সংজ্ঞা

Girls enter puberty between the ages of 8-14. Boys enter this stage between the ages of 9-14. Sometimes the physical changes may happen earlier. This is called precocious sexual development or premature puberty.

For girls, this means that before the age of eight they may:

  • Develop breasts
  • Have armpit or pubic hair
  • Have mature sex organs
  • Experience their first period

For boys, this means before the age of nine they may have:

  • Enlarged sex organs
  • Armpit, pubic, or facial hair

কারণসমূহ

In about 25%-75% of affected boys, this condition is due to an underlying medical conditions. However, for many girls and some boys there is no known cause.

Some known causes of premature sexual development include:

  • Hormone-secreting tumor (gonadotropin-secreting tumor)
  • Severe hypothyroidism
  • Congenital adrenal hyperplasia
  • McCune-Albright syndrome (females)
  • Adrenal tumor
  • Tumor or lesion
    • Central nervous system
    • Pituitary gland

অকাল যৌন বিকাশ

Causes specific to girls:

  • Having ovarian tumor or cysts
  • Taking estrogen

Causes specific to boys:

  • Having tumors on the testicles
  • Taking male sex hormones (androgens)

Other causes:

  • Acute head trauma
  • Central nervous system infection
  • Radiation treatment

ঝুঁকির কারণ

Factors that increase the risk of precocious puberty include:

  • Sex: girls are 2 to 5 times more likely to experience premature puberty than boys
  • Family history—some cases may run in families
  • Taking sex hormones
  • Head injury
  • Radiation of head
  • Infection in brain
  • Some studies have suggested a link between obesity and premature puberty

লক্ষণ

One symptom common to both boys and girls is a premature growth spurt in height. Children with this condition may be taller than their peers. As an adult, they may be shorter. The rapid growth also makes their bones stop growing sooner than normal. Other symptoms include:

  • In girls, early arrival of:
    • Breast development
    • Pubic hair
    • Armpit hair
    • Onset of period
    • Ovary enlargement
    • Cysts on ovaries
  • In boys, early arrival of:
    • Facial hair
    • Armpit hair
    • Pubic hair
    • Penis growth
    • Increased masculinity
    • Testicle enlargement
  • In both girls and boys, early arrival of:
    • Body odor
    • ব্রণ
    • Behavior changes
    • Growth spurt

রোগ নির্ণয়

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. An assessment of puberty milestones and growth will be done. An x-rayof the left wrist bone may also be taken. This will help to assess if the bone growth is normal for your child’s age.

এই ফলাফলের উপর নির্ভর করে, অন্যান্য পরীক্ষার আদেশ দেওয়া যেতে পারে, যার মধ্যে রয়েছে:

  • Adrenal and pelvic ultrasound —images of kidneys and sexual organs created by sound waves
  • Testicular ultrasound if testicular enlargement is uneven
  • MRI of the brain—detailed মস্তিষ্কের ছবি
  • Blood tests to measure the levels of hormones such as:
    • In girls: follicle-stimulating hormone (FSH), luteinizing hormone (LH)
    • In boys: testosterone
    • Human chorionic gonadotropin (hCG) levels—hormone that affects growth
    • Thyroid hormone levels—if hypothyroidism suspected
    • Growth hormone-releasing hormone (GHRH) stimulation test
    • Dehydroepiandrosterone (DHEA) levels—early form of sex hormones

চিকিৎসা

দ্য treatment depends upon the cause.

If the bone age is about the same as the child’s actual age and there is no known cause, there is no treatment. The child will continue to be monitored. Psychological support may be recommended if a child is struggling.

Other children may require treatment. This may include medication or surgery.

ওষুধ

Medication is often used in শিশুদের whose bone age is older than their actual age. These medications stop or slow sexual development. They also halt the rapid bone growth and encourage normal growth.

These medications called hormone suppressors may include:

  • Leuprolide acetate
  • Histrelin
  • Nafarelin

Metformin has also been shown to be effective in delaying puberty.

মনস্তাত্ত্বিক সহায়তা

Developing before their peers may cause social challenges in some children. Psychological support may be helpful. Talk to your child’s doctor about what options are available.

সার্জারি

Surgery may be needed if the early puberty is caused by a tumor or other lesions. The procedure will depend on the location and size of the tumor.

চলমান মনিটরিং

The doctor will continue to check your child’s height, weight, and sexual development. This will help to note any changes or show if the treatment has been effective.

প্রতিরোধ

Most precocious development cannot be prevented. To help reduce the chance, make sure your child is kept as healthy as possible. This includes making sure they are eating well and getting all the nutrients they need. Help your child maintain a healthy weight. Avoid exposure to sex hormones.

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