Nowadays, people’s living standard has improved and children’s growing conditions have become better, but more and more parents find that children’s secondary sexual characteristics are developing earlier, not knowing that this is a manifestation of precocious puberty in children. According to a survey, the rate of precocious puberty in Chinese children is about 1%, and in some economically developed areas it can reach 3%. Another survey data from Guangdong Province shows that the prevalence of precocious puberty in children in Guangzhou is 1.3%, which is significantly higher than the prevalence of 0.5% 10 years ago, and this trend will increase year by year. Experts from the endocrinology departments of major hospitals have also indicated that more and more children are coming to hospitals for diagnosis of precocious puberty. Now, we will briefly introduce the knowledge about precocious puberty in children.
What is precocious puberty?
Precocious puberty is defined as a pediatric endocrine disorder in which boys present the development of secondary sexual characteristics before the age of 9 and girls before the age of 8. For example, girls show early menarche, breast and axillary hair development, while boys show external genitalia and axillary hair development, beard growth, etc.
What are the classification, definition, etiology and clinical manifestations of precocious puberty?
Precocious puberty can be divided into central precocious puberty, peripheral precocious puberty and partial precocious puberty, of which partial precocious puberty can also be considered as a special type of central precocious puberty, which can be transformed into central precocious puberty. The most important difference between central precocious puberty and peripheral precocious puberty is the dependence on the hypothalamic-pituitary-gonadal axis (HPGA). The typology, definition, etiology and clinical manifestations of precocious puberty are detailed in the following table.
Typology
Central (true) precocious puberty.
Peripheral (pseudo) precocious puberty.
Partial precocious puberty.
Idiopathic central.
precocious puberty.
Secondary central precocious puberty.
Simple mammoplasia.
Simple pubic hair development.
Simple early menarche.
Definition
Central precocious puberty without organic pathology.
Precocious puberty caused by organic lesions of the central nervous system.
Precocious puberty that is not controlled by HPGA, with only partial development of sexual characteristics and no maturation of sexual functions.
The disease is self-limiting and may subside after a few months, and some of them may be transformed into central precocious puberty.
The disease is self-limiting and may subside after a few months.
In girls, only vaginal bleeding is present, which may recur over several years, without any other paraphilia.
Etiology
The etiology is unknown and may be related to genetics, nutrition and environment.
It may be related to genetic, nutritional and environmental factors. It may be related to central tumor, infection, malformation and trauma.
It is associated with familial hypertestosteronism, congenital adrenocortical hyperplasia, tumors with abnormal sex hormone secretion, and exogenous estrogen intake.
Associated with intake of exogenous estrogens.
Associated with the intake of exogenous estrogens.
The etiology has not been clarified.
Clinical manifestations
1. Early appearance of secondary sexual characteristics, including breast and axillary hair development in girls, and external genitalia and axillary hair development in boys.
2, there is the basis of gonadal development, girls according to ultrasound image judgment, boys testicular volume > 4ml.
3, sudden increase in height.
4. elevation of gonadotropins to pubertal level.
5, there may be advancement of bone age, but there is no diagnostic specificity.
6. early appearance of secondary sexual characteristics.
7. the development of sexual characteristics does not progress according to normal developmental procedures
8. gonadal size at prepubertal levels.
9. gonadotropins at prepubertal levels.
10.Breast development only, with no coloration of the areola.
11. Only pubic hair or (and) axillary hair development.
12. Vaginal bleeding, which may be recurrent and irregular in duration.
What are the auxiliary diagnostic methods?
Gonadotropin-releasing hormone stimulation test, measurement of plasma luteinizing hormone (LH) and follicle stimulating hormone (FSH), estrogen level measurement, abdominal ultrasound, breast ultrasound, CT, MRI and serum osteocalcin are important tools for the diagnosis of precocious puberty, among which gonadotropin-releasing hormone stimulation test is the gold standard for the diagnosis of central precocious puberty. Nowadays, determination of bone age is also used as an auxiliary diagnostic method.
Treatment
Precocious puberty caused by different etiologies should be treated in different ways. Treatment usually includes medication, surgery, and cessation of exogenous hormone exposure or intake.
Prevention methods
Some precocious puberty can be prevented and parents and children should pay attention to the following points.
1. Eat a balanced diet and avoid intake of foods or drugs that contain high levels of hormones, such as royal jelly, chicken embryos, and some children’s intelligence growth supplements.
2. Pregnant or breastfeeding women should avoid intake of hormone-containing drugs and use less or no hormone-containing cosmetics.
3, enhance physical exercise, but pay attention to prevent excessive exposure to ultraviolet light.
4, avoid the bad influence of websites, do not allow children to watch yellow web pages, etc.
It is worth mentioning that precocious puberty not only affects children’s body, but also has serious harm to their mental health. Precocious children’s growth and development is different from that of their peers, making them feel anxious, fearful and even inferior. The accumulation of long-term bad emotions increases the child’s psychological burden, which eventually leads to autism, depression and other psychological diseases. Therefore, parents should pay more attention to their children’s growth and development, and once they find the above-mentioned manifestations of precocious puberty, they should seek medical attention in time, choose the right department, make a reasonable treatment plan, and help their children grow up healthily together with doctors.