“I just wanted to pretend it wasn’t happening to me,” she told the U.K.’s Daily Mail newspaper. “Then, one evening when I was in the bath, Mum popped in and I remember her asking me how long I’d had hair like that.”
Fortunately, Tara’s mother reacted calmly and took her for medical evaluation. It was discovered that Tara had a condition known as early-onset puberty.
Puberty is the time of life when children's bodies begin the changes that indicate they are maturing into adults. They start rapidly growing bones and muscles, change in size and body shape, and develop the ability to reproduce.
Normally, girls usually experience puberty starting around age 11. In boys, development begins at approximately age 12.
But some children begin developing early signs of puberty as early as ages 6 to 7. These instances are classified as early-onset puberty (sometimes called precocious puberty).
Normal Vs. Early-Onset Puberty
Full early-onset puberty usually happens at approximately age 8 in girls and before age 9 in boys. Signs include breast growth and the initial menarche in girls. Boys grow facial hair, develop a deepening voice, and the testicles and penis become larger. In both sexes, pubic or underarm hair grows, they develop acne, and adult body odor is present.
The journal Pediatrics issued a study in 2010 that surveyed 1,200 American girls. It found that 23 percent of African-Americans, 15 percent of Latinas and 10 percent of Caucasian girls began puberty at age 7. A 2012 study by Pediatrics found that puberty in boys started up to two years earlier than previously measured, particularly among African-Americans.
Three Causes of Early-Onset Puberty
Precocious puberty has no identifiable causes. However, there are several triggering factors that may contribute to its advent. These can include:
1) A tumor on the brain or spinal cord;
2) A birth defect like excessive fluid buildup;
3) Development of McCune-Albright syndrome, a genetic disease that targets skin color and bones and generates hormonal issues.
Radiation treatments to the brain or spinal cord also may trigger puberty. There’s also the possibility of a condition known as congenital adrenal hyperplasia, which is over-production of hormones by the adrenal glands; or hypothyroidism, which is when the thyroid doesn’t produce the proper amount of hormones. Any of them could be the early-onset culprit.
In precocious puberty, the testosterone or estrogen in a child’s body can cause early puberty onset. This uncommon form of puberty starts when the Gn-RH hormone that typically triggers the start of normal puberty instead releases estrogen or testosterone into the body.
This is usually related to a problem within the testicles, ovaries, pituitary gland or adrenal gland and can be traced to a tumor in the adrenal or pituitary glands, McCune-Albright syndrome, or exposure to estrogen- or testosterone-rich ointments or creams.
In girls, it may be related to ovarian cysts or tumors. In boys, there may be a tumor in the cells that make sperm or testosterone or a gene mutation that causes a defect in which testosterone is produced very early in a child’s life, usually between one to four years old. The complications of precocious puberty include the potential for being short as an adult and the social and emotional issues that arrive with changes.
The height issue occurs as children grow tall at first compared with peers. But because their bones may mature quickly, they stop growing, causing them to be shorter than the average adult. If recognized, early treatment of precocious puberty with medications can help them grow taller.
While out of the ordinary, early-onset puberty isn’t particularly dangerous or life-threatening. The question is whether the children are emotionally ready to handle the changes, and whether their growth will reach a normal stage of development too soon, thereby stunting adult growth potential.
The trigger of early-onset puberty is still unclear. Outside of the timing of the development, the process is the same as normal puberty. The majority of children have no underlying medical conditions.
There are two main types of early-onset puberty, central precocious puberty and peripheral precocious puberty. There is a third and rare type, partial precocious puberty, in which breasts in girls develop and then go away, and both sexes can have underarm or pubic hair appear early without other symptoms.
Early Puberty Diagnosis
If the early onset of puberty is suspected, doctors will conduct a complete medical exam and review family history. They will take blood tests to measure the current hormone levels in the child, and X-rays are necessary to determine bone age and to decide whether growth is occurring too rapidly.
In some cases, the medical professional will ask for a gonadotropin-releasing hormone stimulation test (Gn-RH), followed by a blood sample. This will determine the type of early-onset puberty.
In children with central precocious puberty, the other hormone levels in the body will rise from the stimulation. In peripheral precocious puberty, the other hormone levels stay the same.
To confirm findings, doctors may ask for magnetic resonance imaging (MRI) of the brain. This is done to detect the presence of any brain abnormalities and tumors. They may request a thyroid test to determine if that gland functions normally, particularly if fatigue, sensitivity to cold, constipation or other signs of a slow-functioning thyroid are present. In girls, an ultrasound may be needed to observe any ovarian cysts or tumors.
Treatments for Early-Onset Puberty
Those with central precocious puberty without any other medical condition can be treated with Gn-RH analogue therapy, a monthly injection of leuprolide, which will delay further development. The treatment is usually monthly, although newer versions of the drug can be administered over longer periods. Treatment will be necessary until the child reaches the normal age of puberty’s onset. Some 16 months after injections stop, the child will resume normal puberty.
If another medical condition is discovered, such as a tumor, then treatment of that condition will commence to stop the onset of puberty. The removal of a tumor or other treatments usually will halt the early onset of puberty.
How to Handle – and Avoid – Early-Onset Puberty
While there is no obvious cause for early-onset puberty, there are steps to avoid its potential appearance. Encourage the child to maintain a healthy weight. Many overweight children have early-onset puberty. Parents should isolate any external prescription medications that contain estrogen or testosterone.
The emotional side of puberty should be handled with truth about what is happening. An explanation that the development is normal but early is usually advised, and an explanation of the treatment and reasons for it should suffice. Monitor what happens at school and note any drop in grades, loss of interest in activities or other signs of possible depression.
How well the parent copes with the issue will go a long way in helping the child to cope. The overall goal is to avoid any potential problems with self-image or esteem related to his or her changing body.