Adolescence begins with the growth of breasts in girls and testes (ovaries) in boys. Reasons such as race, climate, genetic predisposition, body weight and body fat affect the age of puberty and the onset of puberty. Signs of puberty begin between the ages of 8–13 in girls (average 10–11 years), and between the ages of 9–13 in boys (average 11–12 years). The onset and progression of puberty symptoms differ between boys and girls. Puberty begins with the growth of breasts in girls and testes (ovaries) in boys. In 15% of girls, the first finding may be hair growth in the genital area, and rarely the onset of menstruation. Since it is difficult to notice testicular enlargement in males outside of a physician's examination, puberty can be evaluated with the progression of genital hair growth.
What are the Events Initiating Puberty?
Puberty begins with the effect of hormones secreted from the region of the brain called the hypothalamus-pituitary. The cells that secrete these hormones are "asleep" until puberty. These hormones stimulate the ovaries in girls and the testicles in boys, causing the secretion of sex hormones (estrogen in women and testosterone in men).
How Does Puberty Proceed?
During adolescence, boys and girls experience physical changes appropriate for their gender. These changes occur in a certain order and the adolescence period is completed in 5 stages. Average 3- It lasts for 4 years and at the end of puberty, it becomes an adult individual who has regained the ability to reproduce.
It may occur due to central or peripheral (not related to the central nervous system) causes of precocious puberty. can be sorted. Causes of peripheral precocious puberty; Tumors in the adrenal or pituitary glands that produce excess estrogen and testosterone. as well as estrogen and excessive intake of testosterone in the form of cream or ointment can also cause peripheral precocious puberty.
In boys; Germ and Leydig cell tumors can cause peripheral precocious puberty.
What are the Signs of Early Puberty?
The first symptom in girls is enlargement of the breast tissue and subsequent genital area and armpit hair growth. With the onset of the first menstrual bleeding, the early puberty process is completed.
The first symptom in men is the enlargement of the testicles. Testicular growth is followed by penis enlargement, genital area and armpit hair growth, thickening of the voice, and increase in body muscle mass.
Is Hair Growth an Indicator of Puberty Alone?
Hair growth, breast development and It can be simultaneous with testicular enlargement, but it is usually seen after 6 months. Genital hair growth alone is not considered puberty, but should be examined. Sometimes at the age of 6-8 years, genital and/or armpit hair may occur due to a weak androgenic hormone secreted from the adrenal gland. This situation, which is called "pre-adolescence" among the people, is normal. However, as early hair growth may be a symptom of some hormonal diseases, it is beneficial to have a physician's examination. Additionally, if early genital hair growth is associated with height and bone age, it should be evaluated. should be elongated. If there are signs of puberty with faster height growth, a physician should be consulted.
Can Mothers Notice Breast Development?
Careful mothers may notice bud growth in the breast. Especially in obese children, hormonal breast growth and breast enlargement due to lubrication can be confused with each other.
Is Breast Pain Normal During This Period?
There may be pain and ache in the breast during the first breast growth (budding). This pain occurs especially with contact.
Within 1 year after puberty symptoms begin, rapid height growth occurs and this is called a “growth boom”.
Average Height Growth Before Adolescence How Much?
In general, breast development in girls After hair growth, hair growth in the genital area and armpits and menstrual bleeding begins within the next 2 years. Menstrual bleeding can begin between the ages of 10 and 16 (average 12.8 years), and irregular bleeding is usually observed in the first years. Rapid height growth occurs within 1 year after puberty symptoms begin, and this is called a "growth boom". Girls grow about 20-25 cm during puberty. In general, after the onset of menstruation, girls grow up to 5-6 cm in height. and continues with hair growth and deepening of the voice in the mustache area. The “growth boom” in boys occurs later than in girls (after an average of 2 years), and they grow up to 28 cm in height during puberty. Boys can have "sexual ejaculation" in mid-puberty. At the end of puberty, boys and girls gain reproductive ability.
Precocious puberty can sometimes be due to a serious illness or have features that require immediate treatment. For this reason, children with this type of problem should be sent to Pediatric Endocrinology specialists.
Is it Normal to Observe Breast Growth Around 7-8 Years in Girls?
8 in Girls Breast enlargement can be observed before the age of 6 and especially around the age of 6. If there is rapid growth in height and progression of bone age with breast growth, these girls should be investigated in terms of early puberty. In these girls, the hormones that cause puberty to enter puberty are secreted early. In this case, there is an early secretion of stimulating hormones and therefore estrogen in the brain or the intake of estrogen from the outside. This is called precocious puberty. Precocious puberty is more common in girls than boys. In most cases, the cause cannot be found. No specific underlying problem can be identified. Precocious puberty may develop due to environmental stimuli, excessive consumption of hormonal foods, and some psychological reasons. Brain pathologies are very rare in girls.
What is the Prevalence of Precocious Puberty in Boys?
Precocious puberty is less common in boys. More likely to be pathological, in more than half of the cases underlying and There is a central nervous system pathology that needs to be investigated. In boys who enter puberty early, testicles and penis enlarge, there is a rapid increase in height, the voice becomes thicker, and aggressive and nervous behaviors occur. However, their stature remains short. The psychological and social consequences of early puberty, including those related to growth, are significant.
What Are Concerns About Premature Sexual Development?
Fear of a serious underlying cause as well as fear of negative effects on growth in the long term - short stature (even though they are taller than their peers at first, but their last adult stature is shorter), psychological problems caused by early menstruation in girls. Puberty sometimes starts at the normal time but is completed in a shorter time when it should last 3-5 years. This is a situation that should be examined under the title of accelerated adolescence. In these children, there is a risk of staying short because there is not enough time for stature growth.
Regardless of the reason, early puberty causes two important problems. These are the behavioral and psycho-social problems that occur in the child and short stature.
How to Treat Early Adolescence?
Whatever the reason, early puberty causes two important problems. . These are behavioral and psycho-social problems in the child and short stature. Therefore, early puberty should be treated.
Early adolescence treatment is handled in two steps; With the effect of hormones, it is aimed to prevent the bone epiphyses from closing early and to prevent the child from being short when he/she is an adult and to protect the child from social and emotional problems that may occur in the child with the development of puberty, unlike his peers.
The treatment is continued until the normal time of puberty for girls and boys. After the drug treatment is completed, the child normally enters puberty approximately 16 months later. Puberty, which has started temporarily early, is stopped. Applied once a month or as 3 monthly injections and its effects are used only Medicines that are valid during the period they are used are used. When the child reaches the appropriate age for puberty, sexual development resumes when the injections are stopped. Generally, parents' concerns that "hormone administration may be harmful" to their children at this stage is completely unnecessary.
The most important point to remember here is that the drugs used do not have lasting effects. When puberty-stopping drugs are discontinued, puberty resumes. The common goal of all of us is to ensure that our children grow up as normal individuals in terms of physical and mental health.
What are the Complications of Early Adolescence?
Adolescence; It is the process in which sexual development is gained, bones and muscles develop rapidly, the body shape is shaped according to gender, and the body's reproductive ability is acquired. stops. The reason for this is that at the end of this rapid elongation period at the bone ends, the epiphyses close and growth stops. This causes children who enter puberty to be shorter when they become adults than other adults. With early diagnosis and treatment, the risk of short stature and early puberty can be prevented.
Read: 19
