Puberty of girls. Special compression technique

Acceleration is a phenomenon that occurs everywhere. Accelerated sexual development teenagers today worry psychologists and doctors. Premature ripening can lead to unforeseen consequences. Outwardly, a teenager may seem quite mature - this is what anatomical features puberty in boys and girls. However, being tall or having a full bust is not evidence of stabilization. hormonal levels and final maturation of the brain. Let's try to figure out how physical and sexual development occurs normally in children, as well as what their parents should pay attention to.

What is puberty

Each of us has our own in the body The biological clock. This abstract concept explains the timeliness of the growth and development of the body, the appearance and withering of reflexes and functions. Babies suck their fingers and learn to walk, but after a few years, having acquired many skills, they go to school to explore the world. Women get wrinkles over the years, and old people get gray hair. All these and many other natural changes are a consequence normal operation endocrine system, as well as the hypothalamus and pituitary gland. These glands are located in the brain and secrete hormonal substances, necessary for the launch of age-related biological processes.

Each has its own characteristics. But the greatest stress to the body comes during puberty. The changes that occur to a fragile child’s body are countless, but right now we will try to sort everything out.

The development of germ cells and organs in representatives of both sexes occurs in three stages. In girls and boys they do not occur at the same time:

Prepubertal. For boys, it begins at age 8 and ends closer to eleven. In girls it begins 1-2 years earlier.
Puberty. The age at which children can be considered teenagers also differs. In boys it occurs between the ages of 11 and 17; in girls it usually ends by age 15.
Growing up. Girls are considered sexually mature at the age of 15-18 years. The formation of young men is completed by the age of 19-20.

How boys grow up

It begins with the formation of secondary sexual characteristics, the impetus for which is an increase in the concentration of testicular androgens in the body.

Male maturation process reproductive system starts with changing the size of the genitals. First, the longitudinal diameter of each testicle increases, and the scrotum becomes pigmented and folded. By the age of 11-12, a teenager develops pubic and axillary hair. IN in rare cases vegetation in intimate areas occurs before the testicles increase in volume. This is not the norm similar violation causes overproduction androgens. In medicine this phenomenon called accelerated adrenarche.

As testicular volume increases, the size of the penis becomes larger. First, its length increases, and then its diameter. Pigmentation (darkening skin) continues to increase.

Around the age of 13-14, a young man begins to develop hair on his face, neck, and chest. At this age, the genitals may well correspond to the size of adult men, but it is too early to talk about the onset of puberty. Spermatogenesis should indicate this. The first ejaculations and wet dreams occur around the age of 16. Puberty in boys continues until the age of 19-20, but they become fertile, that is, capable of fertilizing a female egg, earlier.

Another change that occurs under the influence of increased secretion male hormones, is the acquisition of characteristic architectonics by the body: an increase in the shoulder girdle, growth of bones and muscles.

How teenage girls change

In girls, it also begins with the appearance of secondary signs, and its completion is indicated by the establishment of regular menstrual and ovulatory cycle. The first noticeable changes are expressed by breast enlargement: thickening occurs under the areola area glandular tissue, and the peripapillary zone darkens. The growth of the mammary gland is ensured by the secretion of estrogens - at the age of 10-11 years they are produced in sufficient quantity. Often girls are frightened by asymmetry (one breast seems larger), which disappears only during the formation of a mature gland.

Next secondary symptom sexual development in the fairer sex is pubic and axillary hair growth. Most often, hair growth in armpits ah speaks of the approach of menarche - the first menstruation. Despite the fact that the process of formation of sexual characteristics most often occurs in this sequence, approximately 1% of girls develop hair growth first. The abnormal course of puberty is caused by the increased presence of male hormones in the body.

In parallel with the development of the reproductive system, the architectonics of the body changes. In girls, an increase in body weight occurs due to the build-up of predominantly adipose tissue. It begins to “accumulate” in the body from the age of six. In early puberty adipose tissue redistributed and deposited in the hips and pelvis.

Several stages of maturation of boys and girls

So, each of the periods of sexual development can be briefly described as follows:

A kind of preparation for the upcoming changes is the prepubertal period. Within 2-3 years, the body accumulates enough strength to make a big leap in growth and sexual development. Next comes teenage years, the peculiarities of which every person has to deal with.
Adolescence (puberty) is characterized by intensive growth, hard work gonads, significant changes in figure. Representatives of both sexes also change their voice: in boys, due to mutation, it becomes low and deep, in girls it loses its sonority.
Growing up. Consolidation of acquired sexual characteristics, growth cessation, initiation of active sexual activity and reproduction of offspring.

Negative manifestations of puberty

In addition, with the onset of puberty, girls and boys experience similar health problems. Teenagers often suffer from inflammation sebaceous glands, distribution acne on the face, back, shoulders, sometimes buttocks. Shiny oily skin at the age of 12-16 years is predisposed to acne.

Possible pain in muscles and joints, dizziness and fainting, and lack of coordination. Girls may often have pain in their chest and lower abdomen, and before their first period they may experience severe pain in their lower back.

The complex character of a teenager

The sexual development of representatives of both sexes is accompanied by another important aspect - psychological. Parents know firsthand about the difficulties of adolescence. Changes in character and rebellious behavior are predominantly hormonal in origin. A clear sign“internal withdrawal”, provoked by the entry into the blood of a teenager large quantities testosterone and estrogen, are sudden mood swings. More sensitive to hormonal changes girls. They can become violent for no specific reason, and five minutes later they become pitiful and tearful.

It is immediately worth noting that such psychic phenomena There is no treatment for teenagers. A properly selected diet can help a child overcome puberty. To mitigate the hormonal “storm” of a teenager, it is important to minimize the daily amount of calories entering the body, first of all eliminating fast carbohydrates, chocolate, caffeine, energy drinks and fatty foods. It is better to give priority in nutrition to animal products containing calcium and protein, especially necessary during the period of active growth. In addition, it is important for girls to constantly replenish iron deficiency. It is contained in beef liver, pomegranate juice, apples, red meat.

If a teenager is having a hard time going through puberty, it is worth contacting a neurologist or psychotherapist. Boys and girls are usually recommended to take vitamins, homeopathic sedatives and adaptogens (extract of echinacea, lemongrass, succinic acid).

What diseases occur in teenagers

As already said, age development germ cells and the reproductive system in general serve not the most favorable period for the body. Adolescence is a kind of “trigger” for the activation of a number of diseases and pathological conditions. IN puberty gastritis often worsens, cholecystitis is detected, diabetes. The first migraine attacks in most girls suffering from this problem occurred just in adolescence. Myopia, decompensation of congenital but not diagnosed heart disease in time, scoliosis, flat feet - children aged 10 to 16 years have a good chance of such manifestations. In severe cases, juvenile schizophrenia or oncology develops.

On the other side, active growth during the formation of boys and girls, it allows many to “outgrow” asthma, enuresis, and adenoids. It happens that a child’s allergic reactions weaken or disappear altogether.

Disorders of the reproductive system

There are specific diseases that are typical only for teenagers. The most common of them:

Too early: reasons for acceleration

When talking about disorders of sexual development, we mean two options: premature maturation and its delay. Sometimes during internal system organism, which determines the rhythm of its life, a malfunction occurs, and natural processes arrive earlier or later than expected.

Thus, acceleration is premature sexual development, which begins in boys before the age of 9, and in girls before the age of 8. In such early age the body is not yet ready for pubertal changes. In the future, premature sexual development leads to early extinction reproductive functions. In addition, accelerated children often begin early sex life, which is dangerous to health, especially in the case of an unplanned unwanted pregnancy.

Pathological causes of acceleration are disturbances in endocrine system, benign and malignant tumors brain, pituitary gland, adrenal gland disease and incorrect operation gonads. If the first signs of acceleration occur, you should consult a doctor. To prevent early offensive puberty, doctors recommend that parents do not overfeed their children, limit carbohydrate intake and send them to a sports section.

Five-year-old mother from the Guinness Book of Records

Most famous case in the story of a girl with early puberty is simply shocking. The Peruvian woman was only 5 years and 7 months old at the time of her son’s birth. Despite the fact that the origin of the pregnancy remained unclear, in 1939 her son was born absolutely healthy with a weight of 2700 g. Doctors who carried out C-section, published a report in which they noted that Lina had menarche at 2 years and 8 months, and by the age of 4 her mammary glands were almost formed.

Early maturation is caused either by natural or pathological causes. Today, many doctors believe that the cause of premature puberty is hormonal additives in the feed of livestock whose meat we eat, substances released from plastic packaging and plastics. Maturation ahead of schedule does not occur consistently: for example, a boy may suddenly develop sexual attraction and a full erection, and only then does hair growth develop.

Delayed secondary sexual characteristics

Another situation that occurs in adolescents is delayed sexual development. This disorder is characterized by the absence of secondary sexual characteristics by the age of 14-15: girls have no hair on their bodies, breasts are practically not developed, and in boys the size of the penis does not increase. Sometimes such a delay in development is considered normal. There is no need to panic ahead of time if the teenager is of asthenic physique.

Also, the reason for the delay may be rescheduled serious disease, anorexia (in girls) or occupation professional sports. But if secondary sexual characteristics do not appear by the age of 16, it is simply necessary to consult a doctor: there may be genetic abnormalities.

Girls with hair growth need a detailed examination male type, formed breasts and lack of menstruation - such symptoms can be caused by an abnormal absence of the uterus with functioning ovaries.

For the health of the child in transition puberty need to be monitored carefully. It is important that your teenager eats properly and gets enough rest. For preventive purposes, it is advisable to take laboratory and clinical tests of urine and blood every year - this simplest form examination is sufficient effective way identifying inflammatory processes in organism.

Parents are also responsible to their children for their sex education. Lessons in the form of explanatory conversations about the rules of hygiene, the dangers of early sexual activity and contraception should be carried out with every teenager, no matter how mature and omniscient he considers himself to be.

Of course, the duration of sexual intercourse can be called a problem. Because not every couple can achieve the optimal time that would suit both partners in bed. There is an opinion that this depends solely on the man, his experience and abilities. But this is a mistaken opinion. Because the duration of sexual intercourse can be affected by any of the partners.

Now I want to tell you a few ways exactly how a female partner can influence this very duration.
How to speed up sexual intercourse

If a girl wants it to end faster. Let's say she is not in the mood, or perhaps she has already reached the peak of sexual emotions, but her partner is not. What to do in this case?

1. Squeeze the vaginal muscles.

2. Change the position so that with each movement the head of the penis closely touches the cervix. For example: a woman on her back with her legs tightly clenched. Or “hussar style” - when the legs of a woman lying on her back are thrown over her partner’s shoulders. You can also “fish” - when the woman is on her stomach, legs in sufficiently squeezed, man on top, etc. The Kama Sutra can help, there is plenty of information about poses.

3. You can’t let your partner lose the rhythm.

4. You can have oral sex. This will be a good end to sexual intercourse.

5. If possible, then wrap two fingers around the base of the penis and stimulate it further.

6. You can cheer up your partner with screams and moans. The main thing here is not to overdo it, so that the neighbors don’t panic or the partner himself doesn’t go deaf. It is better to do this quietly or even in your ear and always in an exciting way.

Here, in principle, are the main points, but here you can use your imagination, depending on your personal preferences, and add to this list. The girl probably knows what excites her chosen one - these same actions will help to finish everything faster in bed.

But, if nothing helps at all, then it is better to invite your partner to take a short break of 30-40 minutes or even an hour or two. And then resume contact. Most likely, both will have a desire by that time.
How to prolong sexual intercourse

If a girl wants to prolong sexual intercourse and does not know how to do it. Here are some tips:

1. To avoid premature ejaculation Do not move at too fast a pace.

2. Some time after the start of sexual intercourse, you can stop all movements altogether and just lie down for a few minutes, leaving the penis inside, but not for very long, because you can ruin everything. Such breaks can be taken several times during the process itself.

3. You should also select suitable posture, which helps to increase the duration of sexual intercourse. For example: a woman lies on her back, legs raised and spread wide apart. Or "woman on top" will be good decision this problem. You can also try sitting facing each other.

4. Ultimately, you can simply relax the vaginal muscles or use more lube so that the head of the penis is least stimulated. The man will still be pleased, but the time of sexual intercourse will increase.

If nothing helps and sexual intercourse still ends before it even begins, then it is better to turn to the methods of Taoist and tantric sex. Using certain techniques From these teachings, you can extend the duration of sex as much as you like.

p.s.
Many men, at first after the onset of sexual activity, as well as after a long sexual break, cannot control the duration of sexual intercourse and reach their peak of bliss too quickly, without having time to satisfy the woman. Therefore, if this is the reason for the short duration of sexual intercourse, it is best just have sex more often and after a while everything will return to normal and both partners will enjoy it in bed.

Do you need to worry if your child’s peers have already grown a mustache and a third breast size, but your “baby” seems to have not changed?..

What happens to the body during puberty?

Puberty is the time when a child's body transforms into an adult's body. For girls The mammary glands begin to develop, pubic hair appears, the girl sharply increases in height, and her first periods appear. The body changes - the hips become wider and the waist becomes thinner. In boys Facial hair begins to grow, pubic hair appears, a rapid increase in height is observed, and the genitals become larger in size. The body changes - the shoulders become wider, the body becomes more muscular.

All these changes are caused by sex hormones - in boys, and estrogen in girls. Hormones begin to be produced in large quantities, so changes occur that called puberty.

Puberty can begin between 7 and 13 years in girls; in boys, puberty begins a little later - between 9 and 15 years. Some children puberty comes earlier, for others later. But there are times when baby body does not change, although all deadlines have already arrived or passed. This the deviation is called delayed puberty.

Delayed puberty

A teenager has delayed sexual development - when there are no physical changes during puberty, by the age of 13 in girls, and by the age of 14 in boys, who indicate puberty.

Causes of delayed puberty

Delayed sexual development may be caused by hereditary characteristics, that is late onset physical maturity - can be passed on from generation to generation. In this case there is no additional treatment is not required, maturation will occur on its own, but a little later than in other children.

Delayed puberty may also occur due to chromosomal disorders, hereditary diseases, chronic diseases, tumor formations that disrupt the functioning of the pituitary gland or hypothalamus.

Chronic diseases such as diabetes, cystic fibrosis, kidney disease, asthma can cause delayed sexual development. Children with these diseases need more careful medical supervision; Proper treatment will help avoid delayed puberty.

Children who eat poorly (malnutrition, insufficient quantity nutrients ) may experience delayed sexual development, unlike peers who eat well. If the child has , then with this disorder the body cannot develop properly. Girls who engage in professional sports, have delayed puberty. Physical exercise prevent fat from forming in female body, the body needs fat formations so that puberty goes smoothly and the first menstruation begins.

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Problems with puberty may occur due to dysfunction of the thyroid gland or pituitary gland, which are responsible for the production of sex hormones.

A striking example of chromosome disorders in girls is Turner syndrome, which is characterized by the absence or disruption of one female chromosome (X chromosome). Girls grow more slowly, their ovaries also develop more slowly and sex hormones are poorly produced. If Turner syndrome is not treated, women remain short and often infertile.

Boys with one extra X chromosome are observed, so sexual development is delayed in children with this diagnosis.

What are the symptoms of delayed puberty?

Absence signs of puberty- the main sign that a child has delayed puberty. Exist general symptoms delayed puberty, but each child may only show some symptoms.

Symptoms of delayed puberty in girls:

No enlargement of mammary glands and nipples by age 12.
By the age of 14, there is no first period.

Symptoms of delayed puberty in boys:

No development of genital organs by age 14.
Absence pubic hair by the age of 15.

Symptoms of delayed puberty may be a reflection of other health problems or diseases. To identify the cause of the problem, consult a doctor.

Puberty is a stage of child development during which significant changes occur in the body. hormonal system, which causes the physical changes that signify the transition child's body into adulthood.

During puberty, both boys and girls experience noticeable gain height and body weight, and the sex glands begin to function fully. In girls, secondary sexual characteristics develop: the mammary glands enlarge, hair appears in the armpits and pubic area, and menstruation begins. In boys, hair begins to grow on their face and body, their external genitalia become enlarged, and their voice “breaks.”

Let us note that the timing of the onset of puberty is purely individual and depends, first of all, on the child’s heredity: that is, if the mother’s period appeared late, then, most likely, the same will happen to the daughter; A larger boy tends to experience puberty earlier than his smaller peers.

The age intervals when adolescents of both sexes begin to experience certain changes caused by puberty are presented in the table (see below).

Typically, cases are more late dates the onset of puberty should not be a reason to seek treatment medical assistance. However, such a delay may be caused by any latent (hidden) diseases.

If your child's puberty starts unusually late, you should consult your chart. primary diagnosis.

Primary diagnostic chart for delayed puberty in girls

1. Did the girl have her first menstruation (period)?

- Yes - Beginning of menstruation (monthly)- the main sign that the release of hormones that are responsible for the child’s puberty is occurring normally. Even if, for example, a girl’s pubic hair rarely grows or her mammary glands are small, there is no reason to worry or see a doctor. It happens quite often that periods are irregular at first and may be delayed by several months. If the girl does not show signs of any disease, this should not be a cause for concern.

- No- see point 2.

2. The girl showed the following signs of puberty:

a) enlargement of the mammary glands and/or nipples;
b) pubic hair growth?

- Yes- Such early signs of hormonal activity are often precursors to the appearance of menstruation (menstruation), which indicates normal development child. If a girl at the age of 14 has not started menstruation, she should consult a doctor.

- No- see point 3.

3. Girl under 14 years old?

- Yes - Later development in that age period should not be a cause for concern. Many girls, especially those who are small compared to their peers, do not show any noticeable signs of sexual development until they are 10 or 11 years old. If a girl does not start menstruating at the age of 14 or her physical development is slower than expected, it is necessary to consult a doctor.

- No - Delayed puberty in most cases due to hereditary factors. However, this condition can also be caused by the child's health status, the use of certain medications, or, in rare cases, chromosomal or hormonal disorders. In this case, the child should be examined by a doctor. After carrying out the appropriate diagnosis, the doctor will give appropriate recommendations and, if necessary, prescribe treatment. But, as a rule, doctors do not find serious violations- The girl just needs time.

Primary diagnostic chart for delayed puberty in boys

1. A boy under 12 years old?

- Yes- Very rarely do boys at this age begin to experience changes caused by puberty. And if at that age the boy still looks like a child, this should not be a cause for concern. It is possible that the child is developmentally delayed compared to peers whose puberty began early, or to girls of the same age who begin puberty much earlier than boys.

- No- see point 2.

2. The boy showed the following signs of puberty:

a) hair growth on the pubis and/or other areas of the body;
b) enlargement of the genital organs?

- Yes- The appearance of at least one of these signs, associated with increased hormonal activity, indicates that the child has begun puberty, even if other changes are not very noticeable. It is worth noting that the timing of the appearance of other signs may not always coincide with those indicated in the table (see below), and their changes do not affect further development teenager

- No- see point 3.

3. A boy under 14 years old?

- Yes - Later development across wide age ranges it is very rarely a cause for concern. Most likely, delayed puberty is due to heredity and/or the fact that the child is not as large as his precursors. In more rare cases, the causes of delayed puberty are any previous long-term illnesses and/or taking certain types medicines. If at the age of 14 a boy has not shown signs of puberty or is lagging behind in physical development, he should consult a doctor.

- No - Delayed puberty in boys after 14 years - unusual phenomenon for teenagers and may be caused insufficient quantity secreted hormones or chromosomal disorders. In this case, you need to consult a doctor who, after diagnosis, will give appropriate recommendations and, if necessary, prescribe treatment.

Mental development of a teenager

During puberty, a child experiences physical changes, which are accompanied by mental changes, which are caused by the action of sex hormones that are actively produced during this period. In both girls and boys, such a “burst” of sex hormones begins to awaken an active interest in the opposite sex. Scientists believe that increased concentrations of testosterone (the male sex hormone) play a key role in aggressiveness and inappropriate behavior, which is typical of teenage boys. In addition, an increase in the secretion (release) of adrenal hormones also has a strong influence on the behavior of adolescents, increasing their natural assertiveness (this explains their disobedience and tendency to engage in discussions).

Delay physical development a child is very often accompanied by mental retardation. As a result, a child who is physically less developed is less persistent than most of his peers. Such children may experience psychological and social difficulties.

MAIN PERIODS OF NORMAL DEVELOPMENT OF ADOLESCENTS

GIRLS
Sign of development	Age when changes usually begin	Age when quick changes usually stop	Nature of changes
Increase in height and weight			In children average speed growth is approximately 5 cm per year. one of early signs The period of puberty is considered to increase the growth rate (on average up to 9 cm per year). a growth spurt can last 4 years, but the greatest acceleration in growth occurs in the first two years. At the same time, the child’s body weight begins to increase, and fat begins to be deposited on the hips and buttocks.
Breast development			During the first stage of breast development, there is usually an enlargement of the nipples and areolas (the pigmented area that surrounds the nipples). After about a year, the mammary glands themselves begin to enlarge, the nipples and areolas darken. Breast development in girls is usually completed by the age of 15.
Pubic and armpit hair growth	On the pubis - 10-11 years Under the arms - 12-13 years	On the pubis - 14-15 years Under the arms - 15-16 years	On the pubic hair in the area of the external genitalia, as a rule, it appears in the form of a light fluff. Over time, they become rougher and darker, and over the course of 2-3 years they spread to the pubic tubercle. Hair in the armpit area begins to grow approximately 1-2 years after hair appears in the pubic area. The color, thickness and distribution of hair depend on the child's race and hereditary factors.
Development of sweat glands			Apocrine (sweat) glands secrete a secretion (sweat) that is different from that secreted by eccrine glands (eccrine glands function in the body from the moment a child is born). Sweat glands begin to actively function in the armpit, groin and around the nipples during puberty. Apocrine glands secrete sweat, and if the rules of personal hygiene (regular washing) are not followed, an unpleasant odor begins to emanate from the body.
Start of menstruation	First menstruation - 11-14 years	Establishment of regular menstrual cycle- 15-16 years old	In most cases, girls begin menstruating at age 13. Typically, periods appear approximately 2 years after the start of the growth spurt. By the time the first menstruation begins, the girl should weigh approximately 45 kg. About a year before a girl's first period appears from the vagina. watery discharge white
Boys
Increase in height and body weight			In children, the average growth rate is approximately 5 cm per year. One of the earliest signs of puberty is an increase in growth rate (up to 10 cm per year) over 2-3 years. the boy then continues to grow until about age 20, but at a slower rate. Along with growth, the child’s body weight also increases. The boy's shoulders broaden and rib cage, the length of the body increases, the muscles of the legs and arms increase. During this period, the boy's appetite increases significantly
Development of the genital organs and the appearance of ejaculation			The increased release of hormones at the beginning of puberty stimulates the development of the male gonads (testes), which leads to a noticeable increase in their size. The skin of the scrotum becomes darker, the penis enlarges and becomes longer. The ability to ejaculate (ejaculate), as a rule, appears within two years from the beginning of the development of the genital organs
Hair growth on the body and face			As a rule, hair growth in boys begins on the pubis, and about a year later - on the face, in the armpits and, depending on genetic factors, on the chest, stomach and legs
Development of sweat glands			Apocrine (sweat) glands secrete a secretion (sweat), which is different from the sweat that eccrine glands secrete (eccrine glands function in a child from the moment of his birth). Sweat glands begin to function intensively during puberty in the armpits, around the nipples and groin. Apocrine glands secrete sweat, and if the rules of personal hygiene (regular washing) are not followed, an unpleasant odor begins to emanate from the body
			Development voice apparatus in boys it is accompanied by an enlargement of the Adam's apple (“ adam's apple") and expansion of the larynx. From the moment these changes begin, within about a year, the voice “breaks” (becomes lower).

Precocious puberty is called when secondary sexual characteristics appear in boys under 9 years of age, and in girls under 8 years of age. According to statistics, this symptom complex is common among children all over the world - about 0.5% of children suffer from diseases accompanied by it. However, the most frequently recorded this syndrome in America and African countries.

In this article, we will introduce the reader to the types of precocious puberty (PPM), the causes and mechanisms of its development, and also talk about the symptoms, principles of diagnosis and treatment of this pathology.

Kinds

The classification of precocious puberty syndrome is very conditional, since some of its forms under certain conditions can transform into others. However, there are 4 main varieties this violation, each of which includes several subspecies. Let's look at them.

True precocious puberty

Arises due to increased activity pituitary-hypothalamus system. It, in turn, is divided into 3 types: idiopathic (the causes of which cannot be identified), cerebral and arising under the influence of sex hormones.

Cerebral true PPS can be caused by:

tumors of the central nervous system(optic tract glioma, hypothalamic hamartoma and others);
cysts of the third ventricle;
birth injuries of the central nervous system;
hydrocephalus;
infectious diseases of the brain (, toxoplasmosis);
surgical interventions on the brain;
radiation therapy.

True precocious puberty, resulting from prolonged exposure to sex hormones on the child’s body, can occur in the following cases:

with late treatment congenital dysfunction adrenal cortex;
as a result of removal of tumors that produce hormones.

False PPP

In girls, it usually occurs against the background of:

tumors (carcinomas) of the ovaries;
ovarian follicular cysts.

In boys, the causes of this pathology are:

tumors secreting hCG ( human chorionic gonadotropin person);
tumors (androsteromas) of the adrenal glands;
tumors (leydigoma) of the testicles;
congenital dysfunction of the adrenal cortex (namely, deficiency of the enzymes 11-beta and 21-hydroxylase).

Gonadotropin-independent forms

Such variants of premature puberty occur with testotoxicosis and McCune-Albright syndrome. The activity of the gonads in this case is determined by genetic disorders, it is not associated with blood levels of follicle-stimulating and luteinizing hormones.

Incomplete (partial) forms of teaching staff

They manifest themselves as premature secondary hair growth or isolated early enlargement of the mammary glands.

A separate variant of PPS is such against the background of the primary one in the stage of decompensation. It cannot be attributed to any of the above forms of the disease, since the mechanism of development of this pathology is different.

Causes and mechanism of development

Signs of precocious puberty may appear due to various diseases.

As is clear from the data provided above, premature puberty is not an independent pathology, but only a syndrome, a set of symptoms that arise as a result of other disorders in the body, against the background of a variety of diseases.

True PPS occurs due to premature activation of the secretion of GnRH, a hormone synthesized by the cells of the hypothalamus. The main function of this hormone is to stimulate the release of the anterior pituitary gland of gonadotropic hormones - FSH (follicle-stimulating hormone) and LH (luteinizing hormone). They, in turn, stimulate the functioning of the gonads - their release of sex hormones with all the ensuing symptoms (development of secondary sexual characteristics). IN healthy body all these processes are activated during puberty, and in pathology - ahead of schedule. In most cases, the cause of early activation of GnRH secretion is a tumor of the hypothalamus - hamartoma.

False PPS occurs, as a rule, as a result of a deficiency of the enzymes 11-beta and 21-hydroxylase, which results in increased secretion of androgen hormones by the adrenal glands. In some cases, an excess of sex hormones in the body occurs in the presence of tumors that secrete them.

Gonadotropin-independent precocious puberty is a consequence genetic mutations. They cause hyperproduction of hormones by the gonads without the participation of FSH and LH in this process.

Clinical manifestations

True PPS in girls is manifested by the following symptoms:

breast growth;
“adult-like” appearance of the external genitalia;
hair growth in the pubic and axillary areas, however, it is still less than in healthy girls during puberty;
increased sweating;
, often even regular (observed in 40-50% of girls, and in the rest they may be absent even against the background of all other symptoms of PPS for several years after the appearance of the latter).

At the age of 6-7 years, the ability of the adrenal glands to produce androgens is activated, therefore, starting at this age, symptoms of premature sexual development appear.

Symptoms of true PPS in boys:

an increase in the size of the external genitalia (penis) and glands (testicles);
acne;
increased sweating;
hair growth of the external genitalia, hair growth in the armpits;
deepening of the voice;
muscle growth.

With false forms of PPS in boys, the size of the testicles remains the same, or they are slightly enlarged.

Also this pathology in both girls and boys it is accompanied by rapid growth rates of the child - as in puberty. Such children grow by 10-15 cm in 1 year. Accelerated differentiation of bones takes place - this leads to early closure of growth zones and the person’s overall height is below average.

Diagnostic principles

At the diagnosis stage, the doctor faces the following tasks:

determine the form of the disease;
find out whether the function of the gonads is active (that is, there is a gonadotropin-dependent or gonadotropin-independent version of PPS);
understand why the secretion of gonadotropins and sex hormones is increased.

To answer all these questions, a specialist listens to the patient’s complaints, collects an anamnesis of his life and illness, conducts an objective examination, determines the need additional examination– laboratory and instrumental.

History of life and illness

The most important thing at this stage is to find out what sexual development was like in the patient’s close relatives.

Thus, testotoxicosis is characterized by early puberty in men in families of both mother and father.
Congenital dysfunction of the adrenal cortex will be supported by PPS in the patient’s brothers or symptoms of virilization in his sisters.
Hypothalamic hamartoma is characterized by early onset puberty and the rapid progression of this process.

Objective examination

Actually, the fact of premature puberty is clearly visible “to the eye.” When examining the girl, the doctor will pay attention to:

an increase in the volume of the mammary glands, darkening of the areolas;
changes in physique (the girl’s figure becomes more rounded and feminine);
changes in the area of the external genitalia;
presence, frequency, duration and volume of menstruation.

Examining the boy, the specialist:

assess the size of the testicles and penis;
will clarify the presence of erections and their frequency;
will pay attention to the degree of muscle development of his patient;
will evaluate the timbre of the voice and check with the child’s parents whether the voice has become rougher.

In children of both sexes, the doctor will pay attention to the presence of rashes on the face (acne), axillary and pubic areas, will determine height and body weight indicators.

In addition, during an objective examination, symptoms of various diseases can be detected, the manifestation of which is PPS (coffee-colored spots, subcutaneous fibromas, signs of hypothyroidism, and so on).

Laboratory diagnostics

Patients with PPS may be prescribed the following laboratory diagnostic methods:

Instrumental diagnostic methods

The following methods can be used to diagnose precocious puberty:

radiography of the hands to determine bone age (high level sex hormones in the blood increases bone age);
computer or magnetic resonance imaging of the skull (allows to exclude tumors of the central nervous system);
Ultrasound of the pelvic organs (it is used to determine the degree of enlargement of the genital organs - uterus, ovaries, detect follicular cysts, tumors, adenomatous nodes);
magnetic resonance or CT scan adrenal glands and kidneys (allows us to identify tumors of these organs).

Principles of treatment

It pursues the following goals:

stop the process of development of secondary sexual characteristics;
suppress the rate of bone maturation to delay the closure of growth plates, thereby improving its prognosis.

True gonadotropin-dependent precocious puberty is treated by taking drugs from the GnRH agonist group. The most commonly used drug is diferelin, which actively binds to GnRH receptors in the pituitary gland, preventing the hormone itself from binding to them. Enter this medicine intramuscularly, once every 28 days. The dose is calculated individually, based on the body weight of the sick child.

Forms of precocious puberty that progress slowly, occurring at the age of 5-6 years in girls, usually cannot be treated.

A tumor of the hypothalamus - hypothalamic hamartoma - does not threaten the patient’s life, since, as a rule, it does not increase in size. However, it is accompanied by very unpleasant for humans neurological symptoms, including seizures, which worsen his quality of life and require treatment using radiosurgical methods and radiofrequency thermocoagulation. If PPS is the only sign of this pathology, surgery are not carried out, but GnRH analogues are used.

Gliomas of the chiasmaloptic region may be an indication for surgical and radiation treatment, but sometimes patients suffering from them are simply under dynamic observation at the doctor's. This is due to the fact that in some cases such tumors can involute on their own (undergo reverse development). Therefore, if the glioma does not manifest itself with any life-threatening or very unpleasant symptoms for the patient, it is not touched.

McCuin-Albright syndrome can be treated if it is accompanied by a prolonged increase in the level of estrogen in the blood and frequent bleeding with loss of large volumes of blood. To normalize estrogen levels, the drugs Arimidex and Faslodex are used.

For testotoxicosis, ketoconazole is used. Its leading effect is antifungal, but this drug acts by inhibiting steroidogenesis (blocks the conversion of 21-steroids into androgens, reducing the level of the latter in the blood). During treatment, some patients may develop insufficiency of adrenal and liver function. Cyproterone acetate, Arimidex and Bicalutamide, which do not affect testosterone synthesis, can also be used.

From non-drug methods treatments are extremely important healthy image life and proper nutrition. Patients should avoid external sources of testostenone and estrogen. They should also support normal weight through regular physical activity.

Since children suffering from premature puberty feel different from their peers, they often develop complexes and other psychological problems. In such cases, they are advised to consult and treat with a psychotherapist.