Early detection and prevention strategies for precocious puberty
Worldwide, there is a trend toward a progressively earlier age of onset of puberty in children. However, if abnormal developmental disorders of secondary sexual characteristics (manifested by breast development or first menstruation before the age of 8 years for girls or 10 years for boys, and penile and testicular development before the age of 9 years or spermatorrhea before the age of 11 years) are presented before the age of 8 years for girls and 9 years for boys, they should be considered as precocious puberty.
In recent years, precocious puberty in children has become more common in clinical practice. Although there are no specific statistics yet, from the current situation, the number of children with precocious puberty is increasing, and it has ranked second in children’s endocrine diseases, among which precocious puberty in girls is more common and the age span is larger.
Precocious puberty is not beneficial to the child’s psychological and physical development. Precocious puberty causes early termination of the child’s growth and results in a shorter adult height. At the same time, the child’s physical appearance is different from that of his or her peers, which can lead to low self-esteem or anxiety, which can affect the child’s studies and his or her ability to get along with classmates.
Various factors cause precocious puberty
In addition to genetics and diseases, environmental pollution, over-nutrition, misuse of estrogen-containing drugs, and watching books or videos related to romance and sex are all important causes of precocious puberty in children.
Many children with precocious puberty are related to tumors, so first of all, disease exclusion should be performed to see if the child has tumors of the hypothalamus pituitary gland to avoid missing the diagnosis. Also, exogenous hormones can affect precocious puberty in children. Some children have excessive energy intake and endocrine disorders, which can lead to precocious puberty; intake of food contaminated by hormones; such as livestock may be injected with estrogen to grow more meat and produce more milk, and fish and shrimp eat hormone feed, these environmental hormones may cause precocious puberty; pornography can also cause precocious puberty, of course, this is for some older children.
Children growing too fast should be alerted
If you notice premature development of secondary sexual characteristics, you should send your child to the hospital for examination as soon as possible. When the secondary sexual characteristics themselves are not obvious, parents often lack the ability to discriminate and do not feel the changes in the child’s appearance, and sometimes they may even turn a blind eye to the very obvious changes (such as a boy’s obvious change of voice). This, to a certain extent, leads to children with precocious puberty not seeking medical attention in time, thus delaying the correct diagnosis and proper treatment.
When children have precocious puberty, they invariably have a significantly faster growth rate and can “stand out” from their peers in height in a relatively short period of time. At this time, parents should observe the size of the boy’s external genitalia, especially the testicles, whether the girl’s breasts are developing, and whether there are any stains or even blood stains on the underwear left by the genital tract secretions. Parents should always keep track of their children’s growth and development, for example, by keeping a growth log for them, making a simple ruler on the wall or refrigerator, and measuring their height every two to three months. If you find that your child’s growth suddenly accelerates or the growth rate exceeds 6 cm or more per year, you should take your child to a pediatric endocrinologist to clarify the possibility of precocious puberty so that the best time for treatment is not missed.
Also, there are some children whose precocious puberty is due to tumors occurring in and around the hypothalamus area. These children may exhibit persistent headaches and even loss of vision and visual field deficits. Early detection and treatment of this disease is more effective.
In fact, non-pathological precocious puberty can be prevented, and we suggest that parents should start with the following aspects.
1. Properly control the diet and avoid excess nutrition. Especially avoid foods with a lot of fats and oils, eat less sweets, but ensure the intake of protein and eat more vegetables and fruits.
2.Pack up your medicine cabinet and cosmetics. Do not expose children to cosmetics containing sex hormones
3. Don’t eat things that are out of season. Anti-seasonal vegetables may be ripened by hormones, and children eating them for a long time may lead to precocious sexual maturity.
4, do not take supplements indiscriminately. Commonly used supplements, such as American ginseng, propolis, etc. are rich in hormones. The popular children’s vitamins and other nutritional supplements on the market also contain substances that induce precocious puberty in children. The actual fact is that most children recover quickly after illness unless they are chronically ill and basically do not need to take supplements.
5, eat less chicken, duck neck. The necks of chickens and ducks have lymph inside, and these lymph contain hormones.
6, please turn off the lights at night to sleep. High-quality sleep can ensure that the pituitary gland secretes sufficient amount of growth hormone at night. Strong light will affect sleep and lead to hormone secretion disorders, which may cause increased secretion of gonadal hormones, leading to premature sexual maturity.
7, increase physical activity. Obesity is also an important factor leading to the sexual development of children, especially to exercise the lower limbs, should ensure that more than 30 minutes of exercise time every day, exercise program can choose to run, climb the stairs and jump rope.
8, less children exposed to erotic visual stimulation. Nowadays, many romance dramas and cartoons have adult content, and it is recommended that children avoid excessive watching of love films or novels, which can otherwise contribute to early child development. Hu Xu, Department of Pediatrics, Liuan People’s Hospital
Special tiny puberty phenomenon in infancy and early childhood: Micro puberty is a window period from birth to 6 months of age in male infants (from birth to about 2-3 years of age in female infants), during which the levels of many sex hormones in the body appear to rise rapidly for a short period of time, reaching a secretion level that approximates puberty, and then decreasing. In recent years, research on the relationship between puberty and its associated hormonal changes and sexual development has been increasing, and the value of this window in the diagnosis of abnormal sexual development disorders has been increasingly appreciated. In layman’s terms, the fetus has very high estrogen levels in the mother, and when the umbilical cord is cut, the connection between the baby and the mother is lost, but soon the hypothalamic-pituitary-gonadal axis is established in the baby, which is one of the important axes regulating endocrine secretion in the body. When born, this axis system is not quite stable but relatively complete, and these sex hormones are elevated in the body, which we call micro puberty.
After the age of 1 year, the threshold of negative feedback changes, sensitivity increases, and its negative feedback effect gradually strengthens. 3 years old to prepubertal period is in a hypersensitive state, gonadotropin-releasing hormone (GnRH) secretion is inhibited, and gonadotropin (Gn) is at a low level. On the eve of puberty, the threshold of negative feedback increases, sensitivity decreases, and the secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus and gonadotropin (Gn) by the pituitary gland begins to increase. After puberty, the frequency and magnitude of gonadotropin-releasing hormone (GnRH) release increases significantly, and the pulsatile secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) increases to promote gonadal development.
At birth, the hypothalamic-pituitary-gonadal (testicular or ovarian) axis, as one of the important endocrine regulatory systems in the body, is not yet as stable as in adults, but has been largely established. Before birth, this system is temporarily put on hold in the mother due to the large amount of estrogen available through the placenta. After birth, with the umbilical cord cut, the fetus loses its connection to the mother and the fetal endocrine system must begin to learn to carry the burden alone. Soon after leaving the mother’s body, especially in male infants, within minutes, they begin to commission the operational functions of their reproductive endocrine system, secreting androgen levels up to the low end of normal adult male levels. At this time, the testicles are mildly enlarged, there is penile erection, and even a transient manifestation of a little acne on the face, which can last until about half an age; compared to male infants, female infants are a little slower to respond, but they also start to adjust their reproductive endocrine system within a few hours after birth. At this time, this system is not yet very stable and can produce estrogen intermittently. During this time, estradiol levels can fluctuate between 0 and 50 pg/ml (equivalent to the lower limit of estrogen levels in normal adult women). In a very small number of newborn female infants, pseudomenstruation may occur due to a sudden drop in the level of maternally derived sex hormones.
Some female infants who are estrogen-sensitive may show a milder degree of breast development. These manifestations are usually short-lived and not very pronounced, but can occur before the age of 2 years. This manifestation in infancy is very similar to the process of true puberty. For this reason, it is medically referred to as “micro-puberty”. The formation of micro-puberty may be the result of a surge in hormone levels in the body due to the change from an intrauterine to an extrauterine environment at birth. The hypothalamic-pituitary-gonadal axis is regulated during fetal life, and the first secretion of gonadotropin-releasing hormone (GnRH) begins in mid-gestation. During fetal life, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) concentrations in cord blood are low due to the inhibitory effect of high placenta-derived estrogens in circulating blood on hypothalamic and pituitary function. At birth, the infant experiences a sudden withdrawal of maternal sex hormones, and the suppressive effect of placenta-derived sex hormones on the hypothalamic-pituitary-gonadal axis (HPGA) disappears, resulting in a significant increase in infant gonadotropin levels within the first week of life. The increased secretion of FSH and LH in turn causes a peak in sex hormone secretion, resulting in a transient hormonal surge during microadolescence. Micropuberty usually resolves spontaneously and generally does not require treatment. However, clinically, testing of sex hormone levels and ultrasound imaging of the uterus and ovaries should be emphasized in small infants with signs of sexual development, especially if there is enlargement of the uterus, ovaries, and follicles, abnormal sexual developmental disorders should be considered and need to be examined in detail so as to provide information for early diagnosis of abnormal sexual developmental disorders and to establish the correct direction of treatment.