Boys are starting puberty 6 months to 2 years earlier. The AAP broke this story last week, and it quickly became one of the hottest news stories in the nation. Parents and physicians were concerned about what this meant. Are our boys simply developing earlier, or is this precocious puberty, a medically significant deviation from normal puberty that requires treatment? My own children are well past puberty. If they weren't there are certain things I would want to know. Is this dangerous? What is causing it? What do I need to do as a parent? When should I be worried? This link attempts to address some of these issues.
Girls in the US have been entering puberty earlier for several years. We know that this can be linked to obesity. However, this information on early puberty in boys is new. Perhaps this is because the onset of puberty is harder to track in boys. They don't have menstrual periods or breast development. What does the study mean by "earlier"? Well, we doctors have tables and charts that we use to track physical development. These are our guides as to what is 'normal.' They were developed decades ago. This is the first study in many years that has looked at when puberty begins in boys, and it is earlier than we were taught to expect.
Precocious puberty refers to puberty that occurs earlier than normal. That's not a very useful definition in this case, so let me explain. We used to think that "early" was before age 9 in girls. Now we know that normal puberty in girls can begin as early as age 7. In boys, it refers to puberty before the age of 9. Signs of early puberty in boys include armpit or pubic hair, growth of the genitals, facial hair, muscle growth or deepening of the voice. If you see such changes in your son before age 9, have him see his physician. Your provider may be able to tell by physical examination whether this is normal. Or, he or she may want to run tests to see if these signs are due to changes in the brain, genetic problems, certain tumors that release hormones, or certain creams or ointments that contain hormones.
This AAP study refers to normal puberty occurring earlier than we previously expected. It does not refer to precocious puberty. Furthermore, it refers to the onset, or beginning, of puberty. Boys are still finishing puberty at the usual time. (It is taking longer). There is no immediate danger from this, but we do not know the long term effects. We don't know what is causing it. At this time, we cannot blame obesity, BPA or the hormones in milk. As parents, we need to teach our children what to expect. This means we may need to move the puberty talk to a younger age. There is something else we can do as parents. We can help find out why early puberty is occurring. We can make ourselves available to answer surveys and questionnaires about our boys' health and habits.
In summary, early puberty is occurring in boys as well as girls. There is no immediate danger from this. We do not yet know the cause. Contact your physician if you see signs of puberty in boys before the age of 9. As always, if you have questions or concerns either leave your comments below or contact your child's healthcare provider.
~Dr Nan N~