How do you know your daughter is starting puberty?

The article was professionally consulted by Dr. Le Thu Phuong - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital.

Puberty is a time when girls' bodies and minds mature and they develop into young girls. This usually begins when a girl is about 10 years old. Sometimes, however, a much younger girl begins to show signs of puberty. This is called precocious puberty (pre-KOH-shuss), or (PU-ber-ty). These early signs of puberty can be difficult for your child. So how do you know your daughter is starting puberty? In this article, we will provide useful information to help caregivers promptly recognize and take appropriate care measures.

Precocious puberty is defined as the development of secondary sexual characteristics before the age of 8 in girls. Symptoms such as: children are taller than their peers, but this growth spurt can cause children to be shorter than average as adults, children begin to develop breasts, pubic hair and body odor.

Puberty begins when a part of the brain called the hypothalamus secretes a hormone called gonadotropin-release hormone (GnRH hormone). This hormone travels in the brain to the pituitary gland. The hormone GnRH signals the pituitary gland to secrete two hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
These hormones travel through the bloodstream and reach the ovaries. The hormone LH and the hormone FSH stimulate the ovaries to stop working and prompt them to secrete female sex hormones called estrogen hormones. Estrogen travels in the blood to trigger various changes in the body associated with puberty in girls.
The ovaries continue to produce estrogen, marking the beginning of the female reproductive phase.
This phenomenon is divided into predominant central precocious puberty (CPP - dependent on gonadotropins) and peripheral precocious puberty (PPP - independent of gonadotropins).
Some experts believe that genetics may play a part in central precocious puberty. Mothers who had their first period when they were 10 years old or younger had a girl at a higher risk of developing central precocious puberty. Other experts speculate that environmental chemicals (eg, phthalates) may cause central precocious puberty, but there is no evidence to support this theory.
About 10 to 20% of central precocious puberty is due to medical conditions such as:
Damage to the brain or spinal cord Structural problems in the brain Central nervous system radiation (for cancer treatment) Disorders Hereditary disorders Hypothyroidism.

Peripheral precocious puberty (PPP) occurs when the ovaries or adrenal glands start making hormones earlier than usual. Possible causes of peripheral precocious puberty include:
Ovarian cysts or tumors Adrenal tumors Hypothyroidism Genetic disorders Exposure to hormonal drugs, creams or gels.

Obesity: Girls who are overweight or obese are more likely to show signs of puberty earlier. The hormone GnRH is not only activated by the ovaries but also from fat deposits in the body. This is one of the main causes of precocious puberty in girls Sex hormone exposure: If your child is exposed to creams or ointments containing estrogen, this in turn increases her chances of precocious puberty. young. There are many unconfirmed reports regarding the consumption of hormone-injected meat such as chicken as a catalyst for puberty in children. Eating a lot of meat is also a risk factor: A 2010 study published in the journal Public Health Nutrition, which looked at 3,000 girls, found that those who ate eight servings of meat a week from birth 3 years old and children who eat 12 servings of meat a week from the age of 7 are more likely to have an earlier period. In fact, if a child eats a high-meat diet from the age of 7, her risk of having an early menstrual cycle is 75%. This is especially true if the meat being consumed is high in growth hormone. Growth hormones commonly used in meat include estrogen and progesterone (natural female sex hormones), testosterone (natural male sex hormones), zeranol, trenbolone acetate and melengestrol (synthetic hormones that stimulate growth). prefer faster-growing animals). It is impossible not to talk about soy consumption: a food that contains a substance close to estrogen, can also be the cause of early puberty, according to a recent prospective study in the British BCERP programme. showed that soy consumption not only does not induce precocious puberty but may delay puberty in girls. Radiation exposure: Having a child receive radiation treatment to cure a tumor or other medical condition early in life, can also increase the chance of early puberty.

Breast growth is often the first sign of puberty in girls. You may first notice small nipples below the nipple area. One breast may begin to develop earlier than the other, and you may feel tender to the touch.
This is followed by pubic hair growth, body odor (due to more active sweat glands) and acne (due to more active oil glands). Your daughter will probably also grow a few centimeters taller and develop wider hips and slimmer waist during puberty.
Your child may become erratic and irritable. Some babies may have a white or yellow discharge from the vagina and may also start menstruating any time between a year and a half to three years after their breasts start to develop. Underarm hair also usually appears near the end of puberty. This entire process usually takes about two and a half to three years, but it can take up to five years.

To make a diagnosis, your child's doctor will review your medical history and do a physical exam. Blood tests may be done to measure hormone levels or look for changes in genes (gene mutations) that can lead to an uncommon pattern of precocious puberty. The doctor may order an X-ray of the hand to see if the child's bones are maturing too quickly. Sometimes, a CT scan or an MRI is ordered to check for a tumor.
When your child shows any signs of precocious puberty, see a pediatric endocrinologist. This doctor is an expert in the treatment of hormone-related conditions in children, and can help parents decide what to do based on their child's individual situation and test results (age age). child, rate of maturity, and estimated future height and height, such as absence or presence of underlying disorders).

If your child has central precocious puberty, there are hormones that help prevent further growth during puberty. These hormones are usually produced as medications called gonadotropin-releasing hormone (GnRH) analogues, which your doctor will inject monthly or every three months, or through an implant to release the medication gradually throughout. a year. Children treated with GnRH may experience additional signs of puberty for the first six weeks or so such as mood swings, pimples, etc., but these will gradually stop. Side effects are minimal, and puberty begins again as soon as the child stops taking the drug.
If the problem is peripheral precocious puberty, treatment will depend on the cause. It may involve medication, surgery (if a tumor is present), or removal of an external source of hormone (such as an estrogen cream).

Children with early puberty have more low self-esteem, are more prone to psychological disorders, and are at risk of depression because their physical development is different from their peers. Children with precocious puberty are also at increased risk of being influenced by older peers, which may lead to earlier sexual initiation, substance abuse, or behavioral outbursts at an earlier age. Risk of metabolic cardiovascular disease is also higher Precocious puberty is associated with reduced adult stature because early puberty is often accompanied by earlier bone growth and development, which then stops earlier children with normal puberty. Children with precocious puberty also have a short prepubertal period. And there are also many studies that show that short people are often the earliest and most severe cases of puberty.

For most children, being different is a painful thing, and being physically different can be especially embarrassing for girls. You can reassure, comfort, and support your daughter through her daily struggles, but don't hesitate to seek emotional help for your child or yourself if you need it.
Here are some tips from the experts:
Help your child understand puberty clearly, simply, and honestly by finding materials related to puberty and discussing some with them. your experience. Explain to your child that this is completely normal and that most of his or her friends will soon reach this point; and I just started earlier than the others. Inform your child about what to expect in the coming months and years Monitor your child for signs of behavioral problems or depression Get the help of a counselor for yourself and your daughter , if necessary Ensure a healthy and active environment at home and at school. encourage children to participate in group activities and sports more often. You may also want to help your daughter adjust to her new body by: Go shopping with her for her first bra, buy deodorant or skin care products as needed. At Vinmec International General Hospital, the baby will be examined with a leading expert in Pediatric Endocrinology, will have sex hormone blood tests, bone age assessment tests, ultrasound assessment to assess the health of children. maturation of the uterus and fallopian tubes, brain MRI or some more specialized tests (for mutated genes), to determine the right cause of early puberty and promptly treat.
In addition, children with precocious puberty need a psychologist to monitor mental abnormalities that appear during this sensitive period (Anxiety Disorders, Depression, Emotional Disorders, Acute Stress .. .). It is also here that we provide a team of professional, dedicated and meticulous psychologists, helping children to orient themselves properly, psycho-physiological age.
If you have a need for medical examination with experienced pediatricians at Vinmec, please book an appointment on the website to be served.

References: babycenter.com, hormone.org, beingtheparent.com