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Puberty

Puberty is the process of physical changes that transform a child's body into an adult capable of sexual reproduction, typically starting between ages 8 to 13. Abnormal puberty can manifest as precocious puberty, defined as signs of development before age 8, with various central and peripheral causes, and requires management through surgical or medical therapies. Classification of precocious puberty includes iso-sexual and hetero-sexual types, as well as central and peripheral origins.

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8 views2 pages

Puberty

Puberty is the process of physical changes that transform a child's body into an adult capable of sexual reproduction, typically starting between ages 8 to 13. Abnormal puberty can manifest as precocious puberty, defined as signs of development before age 8, with various central and peripheral causes, and requires management through surgical or medical therapies. Classification of precocious puberty includes iso-sexual and hetero-sexual types, as well as central and peripheral origins.

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uio0007754
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Puberty

Definition:
Puberty is the process of physical changes through which a child's body matures
into an adult body capable of sexual reproduction.
Timing of Puberty: Puberty starts at different times and lasts for different periods of
time for everyone. It can start as early as 8 years of age to as late as 13 years of age.
Puberty Event Age Range

Growth of breasts "Thelarche" 8-13 years

Pubic hair "Pubarche" 8-14 years

Body Growth 9.5-14.5 years

Menarche 9-14 years

Axillary Hair "Axillarche" 2 years after pubic hair shows up

Abnormal Puberty

o Precocious puberty
o Delayed puberty

Precocious puberty

Definition: The appearance of physical and hormonal signs of pubertal development


before the age of 8 years.
Etiology:
◼ Central causes:
− Tumors: Astrocytomas, gliomas, germ cell tumors secreting human
chorionic gonadotropin
− Acquired CNS injury: Inflammation, surgery, trauma, radiation therapy, or
abscess.
− Congenital anomalies: Hydrocephalus, arachnoid cysts, suprasellar cysts
◼ Peripheral causes:
− Congenital adrenal hyperplasia
− Androgen secreting adrenal tumors
− Androgen secreting ovarian tumors
− Estrogen secreting ovarian tumors
◼ Genetic: familial and that the predominant mode of inheritance was autosomal
dominant
◼ Obesity: has been associated with early puberty.
◼ Hypothyroidism
◼ Mac-Cune Albright Syndrome: Café-au lait spots on face, cystic changes of
long bones and precocious puberty.
◼ Iatrogenic: by exogenous hormonal intake
◼ Idiopathic: in 90% of cases
Classifications:
◼ According to sex hormones:
− Iso-sexual precocious puberty: Phenotype and hormones are like genetic
sex. Estrogen is the dominant hormone.
− Hetero-sexual precocious puberty: Phenotype and hormones are
different than genetic sex. Androgens are the dominant hormones.
◼ According to Gonadotropins origin:
− Central or true: with activation of hypothalamo-pituitary axis and high
gonadotropins
− Peripheral or false: no activation of hypothalamo-pituitary axis and low
gonadotropins.
◼ According to clinical presentation:
− Complete: with all signs present.
− Incomplete: only one sign of puberty may be present.
Management:
◆ Surgical treatment: Excision of CNS, ovarian or adrenal tumours
◆ Medical therapies:
o Gonadotropin-releasing hormone (GnRH) agonists: Suppress FSH and
LH.
o Progestin: Inhibits secretion of pituitary gonadotropin
◆ Psychotherapy and assurance.

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