Why can some girls not inject
Puberty Delay and Premature Puberty
Premature puberty(early puberty, precocious puberty): Early onset of puberty. The limit for girls is when the signs of puberty appear before their 8th birthday, and for boys before their 9th birthday. Puberty now sets in at an average of almost 12 years - around 2 years earlier than 20 years ago.
Delayed puberty(too late puberty, pubertas tarda): Absence of any signs of puberty in girls after the 14th birthday, in boys after the 16th birthday without any other illness. Delayed puberty is more common in boys than in girls.
Premature puberty in girls:
- Breast growth before the age of 8
- Accelerated growth in length
- Pubic hair before the age of 9
- 1. Menstruation (menarche) before the age of 9
- Odor of sweat.
Premature puberty in boys:
- Increase in testicular volume to over 3 ml before the age of 9
- Accelerated growth in length
- Onset of body and pubic hair before the age of 9
- Odor of sweat.
Delayed puberty in girls:
- Complete absence of puberty development such as chest and pubic hair in the 14th year of life (or later)
- An ongoing development of puberty comes to a halt
- Failure to have the first menstrual period (menarche) in the 18th year of life (or later).
Delayed puberty in boys:
- Failure to increase testicle volume to over 3 ml by the age of 15 (or later)
- An ongoing development of puberty comes to a halt.
When to the doctor
On occasion if
- You have doubts as to whether your child will go through puberty appropriately.
- puberty development "stagnates" for more than 18 months or girls do not have their period within 5 years of breast development.
- in girls the menstrual period has not started before the 10th birthday or at the 16th birthday.
- puberty begins for your son before his 9th birthday.
In the next few weeks if
- puberty occurs in your child not only very early, but also very quickly.
- after the normal onset of puberty, puberty "stops".
Causes and influencing factors
The onset of puberty is often family-related: "Late igniting" children often have "late-developing" parents.
Birth weight. Low weight at birth often causes early onset of puberty.
Nutrition. Scientists assume that sexual maturity occurs earlier nowadays, mainly because of improved nutrition. This so-called sexual acceleration (lat acellero = to accelerate) affects all boys and girls - it has been observed for decades and continues. The above age information takes into account the current status.
Obesity. Body weight also plays an important role: puberty begins earlier in overweight girls than in normal-weight girls. The opposite is true for overweight boys. This is because the adipose tissue also produces small amounts of estrogens, which aid puberty in girls but inhibit it in boys.
Developmental delay. The most common cause of delayed puberty is family-related constitutional developmental delay. These "late bloomers" show - like most of their parents too - a delayed physical maturation, which can also be demonstrated in the bones as reduced bone age in the X-ray image.
Organic diseases. Other causes of delayed puberty are rare: all chronic organ diseases can not only cause underweight and short stature, but also delay puberty. Some genetic disorders with changes in the sex chromosomes also lead to the absence or delay of puberty. The most common here are Ullrich-Turner syndrome, which occurs in one in 2500 girls, and Klinefelter syndrome, which occurs in around one in 1000 boys. An underactive thyroid or damage or malposition of the testicles or ovaries also cause delayed or absent puberty.
Stress. Severe psychosocial stress such as fear of failure or bullying can cause delayed puberty
Sports. Children who do too intensive physical training (competitive sports) often become sexually mature later.
Puberty usually begins around 10 years old in girls and around 2 years later in boys. The breast or penis and testicles grow and the pubic hair begins to sprout.
Girls have their first menstrual period (menarche) around the age of 13 (on average around 2.5 years after the start of breast development). The year before they had their biggest growth spurt, which then quickly subsided when menstruation began. By the first menstruation, a girl has reached around 95% of her final height (development of puberty in girls). The first nocturnal ejaculations usually occur in boys between the ages of 14 and 15. The boy's growth spurt begins at this time, but the range is enormous.
Single signs of premature puberty
Sometimes there are changes in the genital organs even before puberty, which should always be presented to the pediatrician. In most cases, however, these are not pathological:
- It is not uncommon for girls to have one Breast Development in Infancy observed (premature Thelarche). The affected children are likely to be more sensitive to estrogens, which are also formed in little girls. However, if the growth rate increases at the same time, pubic hair or even menstrual bleeding occurs, pathological hormonal disorders can be behind this.
- If pubic hair starts between 5 and 8 years in girls (or between 7 and 9 years old in boys), it does not have to be pathological (premature pubic hair development, premature pubarche). But here, too, the following applies: If growth increases at the same time or if other signs of puberty can be observed (e.g. the development of breasts in girls or enlarged testicles in boys), a hormonal disorder is possible.
Puberty is said to be too early if a girl develops breasts before the age of 8 or if the testicles in a boy enlarge before the age of 9 (this is when the first pubic hairs usually form). Girls are four times more likely to be affected by this premature puberty than boys.
- Real premature puberty (Pubertas praecox vera): The control hormones of the brain trigger the development of puberty too early, usually without a cause being ascertainable. The various stages of puberty appear in their normal order. The same applies to the familial forms of premature puberty (constitutional early development). In these children, the parents were also early developers; a cause cannot be determined.
- Premature fake puberty (Pseudopubertas praecox): Sex hormones are formed in organs that are not actually intended for this purpose, for example in the case of adrenogenital syndrome (a congenital disorder of cortisone formation in the adrenal gland) or in some tumors. It is typical of these forms that the testicles or - not visible from the outside - the ovaries remain small.
In children with delayed puberty, breast development or testicular growth does not occur until the age of 14 or 16. Late puberty affects boys more often than girls.
Special form of primary amenorrhea. A special form of delayed puberty is the absence of bleeding in otherwise normal pubescent girls (primary amenorrhea). Causes can be malformations of the uterus or the vagina as well as a closure of the vagina by a fused hymen (hymena atresia). In the latter case, the blood that builds up during your period causes cyclical abdominal pain.
How delayed puberty affects children depends on the underlying cause.
Growth. Children with constitutional developmental delay initially grow more slowly than their peers (which can cause a certain level of suffering), but their final size is normal. However, if children reach puberty earlier, they are usually smaller in adulthood. The reason for this: the bones stop growing after the early growth spurt.
Depressions. When adolescents reach sexual maturity earlier than their peers, they are more likely to suffer from psychological, behavioral and interpersonal problems that increase the risk of depression in the years that follow. This is more true of girls than boys.
A physical examination, the determination of the bone age by x-rays of the left hand, hormone tests of the blood and, in girls, a gynecological examination (with ultrasound of the uterus) are part of the basic program, which is supplemented depending on the suspicion.
Too early puberty can be slowed down with special anti-hormones, which are either injected or given as a nasal spray. Conversely, if puberty is delayed, the development of sexual characteristics can be initiated by administering control hormones such as GnRH or sex hormones.
Your pharmacy recommends
What you can do as a parent
Children suffer from being different from their peers. The peer pressure is enormous, especially during puberty. The same applies here as for children that are too small or too big: Strengthen your child's self-confidence so that they can accept themselves for who they are.
AuthorsDr. med. Herbert Renz-Polster in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections “Description”, “Symptoms and key complaints”, “When to see the pediatrician”, “The disease”, “Your pharmacy recommends”: Dagmar Fernholz | last changed on at 15:56
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