Puberty is a process during which children go through a lot of physical changes as they develop into men and women. The first sign of puberty is breast development in girls and increase in testicular volume in boys.
Onset of puberty before 8 years of age in girls and before 9 years of age in boys is known as precocious puberty. Precocious puberty is very common in girls. It is diagnosed based on examination of the child, hormonal tests, ultrasound scan of the uterus and ovaries and sometimes imaging of the pituitary gland in the brain. If not treated precocious puberty may lead to reduced final height. There are hormonal preparations which can be used to delay the pubertal development.
Puberty may be delayed because of various reasons. Commonest reason for this delay in boys is known as ‘constitutional delay’. Other reasons include hormonal problems, poor nutrition, emotional problems and genetic causes such as Turner syndrome. Management depends on the cause.