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Puberty is considered delayed when the child has not begun puberty when two standard deviations or about 95% of children from similar backgrounds have. [7] [8] [9]In North American girls, puberty is considered delayed when breast development has not begun by age 13, when they have not started menstruating by age 15, [2] and when there is no increased growth rate. [8]
[18] [35] [36] As a result, "early puberty" in children as young as 8 and 9 is no longer considered abnormal, particularly with girls. Although it is not considered as abnormal, it may be upsetting to parents [21] [37] and can be harmful to children who mature physically at a time when they are immature mentally. [38]
Research has showed that the average age of starting puberty continues to drop over time: One study published in 2020 shows that the average starting age of puberty for girls has decreased by ...
Starting puberty significantly early — younger than age 8 in girls, 9 in boys — may have health effects lasting into adulthood, including higher risks of breast cancer, diabetes and heart disease.
Early puberty also correlates with increased sexual activity and a higher instance of teenage pregnancy, both of which can lead to depression and other psychosocial issues. [23] On the other hand, late-maturing males develop lower self-esteem and confidence and generally have lower popularity among peers, due to their less-developed physiques.
Although early puberty in boys is not common, studies suggest that the average age of puberty in boys decreased between 1993 to 2008. The researchers attributed the early onset of puberty in boys ...
The underlying cause is due to the defective migration of GNRH neurons from olfactory placode to hypothalamus, leading to congenital GNRH deficiency. This leads to olfactory problems such as anosmia, optic defects like color blindness, and results in hypothalmic deficiencies associated with low levels of LH, affecting sex hormone testosterone in males or estrogen and progesterone in females.
Puberty blockers are commonly used to delay puberty in children with precocious puberty, a condition that activates the hypothalamic-pituitary-gonadal axis prematurely and initiates puberty at an inappropriate age. [30] The main goal of treatment is to preserve children's adult height potential. [31]