An endocrinologist at The Montreal Children's Hospital offers advice to parents
MONTREAL, Sept. 15, 2011 /CNW Telbec/ - "Both boys and girls can be
affected by precocious puberty or delayed puberty," says Dr. Preetha
Krishnamoorthy of The Montreal Children's Hospital, MUHC. "Usually
there is no need to worry because some children are early bloomers and
some are late bloomers. But parents should still raise their concerns
with their child's doctor so any potential abnormal underlying cause
can be ruled out." (Dr. Krishnamoorthy will be giving a lecture on
precocious and delayed puberty during this fall's Mini-Med at The
Children's lecture series. For more information see below).
Precocious puberty and girls
Puberty for girls starts with breast buds. Later changes include the
growth of pubic hair, underarm hair and sometimes acne. During puberty
girls have a growth spurt gaining an average of 8 cm each year. On
average menstruation occurs around age 12½ years old. Dr.
Krishnamoorthy says compared to a generation ago, girls are starting
their periods slightly earlier but she says the difference is not
"If a girl shows signs of starting puberty earlier than age seven or
eight, she may have precocious puberty," says Dr. Kristhnamoorthy but
she hastens to add that in most instances the child is simply an early
bloomer, or in medical parlance, the child may be a variant of normal.
In other words, there is no known cause for the early onset of puberty.
In very rare cases, says Dr. Krishnamoorthy, a tumour on the pituitary
or ovaries might set off the early puberty.
However, Dr. Krishnamoorthy notes that starting puberty early can be
difficult for some girls because they simply aren't psychologically
mature. "It can be difficult when a girl age six or seven starts
puberty. Developmentally, they are way ahead of their friends and
school mates and might think 'What is wrong with me?' They also might
be teased and/or bullied by their peers," says Dr. Krishnamoorthy.
According to Dr. Krishnamoorthy, children who start puberty early are at
risk of being shorter than average because their growth period is
shortened and their bones mature more quickly.
"If parents choose, with the advice of a pediatric endocrinologist, they
can put their child on a treatment that lowers the level of sex
hormones and slows puberty. This can give the child's bones a chance
to grow longer and give the child a chance to mature psychologically,"
says Dr. Krishnamoorthy. "However, in most cases we generally don't
want to interfere with Mother Nature."
In cases of delayed puberty in girls, medical attention should be sought
if there are no signs of the onset of puberty by age 13. Again, Dr.
Krishnamoorthy says the likely cause is the child is simply a late
bloomer, but an underlying medical condition such as a tumour should be
Puberty and Boys
The signs of puberty in boys are the enlargement of the testicles and
scrotum. This is accompanied by pubic hair, penis growth, underarm
hair and voice change. The typical growth spurt for boys occurs later
- usually closer to age 13. "Boys who show signs of puberty younger
than age nine or boys who do not show signs of puberty by age 14 should
be seen by a doctor," says Dr. Krishnamoorthy.
Again she is quick to point out that in most cases there will be no
medical reason for the early or late start. "More often than not it is
simply a case of genetics, such as dad hit puberty later and so will
his child" she says. "Very infrequently, a tumour on the pituitary or
testicles might be responsible for turning puberty on early or delaying
"Ironically, in boys, parents tend to worry more about delayed puberty
rather than the early onset of puberty," says Dr. Krishnamoorthy.
"They worry because their son hasn't had a growth spurt and his friends
are towering above him."
Dr. Krishnamoorthy says for boys, being a late bloomer can be
psychologically bothersome because they might be picked on or bullied
for being short, while everyone around them has had a growth spurt
"It is possible to speed up puberty in boys by giving them a low dose of
testosterone to kick-start the process but before we do this, we need
to make sure there is no underlying cause for the delay. In most cases,
we like to take a "wait and see" attitude, because more often than not
within a year or so, a young man will hit puberty and will catch up in
height and size with their peers."
Dr. Krishnamoorthy concludes by saying in most cases for both girls and
boys, precocious or delayed puberty has no underlying cause. But she
advises parents to talk with their family doctor or paediatrician to
simply make sure.
Dr. Krishnamoorthy will be giving a talk on precocious and delayed
puberty during the 2012 edition of Mini-Med at the MCH. Registration
has begun and seating is limited. Mini-Med is offered in English
starting October 4 and in French starting October 5. The cost is $65.00
for adults and $45.00 for seniors and students. Students can register
online at www.thechildren.com or can obtain more information by calling 514-412-4307.
SOURCE THE MONTREAL CHILDREN'S HOSPITAL
For further information:
To interview Dr. Krishnamoorthy please call:
Public Relations and Communications
The Montreal Children's Hospital, MUHC