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Understanding Precocious Puberty Causes

This document defines and classifies precocious puberty, which is the development of secondary sexual characteristics before age 8 in girls and age 9 in boys. It notes that precocious puberty is more common in girls and often idiopathic, while boys typically have an underlying pathological cause. Precocious puberty can be true or false, depending on whether it is gonadotropin-dependent or -independent. Causes include tumors, cysts, and exogenous hormone exposure. Treatment involves addressing any underlying causes, managing psychological effects, and using GnRH analogues or sex hormone inhibitors.

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Lee Woan Chyi
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439 views13 pages

Understanding Precocious Puberty Causes

This document defines and classifies precocious puberty, which is the development of secondary sexual characteristics before age 8 in girls and age 9 in boys. It notes that precocious puberty is more common in girls and often idiopathic, while boys typically have an underlying pathological cause. Precocious puberty can be true or false, depending on whether it is gonadotropin-dependent or -independent. Causes include tumors, cysts, and exogenous hormone exposure. Treatment involves addressing any underlying causes, managing psychological effects, and using GnRH analogues or sex hormone inhibitors.

Uploaded by

Lee Woan Chyi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

PRECOCIOUS PUBERTY

DEFINITION

 Development of secondary sexual


characteristics before
 8 years old in Girl
 9 years old in Boy

• It is much commoner in girls compared to boys


(F:M ratio 5:1)
• 80% of cases are not related to pathological
causes in girls, whereas 80% have pathological
causes in boys.
CLASSIFICATION

1. TRUE Precocious Puberty (PP)


 Gonadtropin-dependent from premature
activation of hypothalamic-pituitary-gonadal
axis.

2. FALSE Precocious Puberty (pseudopuberty)


 Gonadtropin-independent from excessive sex
hormone.
CAUSES

1. TRUE PP
 Idiopathic
 Secondary to trauma, tumours, hemorrahge
,hydrocephalus, neurofibromatosis, primary
hypothyrodism (the only cause of precocious
puberty with short stature and delayed bone
age)
CAUSES

2. FALSE PP
- Adrenal: Cushing Syndrome, Congenital
Adrenal Hyperplasia, and tumors

- Gonadal : Ovarian cyst/tumor (e.g


granulosa cell). Testicular tumor (e.g Leydig
cell tumor. McCune- Albright syndrome (café
au lait spots, polyostotic fibrous dysplasia
and precocious puberty which cause by
primary ovarian cyst)
- Ectopic : Gonadotrophin secreting tumor (e.g
Hepatoblastoma , Dysgerminoma).
Exogenous hormone administration (e.g
ingestion of birth control pills)
Workout

 FSH, LH (high in True PP, low in False PP)


 Oestradiol , testosterone
 Adrenal hormones ( cortisol , 17-OH-
progesterone )
 Imaging (skull xray, MRI, pelvis ultrasound
and bone age)
Others:

 Isolate premature thelarche (isolated premature


breast enlargement ) cause by ovarian cysts ,
there is no other sign of puberty. It is non-
progressive and self limiting, investigations
usually not required.

 Pubertal Gynaechomastia is common in boys


passing through puberty, and usually coincides
with Tanner stages III and IV. It is caused by
increase in oestrogen/ androgen ratio.
 Premature Adrenache (isolated pubic hair
development): pubic hair develops before age
of 8y/o in girls and before 9y/o in boys but
with no other sign of sexual developmental.
MANAGEMENT

 Detection and treatment of any underlying


pathology e.g. intracranial tumor in males.
 Addressing psychological/behavioral
difficulties associated with early progression
through puberty.
 Treatment for
 gonadotropin-dependent disease->
gonadotropin-releasing hormone (GnRH)
analogue .
 Gonadotropin-independent -> the source of
excess sex hormone need to be identify .
Inhibitors of androgen or oestrogen production
(e.g medroxyprogesterone acetate, cyproterone
acetate, testolactone, ketocanazole) .
THANK YOU FOR YOUR ATTENTION

THE END

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