A 3-Year-Old Girl Hits Puberty
Bhavna (name changed) hails from Nalasopara in Mumbai suburbs. Around the age of 2, she suddenly started gaining weight and eventually menstruating!
Her parents took her to the hospital where she was diagnosed with a rare medical condition ‘Precocious puberty’ – the occurrence of early puberty in children. The usual minimum age to reach puberty among girls is 8 years and boys is 9 years. Anything before that is categorized as Precocious puberty.
Medically, precocious puberty is said to occur when the signs of sexual maturation appear at 2.5 years less than the mean age of puberty.
Precocious puberty was first reported in Ancient Greece and Rome. In the annals of history, Craterus, a Macedonian general under Alexander the Great around 300 BC, was the first to report about a person who was ‘child, adult, father of a child and died’ all within 7 years of life. Seneca (4 BC to 65 AD), a Roman philosopher and statesman, has also mentioned about the few people whose physical growth and development completes much before what’s considered to be normal.
The first medical report on precocious puberty comes from Mandeslo who in 1658 cited a 3-year old girl began her menstruation and then gave birth to a baby at the age of 6 years. Those were the times when precocious puberty was not seen as a medical problem but an act of God or Devil!
Today, there is much more medical awareness and scientific evidence of the disorder.
Puberty is essentially the result of a complex process involving hormonal reactions in pituitary, hypothalamus and gonads. Even though the mechanism of what stimulates precocious puberty is not completely understood but it is believed to be caused by disturbance in the normal processes of puberty due to unknown factors.
The incidence of precocious puberty is found to be 0.6% in the general population.
Psychological issues such as social withdrawal and aggressive behaviour; practical difficulties of handling the menstruation in very young girls; and physical growth such as maturation of bones are associated complications with precocious puberty. The child with precocious puberty shows the physical and hormonal characteristics of an adult.
For example, girls may develop breasts and pubic hair and boys may display pubic hair, enlarged testicles/penis and increased libido. At the childhood stage, such development may bring a lot of emotional stress and negatively impact self-confidence. Children at that age do not have the maturity to understand what’s happening to their bodies. Precocious puberty also impacts the physical development of the child resulting in short stature, weight gain, changes in body shape and ability to reproduce.
Bhavna is all of three years but physically she looks like a 16-year old girl.
Parents should watch out for early development of sexual characteristics such as breast enlargement in girls and deepening of voice in boys. Doctors will conduct a diagnosis with some hormonal tests to confirm precocious puberty. Treatment will help to reduce the developmental differences between the child with precocious puberty and his peer group. Medications are given to slow down, stop and reverse the sexual maturation.
For example, Bhavna is given hormonal injections every month to delay further sexual development and this will continue till she reaches the normal age for puberty. Doctors say that in most cases of precocious puberty, specific cause cannot be pinpointed but it is vital to treat these children because of the implications of precious puberty on physical growth.
Image does not depict baby mentioned above.