Issue: June 2012
Source/Disclosures
Source: Tirumuru SS. TOG. 2012;doi:10.1111/j.1744-4667.2012.00094.
May 07, 2012
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Precocious puberty in girls may carry risk for psychological problems

Issue: June 2012
Source/Disclosures
Source: Tirumuru SS. TOG. 2012;doi:10.1111/j.1744-4667.2012.00094.
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Girls who begin puberty before 8 years of age are at risk for psychological problems, sexual abuse and early pregnancy, according to information published in a review in the United Kingdom.

“Starting puberty early can have a significant impact both psychologically and socially on both the child and her family. Puberty marks the start of a child’s sexual development, and early onset could result in a higher risk of sexual abuse,” Sakunthala Sahithi Tirumuru, MRCOG, specialist registrar in the department of obstetrics and gynecology at Alexandra Hospital in the United Kingdom, said in a press release.

Tirumuru and colleagues said early puberty may cause short adult height, besides psychological problems brought on by high levels of sex steroids and demand for maturity based upon outward appearance.

The cause is often unclear in most girls with central precocious puberty, but evidence of underlying conditions should be examined, they said.

According to the review, treating precocious puberty should halt or regress secondary sexual characteristics, prevent early menarche, slow skeletal maturation and improve adult height and prevent psychological problems. Gonadotropin-releasing hormone treatment, “the mainstay of therapy,” they wrote, is usually ceased during the time at which normal puberty should begin. The decision to end therapy should be shared by the endocrinologist, patient and the parents or caregivers. Adverse effects of treatment include headaches, hot flashes, mood swings and injection site reactions.

However, further review of the effects of hormone therapy is needed, Tirumuru said.

“This all needs to be considered by the health care team, and further studies are needed to evaluate the effects of hormone treatment on quality of life and long-term impact,” she said.

Additionally, to effectively manage girls with suspected premature sexual development, it is paramount that the physiology and timing of normal pubertal events is made clear.

“The appropriate age thresholds for the definition of precocious puberty remain controversial: Well-performed longitudinal assessments of normally developing children are needed to inform these criteria. The best approach for differentiating progressive from non-progressive forms of precocious puberty remains unclear,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.