Measures to identify early puberty in children

The article is professionally consulted by Dr., Doctor Bui Phuong Thao - Pediatric Center, Vinmec Times City International Hospital. Dr. Thao has more than 20 years of experience working in the field of Pediatrics, currently working at the National Children's Hospital. Her strength is in the diagnosis, treatment and care of infants and young children, examination and treatment of endocrinology.

Early puberty is more and more common in modern life, early puberty brings physical and psychological changes to children, causing anxiety and confusion for children and parents. Early diagnosis of precocious puberty is very important.

Puberty is an important stage of life, a transitional step between childhood and adulthood. From a physiological point of view, puberty is the period of sexual maturity, that is, when puberty is the beginning of fertility, in boys it is manifested by the first ejaculation, and in girls, it is expressed by the first ejaculation. equal to having your first period.
Normally, boys start puberty around 9-14 years old, girls start puberty earlier about 8-13 years old. Precocious puberty is puberty before age 9 in boys and before age 8 in girls.
Precocious puberty includes 2 types
Central precocious puberty: Due to elevated GnRH levels from the early activity of the hypothalamic-pituitary-gonadal axis. Peripheral Precocious Puberty: Increased sex steroid hormones due to gonadal or adrenal gland disease. later on, causing panic and anxiety for children, the risk of early sexual intercourse and its consequences...
Precocious puberty is mostly due to maturing ahead of time, however there are some the cause is caused by pathological diseases such as endocrine diseases (pituitary tumor, thyroid tumor, adrenal gland disease, ovarian tumor, testicular tumor...)

To determine the child's early puberty status, it is necessary to clearly identify 2 issues:
First, the child is showing signs of puberty (About external manifestations and biochemical tests) Second, determining the pubertal status What is the cause of early (Is it just an early development or is there a disease). 2.1 External manifestations External manifestations are the first measure, helping parents or doctors to suspect precocious puberty, thereby taking further diagnostic measures. If the boy is under 9 years old and Girls under 8 years of age with the following symptoms should be suspected of precocious puberty.
Typical manifestations of precocious puberty in common of both sexes such as: Rapid increase in height and weight, broken voice, acne, pubic and armpit hair growth.. In addition, there are different specific manifestations. in boys and girls.
For boys, common manifestations such as: Genital development, first ejaculation For girls: Breast development, genital development, first menstrual period. 2.2 Blood and urine biochemical tests

The purpose of these tests is to measure the levels of sex hormones in the child's body, thereby determining whether or not there is an increase in sex hormones such as: FSH, LH, Testosterone, Estrogen..
Also Blood and urine biochemical tests also help to conduct tests to diagnose precocious puberty and determine the cause of precocious puberty, one of the most used tests is the LHRH test, also known as the LHRH test. GnRH test, assessment of response of LH and FSH hormones after LHRH injection, elevated LH value and higher peak of LH secretion than peak of FSH allow the diagnosis of central precocious puberty.
2.3 Diagnostic Imaging While more than 80% of girls have precocious puberty, up to 70% of boys have precocious puberty due to medical causes, especially common brain tumors, adrenal tumors, testicular tumors... So the diagnosis of the causes is very important.
The diagnostic imaging probes include: Ultrasound, computed tomography, magnetic resonance imaging .. aims to assess the size of the genitals, thereby contributing to the diagnosis of early puberty and confirmation of puberty. Identify abnormal tumors to diagnose the cause of precocious puberty.
Commonly used methods such as: Ultrasound of the uterus, ovaries, ultrasound of the mammary glands in girls, ultrasound of the testes in boys. Magnetic resonance imaging of the brain, adrenal gland, pituitary gland...
2.4 X-ray of the wrist to determine the maturity of the bones The X-ray of the wrist helps to determine the bone maturity, thereby contributing to the diagnosis of puberty. early if bone age is older than actual age.
In addition, this method is also valuable in predicting early puberty, whether the child is at risk of not reaching the maximum height in adulthood based on the difference in bone age compared with the real age, if the bone age is too old. faster than the actual age of the child, the risk of the child being short in adulthood is higher.
Determining the status of precocious puberty, diagnosing the cause of early puberty is absolutely necessary, so that there are measures to educate, monitor or even delay early puberty in some cases.

At the Pediatric Clinic - Vinmec Central Park International General Hospital, children will receive an in-depth examination of pediatric endocrinology, kidney and endocrine-related diseases: early puberty, growth retardation, kidney syndrome broken .
Visited by Associate Professor, Dr. Huynh Thoai Loan - Head of Pediatrics - Neonatology Department, Vinmec Central Park International General Hospital, is one of the leading experts in Pediatrics - Neonatology in Ho Chi Minh City Minh, with nearly 30 years of experience in examining and treating pediatric endocrinology, pediatric kidney and other Pediatric - Neonatal problems. During the examination, parents will be completely consulted and answered questions about early puberty in children. Here, children will have sex hormone blood tests, bone age assessment tests, brain MRI scans or more specialized tests to determine the right cause of puberty early and promptly. treatment time.