Causes and risk factors
In Central precocious puberty the pituitary gland is prompted to produce hormones, which in turn stimulate the testicles or ovaries to produce sex hormones (testosterone or oestrogen). These hormones produce changes of puberty. Cause of Central precocious puberty is unknown most of the times. It can be caused due to tumours of the central nervous system such as gliomas, astrocytomas, hamartomas etc, trauma to the central nervous system, congenital conditions like hydrocephalus, arachnoid cysts etc., Genetic causes such as Silver-Russell syndrome, McCune-Albright syndrome, Hypothyroidism, Obesity. Peripheral precocious puberty in which the pituitary gland is not involved. Any local pathology involving the ovaries, testicles, adrenal gland, thyroid gland etc. may produce excessive secretion of testosterone or oestrogen thus giving rise to signs of puberty. It can be caused as a result of congenital adrenal hyperplasia, HCG-secreting tumours in the liver or adrenal glands and choriocarcinomas, ovarian tumors in females, Testotoxicosis in males.
Clinical presentation
Precocious puberty in Girls may present as Menarche (the first period), growth of breast tissue, while in Boys it may be seen as enlarged testicles and penis, facial hair –moustache and beard, deepening of voice. Hair growth in underarm and pubic hair, rapid growth, acne, body odour can be observed in both sexes.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Some tests may be advised such as Tests to measure hormone levels in the blood, X-rays of the hand and wrist, Gonadotropin-releasing hormone stimulation test to determine the type of precocious puberty. Some doctors may advise MRI of the brain, Thyroid function tests, USG of the abdomen and pelvis for detail evaluation.
Treatment
Treatment depends upon the underlying cause. If no underlying medical condition is present, the child is given Gn-RH analogue therapy. Psychological counselling and sexual education will also help in managing the child of precocious puberty.
Other Modes of treatment
The other modes of treatment can also be effective in treating precocious puberty.
Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating precocious puberty.
