When your children are very young, puberty may seem like a distant reality, but it may not be as far off as you think. In fact, your child’s normal sexual development can start earlier than about age 7 or 8 in girls, or about age 9 in boys. Puberty refers to the physical and emotional changes that lead to maturity and allow for human reproduction.
While it may be difficult to think about your child going through these changes at such a young age, puberty is a perfectly normal process. The first signs of puberty can occur at any time between the ages of 8 and 14 for girls, and usually involve the development of breasts and pubic hair. In boys, the first signs of puberty occur between the ages 9 and 16, and involve the development of the testes, a deepening of the voice, muscle growth, and pubic hair.
What if puberty occurs too early? For example, what should be done if you see signs of sexual development in your 5-year old? Seeing a pediatrician is important when body changes occur before the normal average age because a child may have a medical condition called precocious puberty.
Recognizing Precocious Puberty
Precocious puberty, sometimes called early puberty, can be defined as the onset signs of puberty before age 7 or 8 years of age in girls and 9 years of age in boys. Precocious puberty is more common in girls, but occurs in boys as well. Signs of early puberty are typically the normal changes that occur during puberty that simply occur too early. These signs can include the following changes in girls before 7 or 8 years of age:
Pubic or underarm hair development
Rapid height gain—a growth "spurt"
Start of menstruation (her period)
And the following changes in boys before 9 years of age:
Enlargement of the testicles or penis
Pubic, underarm, or facial hair development
Rapid height gain—a growth "spurt"
Keeping Track of the Signs
It’s important to keep an eye on your kids for signs that their bodies are changing. You may want to explain these changes to your child, or start a conversation about what he or she can expect along the way. Take your child to see his or her pediatrician if you notice signs of anything unusual including signs of precocious puberty or having problems in school or with other children.
It is very important to speak with your child's pediatrician if you begin to see signs of early puberty in your young child. This is true not only because precocious puberty can be physically and emotionally difficult for kids, but also because it is sometimes the sign of another health problem.
Take note of the following:
Has your child experienced a growth “spurt”?
Does she/he have body hair?
Does she/he have body odor?
Are her breasts, or his testes or penis growing?
Does she/he seem more irritiable or aggressive than usual?
Causes & Treatment
Some causes of precocious puberty require treatment and others do not. For the majority of girls, there is no particular medical cause that needs to be addressed—in these cases, puberty starts early for no known reason.
Though rare, the onset of early puberty can be caused by a brain tumor, injury or infection. Additionally, problems with the ovaries, testes, or thyroid gland can also cause early puberty. It is important to have a pediatrician or pediatric endocrinologist find the underlying issues. A diagnosis is determined by physical exam that may include blood tests, and bone X-rays.
Even though precocious puberty causes rapid growth, early puberty may also keep a child from reaching normal adult height. This is because bone growth stops too soon. Treatment for kids with true precocious puberty may involve treatment with a GnRH analog, which delays puberty for as long as your child is treated. GnRH analogs work to slow down physical maturation and improve adult height.
Talking to Your Kids
As a parent, be proactive by asking questions about your child’s development in terms of both body and mind. You can start the process with a young child by talking about the simple body changes that are normal and those that are not. By the time children are 8 years old, they should know about the physical and emotional changes to expect with their bodies.
As a pediatric doctor, I often recommended a book called, “What’s Happening to Me?” by Peter Mayle and Arthur Robins. Talking about the changes associated with puberty may be easier when your child is young rather than trying to address issues about pubic hair and body odor with a teenager whose puberty is already in full swing.
Just knowing what’s going on with your child’s body at all stages of development may be the best strategy for keeping track of normal development. Discuss with a pediatrician the changes you see throughout the year at your child’s annual well visit. In the meantime, make sure your child knows how to keep his or her body healthy by eating a nutritious and balanced diet and getting plenty of exercise.
Jose Cara, M.D., is a pediatric endocrinologist, and Vice President of Endocrinology at Pfizer, Inc.
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