depression, body image instability. Nevertheless, how developmental changes at some stage in puberty enhances or minimizes the risks for youth has been the centre of a number of research groups, on a national scale and internationally.

Significantly, the communications between the social world of pubescent and the biology of puberty may be different by gender.

At last, puberty should not be deemed to be the cause of difficulties in adolescent; rather, it is an indicator for the developmental stage that has significant implications for the change from infancy to adulthood.

Reference List

Alsaker, F.D. (1995). Timing of puberty and reactions to pubertal changes. In M. Rutter (ed.), psychosocial disturbances in young people: challenges for prevention (pp.37-82). Cambridge: Cambridge University Press.

Angold, A., and Worthman, C. M. (1993). Puberty onset of gender differences in rates of depression: a developmental, epidemiologic and neuroendocrine perspective. Journal of Affective Disorders, 29, 145-158.

Apter, D (1980). “Serum steroids and pituitary hormones in female puberty: a partly longitudinal study.”. Clinical endocrinology 12 (2): 107–120.

Garn, S. M. (1992). Physical growth and development. In: Friedman SB, Fisher M, Schonberg SK. editors. Comprehensive Adolescent Health Care. St Louis: Quality Medical Publishing;

Hayward, C. (2003). Gender differences at puberty. Cambridge: Cambridge University Press.

Jones, K. W. (2006). Smith’s Recognizable Patterns of Human Malformation. St. Louis, MO: Elsevier Saunders.

Lehrer, S (1984). “Modern correlates of Freudian psychology. Infant sexuality and the unconscious.”. The American journal of medicine77 (6): 977–80.

Litt, I.F. (1999). Self-assessment of puberty: problems and potential (editorial). Journal of Adolescent Health, 24(3), 157.

MacGillivray, M. H., Morishima, A., Conte, F., Grumbach, M., Smith, E. P. (1998). “Pediatric endocrinology update: an overview. The essential roles of estrogens in pubertal growth, epiphyseal fusion and bone turnover: lessons from mutations in the genes for aromatase and the estrogen receptor.” Hormone research 49 Suppl 1: 2–8.

McKenna, Phil (2007-03-05). “Childhood obesity brings early puberty for girls”. New Scientist. Web.

Nelson, R. J. (2005). Introduction to Behavioral Endocrinology. Massachusetts. Sinauer Associates.

Pubertal diagram. Web.

Siegel, M.J., & Surratt, J.T. (1992). “Pediatric gynecologic imaging.”. Obstetrics and gynecology clinics of North America 19 (1): 103–127.

Tanner, J.M., & Davies, P.S. (1985). “Clinical longitudinal standards for height and height velocity for North American children.”. The Journal of pediatrics 107 (3): 317–329.

Treloar, S. A., & Martin, N. G. (1990). “Age at menarche as a fitness trait: nonadditive genetic variance detected in a large twin sample.”. American journal of human genetics 47 (1): 137–148.

Zuckerman, D. (2009). “Early Puberty in Girls”. National Research Center for Women and Families. Web.

It has been alleged that transgender juveniles need easy access to puberty blockers as these drugs inhibit the emergence of unwanted sexual characters. Supporters of this argument feel that these individuals need time to self-explore before settling on identities that they truly recognize (Pilgrim & Entwistle, 2020). I appreciate the need for self-awareness particularly because it enables people to understand their uniqueness and strengths, and identify the aspects needing improvement (Smit et al., 2020). The search for this kind of knowledge should, however, not require the inhibition of other kinds of growth. A child’s biological development should be allowed to run its course. The use of puberty blockers is dangerous, especially because they are largely unknown.

The Drawbacks of Consuming Puberty Blockers

Little is known about the possible side effects of the use of puberty blockers. The widespread use of these drugs could trigger a host of medical complications and actually ruin the lives of the juveniles we purport to be helping. We are not even sure if they are transgender or not, and hence a mistake can occur, which is equivalent to prescribing Paxil upon a misdiagnosed depression. Would the proponents of the use of puberty blockers still support their idea if these drugs end up causing the transgender youths to, for instance, attempt suicide like it happens with those who take Paxil?¹

A quick check of those encouraging the consumption of puberty blockers shows that none of their children is actually taking them.² This shows they are dishonest as they do not lead by example. Their sound bites have been persuasive to many other children, and it is likely that some will start using these drugs based on their alleged values. Besides that, it is apparent that advocates of puberty blockers are clearly trying to undermine social order.³ Their propositions are bound to trigger an increase in the levels of anxiety and stress among individuals, and this has the compounding effect of diminishing the degree of satisfaction with life. Additionally, there will be relationship difficulties, especially at the familial level. Certainly, there will be conflicts in a scenario where a parent does not endorse their child’s consumption of these drugs.

At least there should be parental consent before puberty blockers are administered. Fortunately, most parents are against the idea, and I believe they will decline such suggestions emphatically. In my view, they should actually consider changing neighborhoods and transferring their children from schools, which condone arguments in favor of these drugs. When it comes to the protection of a child, no effort should be spared, even if it calls for the entire family to readjust.⁴

Conclusion

A vast majority in society are largely unfamiliar with puberty blockers. The citizenry is skeptical about their effectiveness as well as safety. It is likely that such doubts are what dissuade the proponents of their use from having them administered on their own children. The fact that no one who is adequately informed about the drug is using them means that they are unsafe,⁵ and hence they should not be prescribed on juveniles.

Argument Against the Use of Puberty Blockers

It has been alleged that transgender juveniles need easy access to puberty blockers as these drugs inhibit the emergence of unwanted sexual characters. Supporters of this argument feel that these individuals need time to self-explore before settling on identities that they truly recognize (Pilgrim & Entwistle, 2020). I appreciate the need for self-awareness particularly because it enables people to understand their uniqueness and strengths, and identify the aspects in need of improvement (Smit et al., 2020). The search for this kind of knowledge should, however, not require the inhibition of other kinds of growth. A child’s biological development should be allowed to run its course. The use of puberty blockers is dangerous, especially because they are largely unknown.

The Drawbacks of Consuming Puberty Blockers

Little is known about the possible side effects of the use of puberty blockers. The widespread use of these drugs could trigger a host of medical complications and actually ruin the lives of the juveniles we purport to be helping. Following in-depth research, for instance, Pilgrim & Entwistle (2020) found a strong positive correlation between their consumption and a reduced bone density. This increases the possibility of their posture becoming stooped. Additionally, such individuals can easily suffer fractures, or fail to gain normal height. These are serious challenges that can derail someone’s life significantly, and hence puberty blockers should not be administered on juveniles.

Those encouraging the consumption of puberty blockers have failed to justify why they are absolutely necessary. They, for example, disregard the need to explain why some children need to have their biological growth inhibited. To argue that this is meant to pave the way for self-exploration already shows that the individuals in the group we are targeting with these drugs have not yet decided on how they want to identify. What if we permanently obstruct a teenager’s sexual development only for them to decide to stick with the gender assigned at birth? Would it be possible for us to unblock the process, and what would it take to do that? Instead of ending up with such a scenario, we should opt not to interfere with individuals’ growth and development.

The debate over the use of puberty blockers is polarizing. Besides the concerns about their impact on physical health, a significant number of people are opposed to them on moral and ethical grounds. Because this is not a medical emergency, those proposing the use of these drugs should allow the rest of society time to ponder over the issue. They should, for instance, continue sharing bits of information about why they are important. That should, nonetheless, be done without any kind of coercion as there is no urgency in prescribing them.

At least there should be parental consent before puberty blockers are administered on children. Their autonomy should be respected just like it happens in medical practice in general. Although healthcare practitioners may share the information on the available alternatives, a parent’s decision must not be quashed. Indeed, the presumption should be that they are competent enough to make decisions in the best interest of their children.

Conclusion

A vast majority in society are largely unfamiliar with puberty blockers. The citizenry is skeptical about their effectiveness as well as safety. It is likely that such doubts are prompted by the fact that this is an emergent procedure and, therefore, only a few studies have been published on it. The stakeholders who may wish to be adequately informed prior to making their decisions are currently facing challenges. This is why the proponents need to allow enough time to pass and for more facts to be revealed before they recommend the widespread use of these drugs. Before then, puberty blockers should not be used, and we should let children undergo normal growth and development.

References

Pilgrim, D., & Entwistle, K. (2020). GnRHa (‘Puberty Blockers’) and cross sex hormones for children and adolescents: Informed consent, personhood and freedom of expression.New Bioethics, 26(3), 224–237. Web.

Smit, D., Peelen, J., Vrijsen, J. N., & Spijker, J. (2020). An exploration of the conditions for deploying self-management strategies: A qualitative study of experiential knowledge in depression.BMC Psychiatry, 20(1), 1–11. Web.

Footnotes

1. Straw Man fallacy.
2. Ad Hominem fallacy.
3. False Dichotomy fallacy.
4. Appeal to Force fallacy.
5. Appeal to Ignorance fallacy.

Introduction

“I won’t go to school mom. I have a big pimple on my face!”

“Dad, I think I’m growing mustache and my biceps are starting to shape up!”

“That guy/girl is so cute.”

These are some lines we might have used during our teenage years – a time when major physical and emotional changes start to happen in our bodies. At first, we were not aware of these changes. But as time pass by, we start to notice them. Girls get all fidgeted when their hips widen, breasts develop and menstruation starts. On the opposite end, boys get excited when their voice deepens, muscles tone up and facial hairs start to appear. These are signs that we are leaving our playful “childhood life” and will enter a new and critical stage towards adulthood – puberty.

Main body

Much of the major adjustments physically, emotionally, and mentally start to happen when we reach puberty or more commonly called the adolescent stage (Dowshen 2005) Upon reaching this age, humans undergo rapid growth of muscles and bones, changes in body shape, and development of the reproductive system.

Some of these changes manifest differently in both genders. Puberty begins when a part of the brain, called the hypothalamus, releases gonadotropin-releasing hormone (GnRH) to the pituitary gland (a small bean-shaped gland found at the base of the brain). The GnRH signals the pituitary gland to release more hormones, the luteinizing hormone and follicle-stimulating hormone (FSH).

The latter causes ovaries to produce estrogen for females and the testes to produce testosterone for males. The production of such makes the body undergo physical changes. (Mayoclinic) As an effect of what is physically happening, adolescents also begin to undergo psychosocial maturation. (Blondell 2005) They begin to have groups that are of the same age, spend more time with them, and discuss topics that deal with their hobbies, interests, people, and events.

These things normally take place between 8 to 16 in girls and between 9 to 14 in boys. (Mayoclinic) However, in some cases, puberty starts to happen at an earlier age. (Ridley 2007) This event is called precocious puberty.

By definition, precocious puberty (La: pubertal praecox) is an early onset of puberty. (Niche) It is an early development of sexual characteristics in girls before 8 years old and in boys before 9 years old. (Kaplowitz 2007) In other contexts, precocious is used more broadly to describe the “early appearance of any of the physical features of puberty even if the complete brain-directed process in not occurring.” ((NICHD) Scientists have various explanations as to why precocious puberty happens to some children.

Most cases of diagnosed early puberty, especially in girls, are idiopathic, meaning there are no causes found. (keepkidshealthy) Other cases of precocious puberty are classified as either central precocious puberty or peripheral precocious puberty (Mayoclinic) both differ in the body part where the problem starts.

In central precocious puberty, the secretion of the GnRH by the hypothalamus starts too early. The pattern and the timing of the other process take place in a normal condition.

Most of the children with this case are found with no medical problem history. In some rare cases, causes might be a tumor in the brain, an infection such as meningitis (inflammation of the meninges), a defect in the upon birth (hydrocephalus), exposure to radiation, brain injury, an obstruction of blood flow to the brain, abnormalities in the thyroid glands and genetic diseases such as McCune-Albright syndrome (causes hormonal problems) and Congenital adrenal hyperplasia (abnormal hormone production by the adrenal glands). (Mayoclinic)

On the other hand, peripheral precocious puberty is not triggered by the early release of the GnRH. (healthsystem.virginia.edu) It is usually caused by problems of the ovaries in females and the testes in males or the adrenal and pituitary glands. These problems are often associated with tumors and external exposures to estrogen and testosterone such as creams, ointments, or hormone tablets. (Mayoclinic)

There are also certain risk factors that might increase the chance of having precocious puberty. Studies show that girls have a higher chance of developing at an early stage. In 200 patients evaluated in one hospital, Central precocious puberty (CPP) occurred 5 times more often in girls than in boys. Idiopathic CPP occurred 8 times more often. (Kaplowitz)

The race is also a risk factor considered. In 1997, a study of 17,000 US girls aged 3-12 conducted from 1988-1994 by Hermann-Giddens and data from the National Health and Nutrition Examination Survey (NHANES) showed that black girls develop a year earlier compared to white girls.

They estimated that sexual precocity is exhibited in 25% of black girls and 8% of white. (Kaplowitz) On the other hand, in a study of 2,000 boys lead by Marcia-Hermann Giddens, 38% of African-American boys and 30% of Caucasian boys showed signs of sexual development by age 8. (Ridley 2007)

Aside from sex and race, obesity is also a seen as a potential factor for precocious puberty. (mayo clinic) A recent study of 254 girls by Lee et al (in Kaplowitz 2005) found that higher BMI at 3 years old and the increase in BMI at the same age were both positively associated with early onset of puberty in females. However, there is still no clear association between obesity and early puberty in males.

Doctors must do clinical tests before diagnosing precocious puberty because, in some children, signs of maturation normally start at an earlier age. Breasts development in girls younger than 3 and the appearance of pubic hair younger than 7 years can sometimes resemble precocious puberty but are nonprogressive.

This means that the other signs of puberty do not develop and such physical development is just a variant condition. (medicine) Basically, when all the signs of puberty start before 7 years old in girls and 9 years old in boys, most likely it is considered precocious. Such signs include growth of pubic and underarm hairs, acne, and adult body odor. For girls, the most reliable sign that she is already releasing estrogen is breast enlargement which could be unilateral or asymmetrical.

Gradually, the breast diameter, the areola darkens and the nipples become prominent. A genital examination may reveal a pastel pink appearance of the vaginal mucosa from a deep-red color in pre-pubertal girls. For boys, the earliest sign is the enlargement of the testes. Increased testosterone levels also result in penis growth, reddening, and thinning of the scrotum. Children also experience rapid bone development thus making them grow fast.

As a result, they often stop growing earlier than usual and will not reach their height potential. At first, they tend to look taller than the other children of their age. However, in later years, they would be shorter than average as adults. (Mayoclinic)

To correctly diagnose precocious puberty, pediatric endocrinologists first review the child’s medical history followed by series of tests. Such tests include bone x-rays, usually of the wrist and hand, to determine the chronological age of the child’s bones or if the bones are quickly growing. Another is by injection of GnRH hormone and then taking blood samples. If the child has central precocious puberty, the LH and FSH levels will increase.

To test if tumors or other abnormalities are present, doctors do Magnetic resonance Imaging (MRI) of the brain or of the thyroid glands. Other clinical tests include abdominal ultrasound, specifically in girls, to detect ovarian cysts or tumors. (Mayoclinic) It is also used to assess blood flow through various vessels. (healthsystems.edu)

Treatments are also available once precocious puberty is diagnosed. It depends on whether or not there are underlying causes, the child’s condition, or the child’s level of tolerance for specific medications or therapies. (health system. Virginia)In the case of idiopathic precocious puberty, treatment is focused on inhibiting the release of the GnRH by the hypothalamus. The patient is usually prescribed synthetic long-acting agonist GnRH such as leuprolide. (Mayoclinic)

With this treatment, it is expected that puberty will regress, decrease the rate of bone growth, and return to the normal hormone level. This treatment requires frequent visits to the doctor to monitor growth and development. This is done until the age of 11 or 12 for girls and 12 or 13 for boys when normal puberty starts to happen. (keep kids healthy) In cases where tumors or cysts are found, doctors might do a surgical removal in order to make the organs affected function normally.

The third treatment option is to do nothing. The decision to treat or not to treat has to be arrived at with all of the information and must be made by the doctor and parents. (www.asbha.org.au) It is just important to note that effective treatment must begin early in puberty.

Children suffering from precocious puberty often experience difficulty in coping with the changes they are undergoing since it is happening at a much younger age. The effects manifest in how a child responds to his/her social environment. One particular social problem is that the child develops low self-esteem he/she might feel different from his/her peers. (Mayoclinic) For example, a five-year-old girl would normally be with her peers playing stuff toys or dollhouses.

However, if a five-year-old girl who has precocity develops breast and start her menstruation which other girls her age does not experience, she would feel awkward and uncomfortable with her sexual changes and tend to shy away from such activities to avoid further teasing that her playmates might give her. The sense of being different coupled with the hormonal change-induced emotional mood swings will make the child feel more self-conscious. (healthsystem.virginia.edu)

Since she no longer fits with the other three-year-olds, the tendency for her is to find a peer group that is much older than she is. Another problem might surface because the older group might not accept her. (Green 1996) He/She will not be given the chance to enhance their social interaction skills which would pose problems when they reach adulthood.

Another effect of early puberty is the depression that the child undergoes. Since the feeling of being different blankets their personality, they are covered with sadness because they cannot do the things that they want to do such as playing. Depression often leads to many circumstances that will be harmful to the child’s development.

They may do things like running away from home or start having vices at a very young age. Other causes of depression include eating too much and spending more time being alone. Although children might not verbally say what they feel their actions manifest the extreme confusion that they are feeling.

The change in the hormone levels of children with precocious puberty might also affect their behavior. This is similar to what is felt by normal children, however, at a later age. Girls would become irritable and moody. They easily get angry if conditions are not favorable to them. Their emotions are unstable and can be expressed differently.

For children below the normal adolescent age, this is harder to control. The tendency is too explicit tantrums such as shouting out loud or throwing things on the floor. In contrast, some would cry easily for no reason at all. Aside from this, precocious puberty can make girls able to conceive at a very young age since their ovaries are already releasing viable eggs and hormones. On the other hand, boys show signs of aggressiveness.

They could engage in bullying activities that might lead to fistfights with other kids. Both sexes, but are more prominent in boys, may have an increase in libido leading to increased masturbation or engaging inappropriate sexual behaviors at a young age. Girls, however, with a history of early puberty have a slightly earlier age of sexual activity initiation.

Other problems could arise with the behavioral change both in girls and boys. These include performing poorly in school and loss of interest in daily activities. (Dowshen 2005) They tend to be less competent academically since they are more focused on dealing with physical changes. They also experience increased stress levels because of the physical and hormonal changes that they are not prepared to face.

Other effects are not readily manifested. Some of it will appear when the child reaches adulthood. Some studies show that the earlier the child starts her period, the higher risk she might have to develop breast cancer. This is probably due to prolonged estrogen exposure. The highest average risk for breast cancer is in non-Hispanic white women, where it is 1 in 8 or 12.5%. Altogether, there is a 16.25% risk of girls who will have breast cancer when their menstruation starts before 12 years old. (Greene 1996)

The family, especially the parents, also suffer when their children have precocious puberty. They struggle to fight their emotions seeing that their young child already exhibits unusual physical and behavioral changes. Parents also wrestle with painful decisions such as whether or not they would give their children injections of drugs.

Some medicines, such as Lupron, suppress hormones but have 26 possible side effects. (Ridley 2007) Parents also exert greater tolerance, patience, and continuous emotional and physical nourishment to support their children. They have to take practical steps to “minimize their children’s risk for early puberty and encourage a healthy lifestyle.” (Ridley 2007) Such parental activities might also be stressful to the parents.

Some steps are suggested to lessen the chances of children having precocity. Controlling and eliminating some environmental elements could help minimize the risks. One is to avoid meat, milk, and dairy products containing growth hormones because they can trigger the development of bones and muscles.

Instead of ingesting such, parents should buy natural products. Organic fruits and vegetables help the body to function normally and make cell reproduction stay active and develop at the right time. Another way of controlling the type of food intake is by minimizing soya, which mimics estrogen, especially in girls. A low-fat diet, especially food containing vitamins A, C, E, and zinc protects them from breast cancer. Also, encouraging children to eat well and exercise daily could greatly help in order to prevent obesity and have a healthy lifestyle.

Another suggested way to control precocious puberty is preventing children from chewing on plastic toys. Plastics with polyvinyl chloride (PVC) might expose children to mutagens, or cancer-causing agents. It might expose children to endocrine-disrupting chemicals. This includes vinyl shower curtains and toys with packaging that bear the number “3” indicating they’re made with PVC. (Ridley 2007)

It is also important that the child have a support group that will strengthen her and lessens the effects of early puberty. Parents must be constantly aware that the moment precocity signs are showing an appointment with healthcare practitioners must be made so that immediate tests and medication can be done.

Doctors help in making children understand the situation they are in including the dilemma they will face. They should also continuously monitor the situation to make the child feel at ease. Together with the doctor, the parents however have a greater responsibility. Giving their child a simple, truthful explanation about what is happening would extend a helping hand to them. Also keeping the child informed about his or her treatment will prepare him/her for what is expected to happen along the way.

Parents should also watch for signs that teasing or other difficulties associated with precocious puberty may be affecting the child’s emotional development. They should constantly talk with their children allowing them to express their feelings and resentments. Parents often tend to give suggestions of do’s and don’ts and give judgmental comments. However, they should just carefully watch, listen and help them put their feelings into words.

In a way, parents should try to create a supportive environment for the child that instead of focusing on the physical appearance, they should praise the child for the achievements in school or sports and encourage them to join and participate in other activities. (Dowshen 2005) Since early puberty is more prone to girls, parents can also teach their child the habit of regular breast self-examination. Exposing and being with their children in strenuous exercise such as running and gymnastics could greatly help.

Aside from doctors and parents, psychological counseling can help cope with the situation. (Mayoclinic) Sometimes, parents will also have difficulty adjusting to their child’s needs. Qualified counselors can help the family or even the child to better understand and handle sudden outbursts of emotions, issues, and challenges that accompany early puberty. Coping with such medical conditions can be very challenging but it does not have to be done alone. (Mayoclinic)

There are rare cases of precocious puberty in children under 5. Pregnancy and child delivery also remains rare because extreme precocity is treated to “suppress fertility, preserve growth potential and reduce the social consequences of full sexual development in childhood.” (www.incrediblebirths.com)

One such rare instance of pregnancy at an early age is the case of Lina Medina. Lina is the world’s youngest confirmed mother giving birth at the age of 5 years, 7 months, and 21 days. (Wikipedia.org) She was born in Peru on September 27, 1933. She hadn’t turned 5 years old yet when the shamans in her village were alarmed because of the growing belly she was having. One shaman performed a ritual trying to “diagnose” what was happening.

At first, they thought that she was just possessed with a bad spirit and an exorcism ritual must be performed. The shamans asked permission from her father Tiburcio. Upon approval, Lina was subjected to Inca rites in the south American cordillera. However, to their dismay, none of these procedures worked. Tiburcio, carrying her child on the back, walked for two days through valleys and hills intensively looking for a real doctor. As they got to the town of Pisco, 70 kilometers away from their village, they found Doctor Gerardo Lozada. Dr. Lozada was surprised to see the size of her belly.

At first, he thought it was a growing tumor. He then administered preliminary tests. The girl’s clinical tests showed that it was not a tumor but an eight-month baby that she is carrying. This greatly astonished Dr. Lozada forcing him to immediately call the police to arrest Lina’s father.

The policemen immediately imprisoned the father as he was pointed as the main suspect of the rape and pregnancy. But after a few days, he was set free because of a lack of sufficient evidence. One of Lina’s brothers, a mentally disabled boy replaced him in the prison cell. He was also released because there was no direct link to him either.

In the meantime, Dr. Lozada took Lina to Lima and confined her in a clinic while he sent an emissary to Antacancha to compile more information about her. He found out that before she was 4, Lina already exhibited breast and pubic hair development and had her menstruation. Her neighbors told stories that “Lina’s mother would just carry her to the river and wash her off whenever this happens.”

During Lina’s confinement, Doctor Lozada organized everything to perform a caesarian section. Together with him, Dr. Busalleu (surgeon) and Dr. Colretta (anesthetist) were there to help him. Finally on May 14, 1939, ironically a Mother’s Day, Lina gave birth to a healthy and strong 2.7 kilograms, 48 centimeters long baby boy. He was named Gerardo, after Dr. Lozada. (www.pyrophoitos.blogspot.com)

The news of a Peruvian 5-year old giving birth to a baby immediately spread all over the world. During this time, the mother and her son were taken care of at the clinic. Officers, artists, diplomats, merchants, and politicians visited and filled their rooms with gifts. Lina was given education by teaching her how to read and write.

On the other hand, some “childhood attitudes are exhibited by Lina herself. Reports show that she was seen taking the toys away from her baby boy. Many years later, Dr. Juan Falen explained that Lina has precocious puberty. People from other countries saw the potential money opportunity from Lina’s unusual puberty. Many offered her juicy money. One such offer was a 4000 dollar a month plus expenses if the girl traveled to New York for a year to be exhibited as freaks in the World Fair.

The family refused the offer. Other proposals include an allowance for life for both from Oscar Benavides, then president of Peru. The family signed an agreement with the Seltzer Company allowing the latter to study the case. However, the mother and son never saw one penny. (telegraphindia.com)

Lina’s son Gerardo was raised in the belief that Lina was her sister. However, he found out the truth at the age of 10. He died in 1979 of a bone marrow disease. There was no clinical evidence that it was related to his extraordinary birth circumstances. Lina on the other hand married Raul Jurado at the age of 33 and had another son in 1972. She, with her husband, still lives today in a poor suburb in Lima while their son lives in Mexico. She is 73 years old now and has only one ambition: that the government compensates her for the house they demolished.

Conclusion

Although this phenomenon happened many years ago, one thing is left unanswered. Who is the father of Gerardo Medina? Lina refused to answer this question when she was asked about it. Up until now, she keeps it to herself and has long refused requests to rake up the past. (telegraphindia.com) In 2002, Lina’s name barely brushed the surface of media attention again when she refused to do an interview with Reuters. (Krech 2007)

Precocious puberty still needs more researches and studies. The future generation hopes to find the cure in the hands of skeptical and talented scientists we have today.

References:

Antoniazzi, F.; Zamboni, G.; “Central Precocious Puberty – Current Treatment Options;” Pediatric Drugs 2004, Vol. 6, No. 4, pp. 211-231.

Diabetes and other Endocrine and Metabolic Disorders. 2004. University of Virginia Health System. Web.

Dowshen, S. 2005. Precocious. Kidshealth organization. Web.

Iron Queen. 2007. Web..

Kaplowitz, Paul B. 2007. Precocious Puberty. Web.

Greene, A. 1996. Precocious Puberty. Web.

Lina Medina – World’s Youngest Mother – Precocious Puberty. Incredible births. Web.

Lina Medina. 2008. Wikimedia Foundation Inc. Web.

Mayo Clinic Staff. 2007. Precocious puberty. Children’s health. Web.

Precocious Puberty. 2001. Keep Kids Healthy LLC. Web.

Shiver, E. 2007. Precocious Puberty. National Institute of Child Health and Human Development. Web.

“Six decades later, world’s youngest mother awaits aid“ 2002. The Telegraph (Calcutta, India). Web.