Adolescence is the transition period from childhood to adulthood, and during this period, breast growth in girls and hair growth in the genital area, fat distribution specific to women; In men, with the enlargement of the testicles and penis
, visible gender-related changes such as hair growth in the genital area, as well as important developments such as the acquisition of reproductive ability
and rapid height growth occur. Towards the end of puberty, menstrual bleeding begins in girls and ejaculation in boys, and after a while, the height growth stops. p>
It is evaluated by breast growth, which shows the effect of the hormone, and by the growth of the testicles in boys.
In other words, the breast growth in girls and the start of testicle growth in boys are taken as a "reference point" regarding puberty. and other endocrinological, biological, physical and spiritual changes are assumed to follow each other. The age limits still used today regarding the age at which puberty begins are (for girls, the earliest is 8, the average is 10.5, the latest is 13; for boys, the earliest is 9, the average is 11.5, the latest is 14) and this
The data mean that 95% of children will enter puberty in these age ranges. Here
It should be kept in mind that normal and average are different concepts, and that the onset of puberty in the periods between the average and the earliest and latest ages should also be considered within normal limits.
Scientifically, breast growth in girls before the age of 8 is considered precocious.
However, in some girls, breast development may occur on its own, before the pubertal center in the brain begins to function, that is, without ovarian growth and other signs of puberty. For these cases, the definition of premature breast development (premature thelarche) or “normal early
puberty” is used. In other words, breast development before the age of 8 does not always mean early puberty. In the majority of these cases, breast development occurs before the hormones that initiate puberty are activated, that is, independently of pubertal hormones. In recent years, more and more people have gained weight rapidly. It is observed that hair growth begins early in the genital area or armpit, and this is often accompanied by breast development mixed with fatty tissue. In some girls, the odor change characteristic of puberty may occur early. These events are due to the early
secretion of hormones we call androgens in the adrenal glands, for reasons we do not know yet, and this situation mostly does not cause any negativity. There is no earlier shift in these children's menstrual age, and their height is not negatively affected.
Another important point is the relationship between breast development and menstruation time. In general,
Girls who develop breasts around the age of 10.5 experience menstruation approximately 2 years later, whereas
As mentioned above, breast development is early, which is not due to a disease
In some cases, the time between breast development and menstruation becomes longer, in other words
The time of menstruation does not shift earlier.
Does the age of puberty shift earlier?
In research conducted in our country, the age of menstruation Based on this, it shows that there is no shift in the age of puberty
. Even if there is an increase in the frequency of breast development between the ages of 8-10.5 and before the age of 8 in girls, this does not affect the age of menstruation, in cases of early breast development and/or early puberty that are not due to a disease. We can say that there is no need to automatically worry about short stature and early
menstruation. In our country, the majority of the children that families bring to hospitals with concern are girls between the ages of 6-9 who have only genital hair growth or breast development. Puberty of these children progresses slowly and most of them menstruate at normal times and their height is in accordance with their genetic potential.
Breast development and/or puberty are partially delayed. Do environmental factors have an impact on the shift
?
Recent studies on Finnish twins have shown an 82-86% difference in the time and tempo of puberty onset in girls and boys. genetic factors
In addition to genetic factors, ethnicity, nutrition, especially infancy and early childhood
excessive weight gain or obesity during the period, consumption of sugary drinks, low birth weight, mother's p>
The age of menstruation, adoption by families in developed countries, absence of the father at home, and
in recent years, estrogenic endocrine disrupting chemicals have been emphasized as affecting the age of puberty
. It is often not necessary to treat girls with early breast development and/or early puberty due to poor nutrition and/or obesity as early puberty due to a disease and start medication. Nowadays, there is not yet fully proven data on environmental factors that affect the onset, speed and normal physiology of puberty, and there are extensive discussions on these issues on scientific
platforms.
Premature onset in girls. When should puberty be considered a problem?
In general, delayed puberty is common in boys and early puberty is common in girls. Just as no cause can be found in the majority of cases of delayed puberty in boys
, no disease can be detected in the majority of cases of early puberty in girls
. First of all, it should be kept in mind that early puberty in men may mostly be due to a disease. In girls, there is a high probability of a disease in cases of early puberty occurring before the age of 6
. Although the first sign of early puberty in girls is breast development, rapid growth in height, hair growth in the genital area, worsening sweat odor and psychological changes specific to puberty are added to this. For this reason, if breast development
is early, there are other signs of puberty and there is a rapid progression, the possibility of early
puberty is high. Otherwise, premature breast development should be mentioned.
The probability of a disease in cases of early puberty in girls between the ages of 6-8 is around 2%.
In general, hormone levels, bone age determination, pubertal findings Treatment decision is taken by evaluating the rate of progression, ovary and uterus
sizes and, in necessary cases, brain MRI examination
should be given. There is no doubt that cases of early puberty due to a pathology should be treated. In cases that are not due to a cause and in cases of puberty that begins after the age of 6, the treatment decision should be made according to whether puberty
is progressive and other parameters. In these cases, it should be kept in mind that early breast
development does not mean early menstruation and that the treatment does not have a noticeable
effect on height gain. It is known that breast development between the ages of 8-10.5 does not generally require treatment if it is not due to a disease.
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