Some causes of early puberty in girls include thyroid disorders , abnormal brain structure, exposure to radiation therapy, or ovarian cysts. Genetic conditions may result in early puberty and can be detected with testing. Early puberty in boys is more likely to be caused by an underlying disease. Causes of early puberty in boys are similar to girls, and include thyroid disorders , abnormal brain structure, exposure to radiation therapy, and certain genetic conditions.
Your child may have a noticeable growth spurt because of their early puberty, but one of its complications is an abrupt and early end of that growth, leading to short stature as an adult.
Children with early puberty are more at risk for low self-esteem, depression, and substance abuse. Your son or daughter may require counseling to help address the changes in their body and the effects of any treatments they receive. Your doctor will help you access counseling services. Blood tests may also uncover hormonal changes.
Additional tests may include an ultrasound for girls to check for ovarian cysts, or a brain MRI for boys and girls to look for abnormalities. In some cases, medication may be prescribed to stop or slow puberty. Surgery is rarely needed to treat early puberty, unless it the cause is a tumor. Duke Header Image Link. Stories and news about treatment advances that improve your health and quality of life. Peer pressure may affect your decision-making. How to talk to boys about puberty —— and sex Parents need to offer advice but often find it uncomfortable to talk about puberty and sex.
Your testicles will grow too, and one might become lower than the other. You will start growing hair in your armpits, on your chest and all over your body too. Next your voice will become deeper. They are a normal part of growing up and will become less frequent as you get older.
They are nothing to be ashamed of. It can help you relieve sexual urge without having sex. I want you to understand how sex works and how a girl gets pregnant. This will be a longer conversation and should include the facts about using birth control and needing to protect yourself against sexually transmitted diseases — every time, no matter what.
Appointments KIDS. Appointments KIDS Norton eCare. Video Visit. Pay My Bill Online. Pay your bill with a credit card. The mother may have had delayed puberty if she started her periods after age 14, and the father may have had delayed puberty if he started his growth spurt late after age 16 or if he continued to grow after he graduated from high school. Boys with chronic illnesses such as inflammatory bowel disease, sickle cell disease, or cystic fibrosis often mature late.
A smaller number of boys with delayed puberty have a lifelong deficiency of the puberty hormones LH and FSH, a problem we call isolated gonadotropin deficiency IGD. This is usually a condition present from birth, and many boys with IGD are born with a penis that is smaller than it should be. Other pituitary hormones in this condition are made normally, and usually growth is normal. Failure to start puberty by age 17 is one sign a boy might have IGD. Another clue is that some boys with IGD also have a poor sense of smell, a condition referred to as Kallmann syndrome.
Finally, a few boys with delayed puberty have a problem with the testicles themselves. Because it is easy to determine the size of the testicles on a physical exam, having very small testicles or testicles that cannot be readily felt is a clue to the condition.
There are several causes, including previous surgery for undescended testicles or cancer treatments , which can injure the testicles. The key finding is that the penis and testicles do not enlarge by age 14, which is easily noted on physical exam. Often, the testicles have just started to grow but the penis is still small, which suggests that other signs of puberty will appear in the next months. Most boys with constitutional delayed puberty are short compared with their peers, but because they have a delayed growth spurt, they usually catch up to other boys by the time they are 18 and have heights in the normal range as adults.
Sometimes just the physical exam is enough, but many doctors will order some tests to confirm what they suspect and to make sure that the problem is not in the testicles. The most common tests to order are testosterone, LH, and FSH first thing in the morning, when the levels in early puberty are usually higher.
An X-ray of the hand and wrist to determine the bone age is often ordered to help predict adult height , and is typically at least 2 years behind the chronological age, which means that there is more time remaining for growth.
For constitutional delayed puberty, the problem will resolve with waiting and reassurance. However, late-maturing boys are often impatient to start growing and do not want to wait another months for the pubertal growth spurt to start naturally.
Therefore, many pediatric endocrinologists may offer a brief course of testosterone to "jump-start" puberty. It is most often given in the form of a monthly injection for several months; different doctors use different doses and numbers of injections. When the boy is seen back after the injections, there is usually a very good gain in height and weight as well as growth of the penis and pubic hair, and puberty will, in most cases, progress without any further treatment.
Studies show that a brief course of testosterone will have no effect on the adult height but will allow the boy to get there faster. When the problem is either IGD or damage to the testicles, testosterone is still the treatment of choice, but the dose will need to be increased over time and it will need to be continued well into the adult years.
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