If you’ve noticed early signs of puberty in your son or daughter, you’re not alone. Parents in South Africa and around the world are increasingly concerned that their children will enter puberty too soon.

Puberty typically begins in girls between the ages of eight and 13, and in boys between the ages of nine and 14, according to the National Institutes of Health. Some children, however, reach puberty earlier.

Puberty, also known as precocious puberty is considered to be early in boys before the age of eight, and in girls before the age of nine.

What exactly is precocious puberty?

Precocious puberty occurs when your child’s body matures faster than usual. While this does not necessarily imply that there is something wrong with your child, it’s important to understand how your precocious puberty can affect your child.

Good to know: The onset of puberty has been gradually declining for some time, but it is only in recent years that it has taken such a sharp drop and has begun to occur universally.

Sexual and emotional growth

Puberty starts when the body is becoming fully prepared for reproduction, but this does not imply that emotional development is progressing at the same rate. Adolescence was once a time when both sexual and emotional development occurred as boys and girls entered their teen years. However, children as young as six years old have sexually developed bodies long before their minds can comprehend what is going on.

This can be dangerous because it makes children more vulnerable to sexual abuse and can lead to experimentation and, in the case of girls, pregnancy at very young ages. As a result, parents are dealing with a whole new set of issues, and doctors are dealing with medical issues they have never seen before.

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Other complications associated with precocious puberty

Early puberty can lead to the following complications:

Short stature: Children with precocious puberty may grow quickly and be taller than their peers at first. However, because their bones mature faster than normal, they frequently stop growing earlier than normal. As a result, they may be shorter than average as adults. Early treatment of precocious puberty, particularly in very young children, can help them grow taller than they would otherwise.

Social and emotional issues: Girls and boys who reach puberty earlier than their peers may be extremely self-conscious about the changes taking place in their bodies. This may have an impact on self-esteem and increase the likelihood of depression or substance abuse.

What is causing this dramatic shift in the onset of puberty?

Scientists have looked into the subject to try and determine what might cause these kinds of changes as the age of children entering puberty has decreased. The precise answers are still unknown, but they have identified a couple of modern-day factors that may hold a key.

• An unusual genetic mutation in some children can result in the release of sex hormones.
• Certain medical conditions, such as hypothyroidism (a common condition in which the thyroid does not produce and release enough thyroid hormone into the bloodstream).
• The rising rate of childhood obesity. Children with excess body fat will enter puberty earlier, on average, than those without additional body fat.
• Toxic and chemical exposure (everything from plastic baby bottles to food wrappers can contain harmful chemicals that can cause a variety of physiological problems, including early puberty).

Early puberty symptoms

Precocious puberty signs and symptoms include the emergence of the following before the age of eight in girls and before the age of nine in boys.

• In girls, female breast development and the first period
• In boys, enlarged testicles and penis, facial hair, and a deeper voice
• Underarm or pubic hair
• Acne
• Body odours

Good to know: Make an appointment with your child’s doctor for an evaluation if your child has any of the signs or symptoms of precocious puberty.

How is precocious puberty diagnosed?

To diagnose precocious puberty, your child’s doctor may do the following:

• Examine your child’s and family’s medical history.
• Perform a physical examination.
• Perform blood tests to determine hormone levels.
• Take x-rays of your child’s hand and wrist. These X-rays can assist the doctor in determining your child’s bone age, which indicates whether the bones are growing too quickly.

Identifying the type of premature puberty

There are three types of precocious puberty that may affect a child: central precocious puberty (the most common type), peripheral precocious puberty and incomplete puberty. Your child’s doctor will also need to determine the type of precocious puberty they have. They may do so by administering a gonadotropin-releasing hormone (GnRH) stimulation test.

The doctor will take a blood sample and then administer an injection containing the GnRH hormone to your child during this test. More blood samples are then taken over time to see how hormones in your child’s body react. The GnRH hormone causes other hormone levels to rise in children with central precocious puberty. Other hormone levels remain constant in children with peripheral precocious puberty.

Children who enter puberty early have the strongest bones as adults ‘and may face a lower risk of osteoporosis as they get older’

• Girls who hit puberty after 12 had 12% less bone strength than earlier growers
• Similar results were for boys, with puberty being measured by growth in height
• As adults, the late-growers still had almost 5% less bone strength 
• Researchers said this puts them at greater risk of osteoporosis  

Children who enter puberty early have the strongest bones as adults, a study has shown. 

Scientists at the University of Bristol studied thousands of British children, taking bone scans over the course of 15 years.

They found the later a child hit puberty – defined as the later they had their growth spurt – the weaker their bones were. 

Growth in bone strength starts to halt in the early twenties, therefore those who hit puberty late still had weaker bones into their adult life.

This can be a crucial factor for whether an adult goes on to develop conditions such as osteoporosis later in life, experts said.  Researchers collected data on 6,389 children who had bone scans between 10 and 25 as part of the Children of the 90s Study. 

They calculated the age a child hit puberty by looking at when they had their largest growth-spurt – called ‘age at peak height velocity’. 

Children who hit puberty earliest – before 10.5 years in girls and before 12.5 years in boys – had 12 per cent more bone strength during puberty than those who hit it later – from 12.7 years in girls and 14.5 years in boys. 

Although teens who had their pubertal growth spurt later than their peers had lower bone-strength, they did ‘catch-up’ to some degree.

By the time they were 18, their bones had acquired density at a much quicker speed. Particularly, boys had a more intense growth.

But it wasn’t quite enough – by age 25 those who hit puberty later still had almost five per cent less bone strength than early maturers.

Puberty is a key life milestone when teenagers go through a growth in their skeletal system, among other things.

The greatest gain in bone size and strength occurs during adolescence because of hormones. 

But bones keep growing in strength well after puberty, reaching their maximum strength – called ‘peak bone mass’ – in the early 20s. 

The study, considered to be the first of its kind, was published in the Journal of the American Medical Association’s Network Open. 

Peak bone mass at the end of teenage growth spurts is thought to be an indication of later risk of fractures and osteoporosis.

One previous study found an increase of 10 per cent in bone density would delay osteoporosis by 13 years.  

The condition is estimated to affect three million people in the UK, according to The International Osteoporosis Foundation. 

Growth-spurts are an accurate marker of puberty, the researchers said, but it does have limitations.

Lead author Dr Ahmed Elhakeem said they also used the age at which girls started their period as an indicator of starting puberty, and got the same study findings. 

Dr Elhakeem said: ‘I’d like to see more advice available for people who reach puberty later on measures they can take to strengthen their bones.

‘The next steps should involve more detailed assessments of the long-term effects of puberty on growth and bone development.’

Alison Doyle, of the Royal Osteoporosis Society, claimed the research filled a gap in understanding how bone density in puberty affects adult life.

She said: ‘Investment in this area of research is vital in furthering our understanding of the causes of osteoporosis and helping people to maintain good bone health throughout life.

‘Understanding changes in bone density during puberty, and the interventions that people can take for their bone health now to prevent osteoporosis and fractures in the future, is an important step forward in finding a cure for this disease.’

The researchers said teenagers going through puberty later than their peers should do more exercise to increase and maintain their bone density. 

The study was not able to make any conclusions about fractures or bone disease later in life because the study finished when participants were 25.