Precocious puberty is an abnormal growth and development phenomenon in which pubertal characteristics appear early. Boys can be diagnosed as precocious puberty if they have secondary sexual characteristics such as bulging throat nodes, thick voice and developed muscles before the age of 9; girls can be diagnosed as precocious puberty if they have symptoms such as growing breasts and pubic and axillary hair before the age of 8, or if they have the first menstruation before the age of 10.
I. Causes of precocious puberty
The causes of precocious puberty are many and complex. Diseases that cause precocious puberty include tumor, brain abscess, encephalitis, hydrocephalus, traumatic brain injury, intracranial surgery, intracranial radiotherapy and chemotherapy, etc. Adrenal gland diseases such as adrenal tumors and congenital adrenocortical hyperplasia; testicular mesenchymal cell tumors and familial testicular toxicosis, ovarian tumors and ovarian cysts, etc. In addition, liver tumors, hypothyroidism and some drugs such as some antineoplastic drugs, isoniazid, ketoconazole and sex hormones can also cause precocious puberty.
In addition to the above, environmental factors also have an impact on precocious puberty. Due to the improvement of people’s material living standard, protein intake increases, and even over-nutrition and obese children appear. And excess nutrition helps sexual development, and some studies have confirmed that moderately obese children are prone to precocious puberty. Secondly, in some foods, health products and fruits, they may contain sex hormones or hormone-like substances, i.e. environmental hormones, and children are prone to precocious puberty when they often use these hormone-containing foods. Once again, the realistic environment gives children more opportunities to witness scenes, images and books about lovemaking, which also has a facilitating effect on sexual development. There are also a small number of children who have precocious puberty due to misuse of birth control pills. This is because parents fail to keep the pill well, and young children mistakenly eat the pill as sugar, which is composed of sex hormones, leading to precocious sexual maturity.
Second, the harm of precocious puberty
Among the children with precocious puberty, about 10.8% have organic lesions, some of which are caused by tumors; some are caused by adrenal gland diseases. If it is clear that the cause is a tumor, the tumor should be removed immediately or radiotherapy or chemotherapy should be administered. For other causes of precocious puberty, special medications should be used to treat them.
Secondly, many children with precocious puberty are short in height as adults. This is because after precocious puberty, sex hormones can both promote bone growth and accelerate growth; and also promote epiphyseal closure, so that the growth is terminated early. Therefore, the growth cycle of children with precocious puberty will be significantly shortened, eventually making their adult height shorter than the average person.
Third, early sexual behavior. The psychological development of precocious children is extremely mismatched with their physical development, coupled with their young physical age, shallow social experience and poor self-control, the risk of early love, early pregnancy and early marriage increases; the risk of being sexually abused also increases.
Fourth, personality repression. Children with precocious puberty may carry a heavy burden of thought prematurely because they are different from their peers in body shape and appearance, resulting in low self-esteem, fear and anxiety, increased psychological burden, decreased interest in learning and academic performance, and cognitive ability lagging behind students in the same grade. It has a long-lasting negative impact on the mental health in the future.
Therefore, once a child is found to have signs of precocious puberty, parents should take the child to the hospital as soon as possible, and should choose a hospital with endocrine specialists, because first of all, a physical examination by experienced specialists and a series of special laboratory tests should be conducted to clarify what kind of precocious puberty the child is suffering from, in order to choose the correct treatment plan for the cause.
Life guidance for children with precocious puberty
1.Rational diet
Parents should feed their children scientifically according to their own situation, and try to take in nutrition directly from natural animal and plant foods, avoid taking in foods containing sex hormones and foods with high phytoestrogens, and be cautious about eating anti-seasonal and “abnormally fast-growing” vegetables and fruits. Avoid eating animals that are obviously raised with “hormone feed”. Ensure a balanced diet to prevent excess fat and nutrition, because excess energy is also a cause of early development. Foods that need to be controlled include meat, especially chicken, poultry, especially poultry neck, pork, fast food, puffed and fried food, seafood, and river food. Foods to be avoided include anti-seasonal fruits, soybeans and soy products, supplements, especially ginseng and royal jelly, chicken embryo, cordyceps, etc. Children should be careful with adult tonic foods (including dietary therapy). Do not believe in the excessive propaganda of various health products with the effect of “growing taller and stronger”, blindly follow and believe in advertisements, but firmly believe that the existing normal and reasonable diet can fully meet the needs of children’s growth and development, and control the annual weight gain to about 2-3 kg per year.
2.Living and living
Separate bed with parents as early as possible to avoid the hormones around the parents from affecting the child. Scientific arrangement of children’s life and rest time, avoid overnight “study”, affecting the quality of sleep, and not to sleep with the lights on all night, misleading children’s internal biological clock. At the same time, avoid watching TV for a long time and reduce watching commercials. Physical exercise, appropriate to strengthen physical exercise, promote the enhancement of extracurricular sports activities, weight control, avoid obesity, exercise also helps children grow taller. However, attention should be paid to reducing ultraviolet radiation, because too much ultraviolet radiation may promote sexual development. Exercise effectively with a heart rate of 120-140 beats per minute and jumping 1000 times/10 minutes/day, e.g., jumping in place with both feet up.
Avoid exposure to environmental endocrine disruptors, which can cause changes in the morphology and function of the body’s endocrine organs, resulting in significantly higher levels of estrogen in the body, increased sensitivity, and premature development. There are thousands of environmental pollutants, of which more than 80 have been confirmed, and they can be divided into four categories: ① chemical pollutants in the environment, detergents, plastic plasticizers, flame retardants, and pesticides; ② natural estrogens; ③ fungal and phytoestrogens; ④ synthetic estrogens; parents should supervise their children and avoid exposure. Avoid contact with toxic substances; avoid misuse of birth control pills, avoid contact with female skin care products and cosmetics, which more or less contain estrogen or affect the secretion of sex hormones.
3.Psychological guidance
For children with precocious puberty, we should emphasize not only physiological treatment, but also psychological treatment, because the anxiety, fear, inferiority and anxiety that are easily generated by the early development in physical shape and appearance different from the surrounding children, which affect their life and study, leading to low self-esteem, autism, restlessness, decreased academic performance, etc. Serious cases may lead to crime, premature sexual behavior and other consequences, resulting in social and family tragedies The most important period of human development is childhood.
Childhood is the most important period of human development, parents should improve family relations, often pay attention to observe the physical changes of children, pay attention to the psychological changes of children, eliminate worries, fully understand the psychological state of children with precocious puberty lags behind their sexual development, parents need to reduce the negative psychological emotions, increase confidence to help children overcome the disease, actively cooperate with medical treatment, do a good job of children due to sexual development and a variety of tension, anxiety Parents need to reduce negative psychological emotions, increase confidence in helping the child overcome the disease, actively cooperate with medical treatment, do a good job of soothing the child’s various tensions and anxieties due to sexual development, correctly guide the child’s “sexual” psychology, advocate “green” Internet access, avoid watching various types of films and TV works that promote violence and sex. Give the child care and love in all aspects, pay attention to the child’s feelings, patiently provide the child with the necessary sex education, for girls who have menstruation, to teach them to pay attention to the physiological hygiene of menstruation, know how to protect the breasts, genitalia and other parts. Make the children understand the real situation of their disease, treat it correctly and actively cooperate with the medical care.
4.Improve physical fitness
Some research shows that the most common type of premature sexual maturity in children is heat type, mostly liver and kidney yin deficiency, yin deficiency and fire type. If we can improve the physique before the occurrence of the disease, we can prevent the occurrence of the disease. For those who have a biased constitution but have not developed the disease, we should take appropriate measures to avoid the attack of disease-causing factors on the human body, actively improve the biased constitution and strengthen their own resistance, so as to achieve the prevention of the cause of the disease in special groups and prevent the occurrence of related diseases. For those who are suffering from certain diseases, timely treatment is required to prevent their development. Therefore, early identification of the deviant physique of the affected children, in addition to promoting a healthy lifestyle and scientific dietary habits, as well as improving the physique type of the affected children, is important for the prevention and early identification of precocious puberty. Parents can improve the physique of their children with precocious puberty by adjusting their diet, living habits and other living habits and using drugs reasonably and appropriately.
5.Already diseased care
For children who have been diagnosed with precocious puberty, parents need to do the following.
Observe the development of female children’s breasts, pay attention to the presence of hard nodes, enlargement, areola coloring and tenderness, the nature of vaginal secretions, the phenomenon of menstruation, the thickening of labia majora and the coloring of labia minora. Pay attention to the degree of areola coloring and breast enlargement, the size and coloring of the penis and testicles, and the presence or absence of seminal emission in male children to provide reliable information for clinical diagnosis and treatment.
Perineal care: Keep local cleanliness, parents should wash the vulva for the child diligently, change underwear regularly, instruct the child to clean hands before and after pooping to prevent local infection, if the vulva has inflammatory manifestations, prepare 1:5000 potassium permanganate solution or Chinese medicine sitz bath and other anti-infection treatment under the guidance of the doctor.
Cooperate with the examination: the examination required for children with precocious puberty are: medical history, physical examination, breast measurement, hypothalamic-pituitary-gonadal axis function determination, pelvic ultrasound, X-ray bone age determination, cranial magnetic resonance imaging, etc. Parents need to properly cooperate and prepare for the examinations, such as drinking plenty of water to fill the bladder before the uterine ultrasound examination for female children, fully exposing the hand bowl joints during the X-ray bone age examination, drawing blood for biochemical examination in the early morning on an empty stomach, paying attention to the accuracy of height and weight measurement, and observing the development of body posture.
Health education: With the emergence of sexual development signs, there will be many physical and mental changes in the affected children, so do health education early, including physiological characteristics and knowledge of sexual health care, so that they can correctly deal with their own changes. For girls who have menstruation, we should teach them to pay attention to the physiological hygiene of menstruation and know how to protect their breasts, genitals and other parts.
6.Treatment methods of education
Once parents find that their children have signs of precocious puberty, they should go to the relevant specialist in time and use GnRHa drugs under the guidance of doctors, or use Chinese medicine orally or other special treatment, such as auricular acupressure, Chinese medicine external pills, acupuncture therapy, tuina therapy, acupuncture point injection, etc.