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Home > Child Health: Puberty
puberty, boy fathers?
What next: Boy fathers?

puberty

puberty resource and reference pages for parents

This section of FatherMag.com is intended as a resource for parents who want to learn more about how puberty progresses. Often, questions arise because a suggestion has been made to accelerate or delay the rate of puberty in a child whose body is perceived to be changing into that of an adult too early or too late.

The sexualization of childhood: Do parents have to accept early puberty? In a word, no. Safe and effective means to control the onset of puberty have been available for thirty years. Many parents would exercise this control, but they usually fail to recognize the signs before it is too late.

Adrenogenital symptoms such as rapid growth, body odor, underarm hair and pubic hair are signals of an already advanced stage of adrenarche, which precedes the onset of true central puberty.

The safest therapies to control the onset of puberty are only available in this early phase, before true central puberty begins.

Safely delay puberty with GnRH Treatment Options for Central Precocious Puberty.

Treatment for early puberty will not remove pubic hair that has already started growing. Check availability of effective devices for removal of age inappropriate pubic hair in the privacy of your home.

In girls, Herman-Giddens, et al found puberty to be occurring at a much earlier age than just a few years ago.[1] Adolescent boys seem to be completing puberty at the usual age, but in younger boys (eight to twelve years of age), sexual characteristics are evident at a profoundly earlier age (Tanner stage 2 in up to 58.2% of nine-year-old boys versus 0.62% a few years ago).[2] This change to an earlier puberty is quite literally the sexualization of childhood in a physical sense. Accelerated pubertal timing occurs most frequency in those population groups at the bottom of the economic scale, in contrast to the once held notion that all early puberty results from "good nutrition."

The visible markers of sexual maturation are a slow and lagging indicator of high sex hormone levels in the bloodstream. In order to morph a child's body into one with adult sexual markers, internally produced sex steroids must usually build at heightened levels for several years. This buildup of adult sex hormones in a child's blood occurs long before the first outward signs are recognized by the untrained eye of parents. Because of this time lag parents usually underestimate the brewing steroid power that lies behind the first visible changes of pubescence.

Whether due to the effect of endocrine disruptors or other causes, early or late puberty can be emotionally difficult. Yet the issues here not just ones of convenience. There are genuine health concerns, and most parents of children with early puberty are so late in seeking treatment that irreversible damage is done to their child's health.

The damage caused by early puberty is not just physical. Very young children lack the socialization and self restraint that we expect of older children. No matter what you tell them, young children tend to judge things by the concept that whatever FEELS good, IS good. A young child filled with adult levels of sex hormones easily becomes involved in sexually charged situations that an older and more emotionally mature adolescent would avoid.

Health effects associated with early puberty in girls:

  • greater lifelong risk of breast cancer, metabolic syndrome X, PCOS
  • age inappropriate behavior, skin acne, hirsutism
  • greater risk of becoming willingly involved in incest and other illicit sexual encounters
  • by attracting the attention of older males, fertile young girls may also be more at risk of becoming the victim of a forced sexual encounter
  • premature risk of pregnancy and sexually transmitted disease (STD)

In addition, many of the risks that boys face (listed below) also apply to girls.

Assessment of pubertal status
In girls, the formation of breast buds is normally the earliest indicator of sexual maturation. In the absence of breast buds, early pubic hair may be a sign of adrenarche rather than true puberty.
Tanner staging: girls



Health effects associated with early puberty in boys:

  • early virilization, resulting in a greater lifelong risk of testicular cancer
  • problems due to lack of self-control: the combination of testosterone and social immaturity may make it difficult or impossible for the child to control his own behavior
  • greatly increased risks of academic failure/expulsion, incarceration, alcohol and other drug abuse, accident, suicide
  • age inappropriate sexual behavior leads to illicit sexual involvements with other children and adults
  • increased legal and medical risks, including paternity/child support liabilities, STDs
  • the behavioral effect of high androgen levels in young boys is sometimes diagnosed as attention deficit hyperactivity disorder ADD/ADHD
  • and in the most extreme cases (such as full adult sex hormone levels in a boy less than ten years old):
    • very early puberty will produce a tall child who abruptly ceases growth before reaching adult height; this condition is untreatable once the bone growth plates close.
    • particularly in boys, very early puberty should always be investigated carefully, as it sometimes indicates the presence of a brain tumor or other serious disease

In addition, many of the risks that girls face (listed previously) also apply to boys.

Assessment of pubertal status
In boys, an increase in testicular volume is normally the earliest indicator of sexual maturation, though in the absence of testicular enlargement, the first traces of pubic hair may be a sign of adrenarche which is soon followed by true puberty.
Tanner staging: boys



In mail to FatherMag.com, parents complain of doctors who try to put a "they're just growing up early" spin on early puberty. By delaying treatment, or by withholding medical treatment from all but the most extreme cases, some medical professionals may leave parents with psychotherapy as the only means to help their children cope with the excesses of early puberty.

Once a sympathetic physician is found, treatment may still be delayed by a long sequence of testing and case assessment. Meanwhile, irreversible changes are left to advance in children who are years away from being ready to cope with adult sexual characteristics. To be effective, treatment must be applied early, before the HPG axis is triggered into starting the production of hormones that will lead to full central puberty and adult sexual characteristics. Unfortunately, many parents do not realize that adult hormones are rising until is too late to prevent activation of the HPG axis. GNRH analogs have been effective as the traditional puberty blockers, but kisspeptin antagonists show promise as perhaps opening new treatment options that are both easy to implement and effective.



Ref.:
  1. Herman-Giddens ME, Slora EJ, Wasserman RC, et al. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. Pediatrics. 1997;99:505-512.
  2. Herman-Giddens ME, Wang L, Koch G. Secondary sexual characteristics in boys: estimates from the National Health and Nutrition Examination Survey III, 1988-1994. Arch Pediatr Adolesc Med. 2001;155:1022-1028


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Puberty Resource Index

    Puberty
    Puberty in boys and girls is related to their later health in adolescence adulthood.

    what is puberty?
    understanding puberty in boys and girls

    breast buds
    normally the earliest indicator of sexual maturation in girls

    testicular enlargement
    normally the earliest indicator of sexual maturation in boys

    adrenal androgens
    the effects of adrenal androgens on pubertal children

    adrenarche
    adrenarche in children is the precursor of true puberty

    congenital adrenal hyperplasia
    effects on pubertal children

    activation of the HPG axis
    the increase in androgen levels precedes luteinizing hormone

    endocrine disruptors
    Even transient exposure to endocrine disruptors can affect the programming of sexual development.

    late puberty
    delayed puberty in boys and girls may cause stress and can be easily treated

    testicles, testosterone, and treatment
    Late puberty: Consider the puny kid getting sand kicked in his face in the old Charles Atlas ads. Just a puny kid who needs to work out? Perhaps not. What if that kid has a testosterone problem?

    Polycystic Ovary Syndrome (PCOS)
    My young daughter may have PCOS. Is that serious? In a word, yes.

    testicular cancer
    This once rare disease has now become the most common cancer in young men.

    timing of puberty
    Our brain tells our sex organs when to mature, controlling them via chemical signals from the hypothalamus-pituitary-gonadal (HPG) axis.

    adult height projection calculation formula and bone age in puberty
    timing of onset of puberty is related more to bone age than to chronologic age. Determination method must be stated along with bone age assessment.

    pubic hair before puberty?
    In the healthy child, public hair comes only after the onset of puberty, pubic hair growth prior to puberty is the result of some other source of androgens, such as endocrine disruptors

    problems of precocious puberty
    Even when it isn't full puberty, high androgen levels drive sexual behavior. Some of the physical signs of androgen are body odor, pubic hair and armpit hair, acne.

    stages of puberty: tanner charts
    It is the brain which tells our sex organs when to mature. The tanner charts give detailed information about each stage of development.

    tanner chart stages of puberty: boys
    Tanner chart showing the stages of sexual maturation in boys. In boys, the visible indications of puberty occur as a result of hormones secreted by the testicles.

    tanner chart stages of puberty: girls
    Tanner chart showing the stages of sexual maturation in girls. In girls, the visible indications of puberty occur as a result of gonadal secretions.

    kisspeptin and the timing of puberty - treatment
    Our brain tells our sex organs when to mature, controlling them via kisspeptin, a chemical signal to the hypothalamus-pituitary-gonadal (HPG) axis.



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