Puberty: Normal, Early, and Late Development n

1 NPuberty: normal , early , and LateDevelopmentnPuberty is the time when your child goes throughmany types of changes: physical, sexual, intellec-tual, emotional, and social. Certain diseases cancause puberty to occur early ( precocious puberty )or late ( delayed puberty ). In healthy children, thetiming of puberty varies widely. Monitoring yourchild s Development is a key part of your child smedical care during the middle childhood to earlyteen is normal puberty ? puberty is the period of life during which boys and girlsstart undergoing the bodily changes that will make themmen and women.

2 These changes are caused by increasedlevels of sex hormones. They include growth of pubic andunderarm hair, enlargement of the testicles in boys, anddevelopment of the breasts in girls. Children also gothrough many intellectual, emotional, and social changesduring generally occurs between the ages of 10 and 12 a little sooner in girls and a little later in boys. Actually, thehormone changes that eventually lead to puberty beginmuch earlier in are sometimes concerned that their child is goingthrough puberty too early or too late .

3 It s true that there aresome medical causes of precocious (too early ) or delayed(too late ) puberty . However, these are uncommon. Chancesare your child is going through puberty at the time that sright for him or her. Your child s doctor will check yourchild s physical Development at each does it look like? Sexual child s sex organs will beginto grow and mature into their adult form: In girls, breast buds and pubic hair can start to developanywhere between ages 8 and 13. Menstrual periodsstart a little later, usually between 9 and 16 years.

4 In boys, the testicles begin to enlarge by about 10 yearsof age; the process may begin as early as 9 hair may start to develop around this time or alittle later. Many boys develop slight enlargement ofthe breasts, but this usually goes away with time. Both boys and girls become more interested in sex andrelationships. Masturbation and sexual fantasies arecommon and normal . Boys often have their first ejac-ulation while asleep ( wet dream ) and may worrythat it s abnormal. Physical boys and girls begin to growrapidly.

5 Girls start growing faster in the early part ofpuberty, while boys grow faster in the later part. Thepeak growth spurt usually occurs 2 or 3 years later inboys than in girls. In addition, boys generally continuegrowing for 2 to 3 years after girls have stopped. Growth may occur unevenly, giving your child a gawky appearance. Other changes may make yourchild feel awkward as well, such as sudden changesor cracking of the voice and acne (the result ofhormone changes). Intellectual and social has a majorimpact in practically every area of your child sdevelop-ment, including intellectual ability, self-esteem, and rela-tionships.

6 It is normal for young teens to be self-consciousabout their appearance and to feel that everyone else isnoticing causes early or late puberty ? Parents and children are sometimes concerned that theyare going through puberty too early or too late . Thetiming of puberty varies widely. Several medical conditions can cause puberty to occurearly or late . All, in one way or another, have to do withthe production or effects of hormones. Most of theseconditions are uncommon. early (precocious) are many possiblecauses of early puberty .

7 early puberty is much morecommon in girls than boys. In 90% of girls with preco-cious puberty , no specific cause is detected. Whetherthe cause is known or not, specific hormone-blockingdrugs can be used to treat precocious puberty if it issevere enough. Usually no specific cause ( idiopathic ). Certain tumors of the ovaries, adrenal glands, or brain. Rare syndromes or genetic diseases. Certain medications. late (delayed) puberty may occur inchildren with certain growth disorders. Other possiblecauses include: Hard physical training (in girls).

8 Chronic diseases (such as cystic fibrosis or sickle celldisease). Certain syndromes and genetic diseases (such as Turner ssyndrome in girls).Copyright 2007 by Elsevier162 What are some possiblecomplications of early orlate puberty ? Even when no specific cause is detected, treatment isavailable for most children with early or late puberty ifneeded. Complications are uncommon. If not detected and treated early enough, late pubertymay lead to reduced final height. Some children experience psychological effects relatedto early or late puberty .

9 Visits to a psychologist can are early and late pubertytreated? Your child s doctor will monitor his or her physicaldevelopment at each medical visit. Although parents areoften concerned about the timing of their child s puberty ,problems that need treatment are uncommon. Your childmay simply be reaching puberty a little ahead of orbehind other children of the same age. Even if early or delayed puberty is not medically abnor-mal, it may be a source of embarrassment to your may help your child to know that puberty and adoles-cence are awkward periods for nearly everyone and thathe or she is just a little ahead of or behind other kidsof the same age.

10 If there is any reason to suspect a medical cause of earlyor delayed puberty , we will probably recommend a visitto an endocrinologist (a doctor specializing in the treat-ment of gland and hormone diseases). This specialistcan perform tests and recommend treatments designedto slow (or less commonly, speed up) the process ofpuberty. Treatment usually consists of hormone-blockingdrugs (for early puberty ) or hormones (for delayedpuberty). If a tumor or other specific cause is identified, treatingthat problem will likely help.