- Appearance of secondary sexual characteristics before age 7:
- growth and development of mammary glands;
- female-type hair growth (hair growth in the armpits, pubic area);
- deposition of adipose tissue according to the female type (rounding of the hips, formation of an hourglass-shaped silhouette).
- The appearance of menstruation (monthly uterine bleeding associated with the physiological rejection of the endometrium - the inner layer of the uterine mucosa) up to 7 years. In this case, menstruation or menstrual-like bleeding (bleeding without ovulation - the release of an egg from the ovary for fertilization) may be irregular.
- Growth retardation (children's growth stops at 150-152 cm) in some cases.
Forms
- True (central, gonadotropin-dependent) premature sexual development.
Occurs due to increased production of hormones from the hypothalamus and pituitary gland (regulatory parts of the brain), which stimulate the maturation and functioning of the ovaries.
- Full form of true precocious puberty
manifested by the early appearance of secondary sexual characteristics of the female type (enlarged mammary glands, hair growth in the armpits and pubis, the formation of female body shapes, etc.), the appearance of menstruation (monthly uterine bleeding associated with the physiological rejection of the endometrium - the inner layer of the uterine mucosa ). As a rule, there is an accelerated closure of bone growth zones, that is, girls quickly stop growing and do not exceed 150-152 cm in height.
- Incomplete form of true precocious puberty
is characterized only by the early development of secondary sexual characteristics, and menstruation appears according to age norms - at 10-11 years.
- False (peripheral, ovarian) premature sexual development.
It is observed in cases where the ovaries begin to secrete excess sex hormones. In the false form, the order of puberty is distorted: irregular uterine bleeding appears first, and secondary sexual characteristics develop according to age norms or are slightly ahead of them.
- Constitutional (hereditary) premature sexual development.
With this type, the speed and order of puberty in a girl does not differ from the norm, and no deviations in health are observed. However, the onset of puberty is observed several years earlier than among peers. Usually this form is hereditary in nature (the mother and other female relatives experience an early onset of menstruation (monthly uterine bleeding associated with the physiological rejection of the endometrium - the inner layer of the mucous membrane of the uterus), growth of the mammary glands, etc.).
- Heterosexual form of precocious puberty in girls:
male sexual characteristics are formed. This condition is associated with the excessive formation of androgens (male sex hormones), which begins during intrauterine development (during pregnancy) and leads to the development of male-type external genitalia if the girl has a uterus and ovaries. This disorder is characteristic of adrenogenital syndrome - a disease of the adrenal glands.
Causes
- Hereditary predisposition to early onset of puberty, which is passed on from generation to generation. In this case, maturation is completed successfully, earlier than that of peers, which subsequently does not affect reproductive function and health.
- Disruption of the hypothalamus and pituitary gland (parts of the brain capable of producing hormones) and excessive production of hormones that stimulate sexual development, which occurs as a result of:
- congenital structural features of the brain;
- complications after viral and bacterial infections;
- consequences of brain injuries;
- disturbances in the blood supply to parts of the brain;
- brain tumors;
- poisoning with poisons (for example, lead);
- exposure (exposure to radiation, radiation therapy).
- Tumors and cysts (fluid-filled cavities) of the ovaries.
Children with a tendency to puberty disorders are more often born to women who, during pregnancy: - drink alcohol, drugs;
- suffer from endocrine diseases (impaired hormone production) in an uncompensated form (without adequate treatment).
Diagnostics
- Analysis of the medical history and complaints (whether there were menstruation (monthly uterine bleeding associated with the physiological rejection of the endometrium - the inner layer of the uterine mucosa), at what age they began, when the growth of the mammary glands began, the growth of pubic hair appeared, etc.).
- Analysis of hereditary history (were there similar developmental disorders in close maternal relatives - mothers, grandmothers, sisters, aunts).
- Analysis of obstetric and gynecological history (past gynecological diseases, surgeries, sexually transmitted diseases, number of pregnancies, abortions, etc.).
- Gynecological examination with mandatory bimanual (two-handed) vaginal examination. The gynecologist uses both hands to touch (by palpation) to determine whether the genital organs are properly developed, what are the sizes of the uterus, ovaries, cervix, their ratio, the condition of the ligamentous apparatus of the uterus and the area of the appendages, their mobility, pain, etc.
- General examination - identification of secondary sexual characteristics and possible manifestations of somatic (non-sexual) diseases: body type, distribution and amount of adipose tissue, striae (stripes on the skin), type of hair growth, development of the mammary glands and nipple discharge, etc.
- Determination of bone age - biological age using x-rays of the hand bones in order to compare the true (bone) age with the passport age and identify the likely degree to which the girl is ahead of age norms in general physical development.
- Laboratory determination of hormones in the blood. The list of hormones depends on the specific situation and is determined by the doctor. Most often these are: sex hormones, adrenal hormones, pituitary hormones (the regulatory part of the brain).
- X-ray of the skull is carried out to identify possible tumors of the pituitary gland and hypothalamus.
- Magnetic resonance imaging (MRI) of the brain is performed to exclude anatomical features of the structure or brain tumors.
- Ultrasound diagnostics (ultrasound) of the pelvic organs to exclude pregnancy, structural anomalies of the genital organs, tumors and cysts (fluid-filled formations) of the ovaries.
- Laparoscopy: using an endoscope (a long tube with a camera at the end) inserted into the abdominal cavity through pinpoint incisions on the anterior abdominal wall, it is possible to determine the condition of the uterus, fallopian tubes and ovaries.
- A biopsy (taking a piece of tissue) of the ovaries, followed by a microscopic examination of a tissue sample to exclude possible malignant changes.
- Consultation.
Treatment of precocious puberty in girls
- Diet therapy aimed at restoring normal body weight.
- Normalization of mental status: psychotherapy, taking sedatives.
- Taking medications that reduce the production of pituitary hormones (a special regulatory part of the brain). Under the influence of these drugs - analogues of gonadotropin-releasing hormone - the maturation and functioning of the ovaries is inhibited, which slows down puberty. After the drugs are discontinued, puberty resumes.
- Surgical treatment is carried out in the presence of tumors (pituitary gland, hypothalamus, ovaries, adrenal glands), anatomical defects of the genital organs or congenital developmental anomalies.
- The constitutional (hereditary) form of precocious puberty does not require treatment. Girls with this type of deviation should be observed by a pediatric gynecologist throughout the entire period of maturation.
Complications and consequences
Without treatment, the following are possible:
- short stature;
- change in body proportions (wide chest, short arms and legs, long body).
Premature puberty, as a rule, is a consequence of serious diseases of the brain, ovaries, adrenal glands, including tumors. Therefore, when signs of premature ripening appear, early diagnosis and treatment of the underlying disease are necessary. Prevention of premature puberty in girls
- A rational and balanced diet (eating foods high in fiber (vegetables, fruits, herbs), avoiding fried, canned, too hot and spicy foods).
- Weight control (obesity prevention).
- Regular visits for newborn girls.
- Observation and timely treatment in girls with a hereditary predisposition to accelerated general physical and sexual development.
Puberty is a process of deep internal hormonal and physiological changes in the body, as a result of which a person reaches sexual maturity - that is, the ability to reproduce.
The age range for puberty is different for boys and girls. Girls usually go through the process of restructuring the body from 8 to 17 years, and boys from 10 to 20 years. But there are cases of premature puberty - when a global restructuring of the entire body begins in children very early.
What is premature puberty?
Signs of Precocious Puberty
Precocious puberty is puberty and the appearance of secondary sexual characteristics that begins in girls under 8 years of age and in boys under 10 years of age.
The most common signs of puberty that appear earlier than expected in girls:
* swelling of the mammary glands,
* appearance of acne,
* appearance of the first menstruation,
* the beginning of hair growth in the armpits and pubic area,
* change in body odor.
The most common signs of puberty that appear earlier than expected in boys are:
* the beginning of facial hair growth (usually the first hair begins to grow above the upper lip), armpits, pubis,
* change in body odor,
* rapid growth of the whole body,
*increase in testicle size,
* appearance of acne.
Causes of premature puberty
Precocious puberty can be central or peripheral. The division of precocious puberty into types is due to the reasons for which it is caused.
Central precocious puberty caused by the following reasons:
* trauma, tumor or radiation to the brain or spinal cord,
* previously suffered infectious diseases associated with the brain (encephalitis, meningitis),
* congenital brain pathology, ![](https://i0.wp.com/users.posobie.info/mt/5e5835d306a48bfd5a7a81fcbdf31515.png)
* congenital adrenal hyperplasia (a disease in which hormones are not produced properly by the adrenal glands),
* hypothyroidism (insufficient production of thyroid hormones),
* McCune-Albright syndrome (a genetic disease that affects bones, skin pigmentation and causes hormonal imbalances).
Peripheral precocious puberty is provoked by disruption of the ovaries, adrenal glands or pituitary gland (part of the brain), as a result of which large amounts of estrogen and testosterone are released into the blood.
But, despite the fact that there are enough reasons for premature puberty, most often this phenomenon occurs as a result of reasons unknown to medicine. Doctors tend to associate premature puberty in children with environmental factors, nutrition, emotional experiences or stress. But, in any case, it is necessary to remember that this diagnosis is associated with hormonal disorders in the child’s body, so it should be observed by a pediatric endocrinologist.
What are the consequences of premature puberty?
Why are we talking about medicine in connection with the early onset of maturity in your child? The fact is that this phenomenon, even if not the result of any disease, can have very unpleasant consequences for the child’s health. What are the consequences of premature puberty?
Firstly, it often happens that due to the earlier start of the transition period, children quickly “stretch” in length, grow taller than their peers, but then their growth slows down. And as a result, in adulthood, children who have experienced premature puberty may be even shorter than their peers.
Secondly, premature puberty can have very unpleasant consequences for girls and provoke polycystic ovary syndrome in them. In addition, girls who mature earlier than their peers have a high chance of developing hormonal disorders and various diseases of the reproductive organs in adulthood. In particular, they may have irregular menstruation, hormonal disorders, ovulation disorders, etc. ![](https://i1.wp.com/users.posobie.info/mt/a28d77ee03b706321c9b42726b377a14.png)
Treatment of precocious puberty
Typically, early maturation is treated using two approaches. The first involves treating the disease that caused premature puberty. The second approach focuses on medications that lower the level of sex hormones and slow puberty. The drugs are administered until the child reaches the normal age of puberty. After stopping the drugs, puberty begins and the child’s condition returns to normal.
Children who have begun the process of premature puberty must carefully monitor their diet to avoid obesity, and also avoid sources of the sex hormones estrogen and testosterone. And in order to prevent a child from developing psychological trauma due to his difference from his peers, you can take him to a child psychologist.
Parents should also be aware that some children may experience "partial" precocious puberty - when the breasts or testicles begin to swell, but soon this process either stops or remains the only one without adding other signs. Such a process, as a rule, does not require any medical manipulation, and full puberty in such children begins on time.
Puberty is a difficult period for both children and their parents. Therefore, if your child has started premature puberty, try to find the cause of this phenomenon and eliminate it as soon as possible. Isn't it better if your child remains a child for a while longer?
It begins and ends earlier than in boys (10-15 years and 12-19 years, respectively). In parallel with the acceleration of the rate of general physical development (acceleration), in the modern world there is a slowdown in the rate of puberty. And yet, puberty and the ability to bear children develop much earlier than the mental and material capabilities to raise and provide for your child. This is the main danger of early onset of sexual activity: the psychological and mental unpreparedness of a teenager, his illiteracy, lack of independence, incl. and material. Therefore, there are no general recommended timing for the optimal start of sexual activity: everything depends on the degree of psychological maturity of a person, on his responsibility, on his literacy. Therefore, puberty means only what it means, and in no case does it mean that a person has become an adult, or that he can have children, or that he has finally grown up and can take alcohol and drugs, because... they can no longer harm him. Puberty only means the end of childhood and the entry into a new period of life - adolescence.
Primary sexual characteristics are formed in the prenatal period, are present in the newborn, and depend on genetic sex. These include the external and internal genitalia. A person has them throughout his life.
Secondary sexual characteristics appear during puberty and disappear after menopause. Depends on hormonal levels. These include: pubic and armpit hair, in men - face, chest, legs, etc.; developed mammary glands; changes in the skeleton, body shape, distribution of fat and muscle tissue; voice changes; differences in character, temperament, psychological and mental characteristics; menstruation in girls and ejaculation in boys; sexual abilities.
In childhood and old age, a person has only primary sexual characteristics, supported by a minimal level of adrenal sex hormones.
1. Accelerate growth
Before puberty (puberty), there is a sharp growth spurt (growth rate of about 10 cm per year). In girls it begins earlier, the pace is less pronounced, and ends earlier. Therefore, girls first overtake boys who have not yet entered puberty, and then they stop growing forever, and the boys leave them far behind. Different bones grow at different speeds, hence the change in body proportions, angularity: the hands and feet grow faster, the bones of the facial skull (lengthening of the face), and lastly the torso. Therefore, teenagers appear thin, with long, awkward arms and legs, and with a horse-like face.
In parallel with the growth of the skeleton, muscle growth and development occurs. The function always lags behind the structure that is responsible for it, muscle growth does not keep pace with the growth of the skeleton (stick arms), and the growth of nerve endings and blood vessels does not keep up with muscle growth, hence the lack of coordination of movements and clumsiness of adolescents
The lower degree of muscle development in girls does not mean that they do not need strong muscles. There are certain muscles that a woman needs primarily - these are the abdominal muscles, pelvic floor and pectoral muscles, which provide the shape of the chest and abdomen and help in sexual activity and during childbirth.
2. Telarche
- maturation and growth of the mammary glands. Starts at age 10, along with accelerated growth. The mammary glands reach the penultimate stage of development by the age of 16, and the last - during the feeding of the child. Therefore, you should not worry about the insufficient size of the gland - it is still growing. Immature, small breasts do not require a bra, quite the contrary. Under no circumstances should the bra squeeze, rub, interfere, or be felt at all. A bra is not a sign of femininity, so there is no need to wear one unless necessary.
Breast growth begins with the growth of the nipple and areola. The color of the nipple can be anything from light pink to dark brown, it depends only on the total amount of pigment in the body (color of skin, hair, eyes) and nothing else, does not affect the function or sensitivity of the gland.
Dark hair may appear around the nipple. If they are rare, this is a variant of the norm (especially in eastern, southern women with dark hair and skin). If their number begins to bother you, it is better to consult a gynecologist-endocrinologist, especially if this is accompanied by hair growth on the face, abdomen, and thighs.
Veins may be visible under the skin of the breasts, especially in girls with fair skin - this is normal.
Before your period, your breasts may swell and hurt. Depending on the severity of these symptoms, you can choose remedies that alleviate them. In mild cases, you can get by with infusions of herbs and vitamins; in more severe cases, accompanied by other complaints of premenstrual syndrome, consultation with a gynecologist-endocrinologist is necessary.
Monitoring the condition of the breast and signs of pathology - see above.
3. Pubarhe
- pubic hair growth. Starts at 10-11 years old. The last stage is reached by 15-16 years. Hair color, stiffness, and curl depend only on genetic characteristics and do not affect sexual function.
In girls, pubic hair occurs in the shape of a triangle with a clear horizontal upper border. Individual hairs going to the navel do not mean anything, but noticeable hair growth in the midline of the abdomen, approaching diamond-shaped, is a reason to contact a gynecologist-endocrinologist. Hair growth should not extend far to the inner thighs. Female sex hormones inhibit the spread of hair, while male hormones stimulate it.
Around the age of 13, hair growth begins in the armpits and the front surface of the lower leg. In modern women, in general, the level of female sex hormones is reduced and the level of male hormones is increased. Therefore, hair on the legs is no longer a rarity, but a variant of the norm. This hair growth should not extend to the back and inner thighs, otherwise it is a sign of increased levels of androgens (male sex hormones), especially in combination with hair on the chest, abdomen, and face.
How to deal with increased hair growth?
Do not shave your legs under any circumstances! Shaving only makes hair thicker and stiffer (just ask men). We specially trim, cut, and “refresh” the hair on the head so that it becomes thicker and grows faster - the mechanism is the same. In addition, shaving is accompanied by cuts that hurt, become inflamed, bleed, and most importantly, shaved legs are visible a kilometer away. Even in winter, do not allow yourself this quick and easy procedure - in summer you will have rough, blue-tinged feet with black spots. If you don’t believe me, look at the chin of a clean-shaven brunette after 30 years.
Legs can only be epilated. In this case, the hair is completely removed, from the root, so the new one grows more slowly, each time becoming thinner and lighter. However, it is, of course, much more painful, longer and more expensive than shaving.
Depilatory creams have an effect similar to shaving, because they only dissolve the outer part of the hair without affecting the root. In addition, they can cause chemical burns or allergies. The next day the same stubble grows.
Mechanical epilators pull hairs out by the roots. The effect lasts 1-2 weeks. The procedure is painful and requires patience. Wax strips do this immediately, with one jerk.
The best method of hair removal is electrical or laser removal of hair follicles. This is irreversible hair removal. It should be carried out only in highly qualified institutions, otherwise you can get scars.
You can only epilate your legs! Hair under the armpits and along the bikini line can only be shaved or removed with a depilatory cream (carefully maintaining hygiene, as there is a danger of infection of the sweat glands, which could lead to surgery). It is better to bleach facial hair with hydrogen peroxide or remove it with wax in a beauty salon.
Epilation does not eliminate the cause of hair growth! Contact a gynecologist-endocrinologist, there are special drugs, androgen antagonists. They reduce the severity of hair growth, oily skin, and the number of acne. They can only be used as prescribed by a doctor, because... they are hormonal.
4. Skin changes
Due to the active growth of the skeleton, the skin does not have time to grow and begins to stretch. To avoid damage and cracks in stretched skin, the sebaceous glands begin to work actively, secreting lubricant. These glands are located at the base of the hair, which is why the hair also becomes oilier. The only way to combat excess sebum is careful hygiene. Hair should be washed every day, with special shampoos for oily hair, suitable for frequent use. Places of increased acne formation (clogged sebaceous glands, inflamed due to infection) - back, chest, neck - must be washed with soap or shower products. Your goal is to degrease the skin, but not dry it completely, because dry skin is many times worse than oily skin; irreversible wrinkles form on it very quickly.
Do not wash your face with soap. There are special lotions for washing. The main thing is to take care of your skin. Most have a mixed type: oily on the forehead, nose and chin, dry on the cheeks. You will use different care products for different areas of your face. Dry skin requires rich nourishing creams, especially before going outside, especially in direct sun or frost.
Under no circumstances should you squeeze out acne or even touch it with your hands! You push the infection, which is limited to one place, deep into the skin, into the blood vessels. There is a so-called on the face. "triangle of death", there are veins communicating with the veins of the brain. If an infection gets into them, inflammation of the membranes or the brain itself can develop - meningoencephalitis. In addition, by squeezing out acne, you stimulate the proliferation of connective tissue cells, and the wound becomes overgrown with a scar. The only way to fight is cleanliness. Do not touch your face with your hands unnecessarily, do not use low-quality cosmetics, and do not try to cover acne with foundation, because... it will clog the pores even more and cause even more inflammation. Wash your face more often, eat less sweets and fatty foods, because... These products stimulate sebum production.
During a growth spurt, the skin can stretch so much that stretch marks may appear on the thighs, abdomen, and mammary glands - purple stripes that turn white over time. If there are few of them, this is a variant of the norm.
5. Fat metabolism
The body shape begins to become feminine: short stature; shorter legs in relation to the body than men; narrow rounded shoulders, rounded wide hips; developed mammary glands; large buttocks; characteristic distribution of fat: belly, thighs. This happens because muscle tissue in girls develops much more slowly and less pronouncedly than in men, and adipose tissue, being the target of sex hormones, develops in those parts of the body where maximum protection of internal organs is necessary (in men this protection is performed by muscles, in women strong abdominal muscles would interfere with bearing a child). Overeating, low physical activity, a sedentary lifestyle, and a passion for sweets lead to impaired fat metabolism, and, consequently, to impaired puberty, because estrogen exchange and androgen synthesis occur in adipose tissue.
6. Menarche
- appearance of the first menstruation. Age 12-15 years. Deviations from this interval, especially strong ones, are a reason to contact a gynecologist.
With the onset of puberty, a girl’s external and internal genital organs begin to actively grow and mature under the influence of hormones secreted by the endocrine glands. The gonads are subordinate to the regulatory endocrine gland - the pituitary gland, located in the brain. The synthesis of pituitary hormones leads to the appearance of external signs of puberty. Growth hormone influences the growth and ossification of cartilage; ACTH stimulates the adrenal glands, whose hormones (including androgens) are responsible for pubic and armpit hair growth, changes in metabolism, and adaptation to a stressful situation. Prolactin stimulates the maturation and growth of mammary glands. Gonadotropic hormones promote the growth and maturation of the sex glands - gonads.
The ovary begins to synthesize female sex hormones - estrogens. The target organs of estrogen are all tissues and organs. First of all, the growth and development of the external and internal genital organs (genitals) occurs. The vaginal mucosa matures, becomes folded, its epithelium begins to peel off, mucous discharge appears in small quantities - this is the norm. If their color, consistency, or smell changes, you should contact a gynecologist without hesitation. Almost all women have one or another chronic infection of the genital tract, which is transmitted through household means (through towels, soap, in the pool, toilet, etc.). At an early stage they are all cured, at a chronic stage - almost never! Do not allow yourself to develop chronic infections!
The external and internal genital organs grow and reach adult sizes. The mucous membrane of the uterus begins to undergo cyclic changes, because... The release of hormones from the pituitary gland, and therefore from the ovaries, occurs cyclically. This is the main difference between the functioning of the reproductive systems in men and women: in men everything happens constantly, throughout life, and in women it happens cyclically, with an abrupt beginning and end of the activity of the gonads. The duration of the established menstrual cycle is 21-35 days. The cycle is established, at most, a year after menarche. The duration of menstruation is 3-7 days, the volume of blood lost is 30-50 ml (no more than 80 ml). Pay attention to these numbers; deviation from them, as a rule, means some kind of malfunction in the reproductive system and requires contacting a gynecologist.
At the beginning of the cycle, FSH is released from the pituitary gland, causing the maturation of oocytes in the ovary. Growing follicles secrete estrogens. Within 5 days, the dominant follicle is selected, the best of all that have entered into growth. The rest die, it grows until it reaches a diameter of 20 mm. Such a follicle synthesizes the maximum level of estrogen. They affect the pituitary gland, causing a decrease in FSH and a surge in LH. Under the influence of LH, ovulation occurs - the rupture of the follicle membrane and the release of the oocyte into the abdominal cavity, where it is captured by the fallopian tube. In the fallopian tube, the oocyte develops into an egg. Fertilization can occur here. If it does not occur, the egg passes through the uterine cavity in transit and exits into the external environment through the vagina. At this time, the uterine mucosa was preparing to receive the fertilized egg and ensure the development of the embryo. This happened under the influence of a special hormone progesterone, secreted by the corpus luteum - the gland left after ovulation. The development of the corpus luteum is ensured by LH of the hyplphysis. It is progesterone, the pregnancy hormone, that causes changes throughout the body that prepare it for pregnancy. With its deficiency, the so-called premenstrual syndrome: swelling of the mammary glands, fluid retention, swelling, changes in weight, mood, attention, pain in the lower abdomen. At the end of the cycle, 14 days after ovulation, the level of all pituitary hormones drops sharply, the corpus luteum atrophies, the level of progesterone and estrogen decreases, a minimal hormonal background is formed with a predominance of androgens (acne, mood changes), insufficient to retain the uterine mucosa, which has grown to adoption of the embryo. The mucous membrane is rejected and comes out along with the egg - menstruation. Immediately, FSH is released, and a new cycle begins - the growth of new follicles and the choice of the dominant one.
An established menstrual cycle means the girl is physically ready for pregnancy. With menarche, it is necessary to think about contraception in case of initiation of sexual activity, because... You can get pregnant even with an unsteady, irregular cycle, on any day.
To start menstruation, the so-called critical body mass (at least 50 kg) and a certain percentage (at least 35) of adipose tissue mass from the total body weight (estrogens depot). Therefore, girls who exhaust themselves with a diet risk losing or severely disrupting their reproductive function.
Menstruation is usually painless or moderately painful. In girls, they can be very painful due to a small hole in the hymen, which interferes with the release of menstrual flow (sometimes this hole may be absent altogether, then cyclic pain appears, increasing from cycle to cycle due to the accumulation of blood, without discharge. This condition requires dissection hymen). In such girls, the pain decreases sharply after the onset of sexual activity. Soreness can be caused by general immaturity of the body, small size of the genital organs, hormonal insufficiency, psychological characteristics, concomitant inflammatory process, strong muscle contractions of the walls of the uterus. Depending on the cause, no-spa or besalol, suppositories with belladonna, heating pads, hot baths (antispasmodics) can help with pain; aspirin, indomethacin, methindole or ketonal (anti-inflammatory); hormonal agents. It is better if the remedy is prescribed by a doctor, at the same time specifying the cause of painful menstruation.
Normally, a small amount of blood is lost during menstruation, which is even useful, because... the blood is constantly renewed, which stimulates the immune system. With increased blood loss, high nervous and physical stress, malnutrition, and hypovitaminosis, a gradual loss of iron occurs. The girl turns pale, has blue circles under her eyes, severe weakness and fatigue. These are signs of anemia, which occurs in almost all women, and especially in young women. It is necessary to take multivitamins with a high iron content.
Hygienic measures during menstruation do not differ from usual ones. The daily routine should not change. Everything is allowed. If pain or profuseness interferes with normal performance, you should consult a doctor.
Girls can use tampons. The hole in the hymen is usually large enough for a small tampon to pass through. The tampon should not be in the vagina for more than 4 hours. Tampons should not be left in overnight. The tampon needs to be changed earlier if it becomes soaked faster. You need to choose the smallest suitable tampon (if 4 hours after removal the tampon is semi-dry, then the smaller size is suitable for you). It is better to combine a tampon and a pad, and at night or when you don’t go out anywhere, use only a pad. Use products from well-known companies, beware of fakes!
A woman should keep a menstrual calendar, noting in it the characteristics of the discharge, its duration, and abundance. These calendars help the gynecologist make a diagnosis upon treatment.
Menstruation is the main criterion for reproductive health. Watch yourself! Don’t hide the incomprehensible, don’t think that some deviation will go away on its own - it doesn’t happen. There is a pediatric gynecologist who deals with virgins. Don't listen to your friends' advice, don't trust cheap brochures! Only a qualified gynecologist can help a woman with the assistance of herself!
7. Puberty is accompanied by an increase in sexual activity, which is provided by androgens
In girls this is expressed to a lesser extent and later than in boys, but later in women sexuality is much more developed. In connection with this problem, the girl needs knowledge! Anything that is not harmful to health is possible. The only thing that can wait for now is sex life. And erotic dreams, involuntary orgasm during physical activity, voluntary during masturbation, reading relevant literature and watching films, as well as a lack of interest in this side of life - this is an individual norm.
Precocious puberty is a term defining a developmental disorder in which a child's body begins to take on adult forms too early. Puberty, which begins up to 8 years for girls And up to 9 years for boys is premature puberty.
Puberty involves rapid growth of bones and muscles and changes in body shape and size.
The cause of precocious puberty often cannot be found. Rarely, certain conditions, such as infections, tumors, abnormalities in the brain or bruises, can cause a child to experience premature puberty. Treatment for precocious puberty usually involves medication to delay further development.
Symptoms and signs of precocious puberty
![](https://i0.wp.com/med8.ru/wp-content/uploads/2018/01/%D0%9F%D1%80%D0%B5%D0%B6%D0%B4%D0%B5%D0%B2%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D0%B5-%D0%BF%D0%BE%D0%BB%D0%BE%D0%B2%D0%BE%D0%B5-%D1%81%D0%BE%D0%B7%D1%80%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5-%D1%83-%D0%B4%D0%B5%D0%B2%D0%BE%D1%87%D0%B5%D0%BA.png)
Many children experience cases like premature breast development and pubic hair - without other associated symptoms, this is normal. These conditions are not signs of puberty. Below we provide a list of symptoms of precocious puberty in boys and girls, how to identify the signs in the early stages.
Signs and symptoms of precocious puberty in girls
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Breast growth
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First menstruation before 8 years
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Beginning of menstruation
Signs and symptoms of precocious puberty in boys
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Enlargement of testicles and penis
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Facial hair (usually grows first on the upper lip)
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There is a hint of rudeness in the voice
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Muscle growth
![](https://i1.wp.com/med8.ru/wp-content/uploads/2018/01/%D0%BF%D1%80%D0%B5%D0%B6%D0%B4%D0%B5%D0%B2%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D0%BE%D0%B5-%D0%BF%D0%BE%D0%BB%D0%BE%D0%B2%D0%BE%D0%B5-%D1%81%D0%BE%D0%B7%D1%80%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D0%B5-%D1%83-%D0%BC%D0%B0%D0%BB%D1%8C%D1%87%D0%B8%D0%BA%D0%BE%D0%B2.png)
Common signs and symptoms that can occur in both boys and girls include:
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Pubic or axillary hair
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Fast growth
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Acne
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The smell of sweat
The symptoms of precocious puberty are similar to the signs of normal puberty, but they appear earlier - before 8 years of age in girls and before 9 years of age in boys - this is important to remember, since all of the above symptoms will no longer be relevant for boys and girls over nine and eight years old, respectively. .
Causes
To understand what causes precocious puberty in some children, it is helpful to know how puberty occurs. This process includes the following steps:
The brain is the first to start working. Part of the brain produces a hormone called gonadotropin-releasing hormone, also known as luteinizing hormone-releasing hormone.
Sex hormones are produced. Luteinizing hormone and follicle-stimulating hormone cause the ovaries to produce hormones involved in the growth and development of female sex characteristics (estrogen) and the testes to produce hormones responsible for the growth and development of male sex characteristics (testosterone).
Physical changes occur. With the development of the main opposing hormones estrogen and testosterone, the physical changes of puberty begin.
Why this process begins earlier in some children depends on whether they have central precocious puberty or peripheral precocious puberty.
Central precocious puberty
There is usually no identifiable reason for this kind of precocious puberty.
In Central precocious puberty, the process of puberty begins too early. Otherwise, the pattern and timing of the process steps are normal. For most children with this condition, there is no underlying medical problem and no identifiable cause for early puberty.
In rare cases, central precocious puberty can be caused by:
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Tumor in the brain or spinal cord
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Brain defect at birth
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Hydrocephalus
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Hamartoma
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Radiation to the brain or spinal cord
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Brain or spinal cord injuries
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McCune-Albright syndrome is a rare genetic disorder that affects bones and changes skin color and causes hormonal problems
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Congenital adrenal hyperplasia is a group of genetic disorders associated with abnormal production of hormones by the adrenal glands
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Hypothyroidism is a condition in which the thyroid gland does not produce enough hormones
Peripheral precocious puberty
If sexual development is driven by the production of estrogen or testosterone in your baby's body, then this is the type of precocious puberty.
Peripheral puberty is the normal onset of puberty only if it occurs no earlier than 8 and 9 years of age for girls and boys respectively. When a child experiences this type of precocious puberty, it is caused by the release of estrogen or testosterone in the body due to problems with the ovaries, testicles, adrenal glands, or pituitary gland.
In girls and boys this can result from:
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A tumor in the adrenal gland or pituitary gland that secretes estrogen or testosterone
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McCune-Albright syndrome
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Exposure to external sources of estrogen or testosterone, such as creams or ointments
In girls, peripheral precocious puberty may also be associated with:
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Ovarian cyst
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Ovarian tumor
In boys, peripheral precocious puberty may also be associated with:
- A tumor in the cells that make sperm (germ cells) or in the cells that make testosterone (Leydig cells)
- Gene Mutation
Diagnosis or how to identify premature puberty in a child
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A doctor can diagnose premature puberty in your child based on the following factors:
Physical examination
Blood analysis for measuring hormone levels
X-ray of hand and wrist of your child are also important for diagnosing precocious puberty. These X-rays can help the doctor determine if the bone is growing too quickly.
Determining the type of precocious puberty
Your child's doctor will also need to find out what type of precocious puberty your child has. To do this, you will need a hormone test called gonadotropin-releasing hormone to perform a stimulation test, and then take a blood sample.
Research on central precocious puberty
Magnetic resonance imaging (MRI). An MRI of the brain is usually done for children who have central precocious puberty to look for brain abnormalities that cause early onset of puberty.
Thyroid analysis. The doctor may also test your child's thyroid gland if there are any signs of thyroid dysfunction ( hypothyroidism), such as fatigue, lethargy, increased sensitivity to cold, constipation, pale or dry skin.
Studies in peripheral precocious puberty
Other tests are also needed for children with peripheral precocious puberty to detect the cause. For example, the doctor may do additional blood tests to check other hormone levels, or, in girls, may need an ultrasound to check for an ovarian cyst or tumor.
Complications
Possible complications of precocious puberty include:
- Small stature. Children with precocious puberty may grow quickly at the beginning of the process and be tall compared to their peers. But because their bones mature faster than normal, they often stop growing earlier. This can cause them to be shorter than other adults.
- Social and emotional problems. Girls and boys who begin puberty long before their peers may be extremely concerned about the changes taking place in their bodies. This can affect self-esteem and increase the risk of depression.
Treatment
Treatment for precocious puberty depends on the cause. The main goal of treatment is to enable the child to grow to normal adult height.
Treatment for central precocious puberty
Most children with central precocious puberty, in which there is no underlying cause of precocious puberty, can be effectively treated with medication. This procedure usually involves a monthly injection of a drug such as leuprolide which inhibits further development.
The child continues to receive this medicine until he reaches normal puberty. On average, 16 months after he or she stops taking medication, the process of puberty begins again.
Treatment of the underlying disease
If a condition is found that is causing your child to go through premature puberty, treatment begins by treating the underlying cause to stop the progression of puberty. For example, if a child has a tumor that produces hormones and causes precocious puberty, puberty usually stops when the tumor is surgically removed.
Prevention
Some risk factors for precocious puberty, such as gender and race, cannot be avoided. But there are things you can do to reduce your child's chances of developing precocious puberty, including:
Keep your child away from external sources of estrogen and testosterone, such as in adult medications or dietary supplements
Encouraging your child to maintain a healthy weight and diet