Pubarche is the technical term for the beginning of the changes of puberty. Most girls begin to show changes of maturation between eight and ten years old. Boys begin a little later--10 to 12 years old. Precocious puberty occurs when these changes begin earlier than normal.
Recently, new recommendations from the Lawson Wilkins Pediatric Endocrine Society redefined precocious puberty for girls. They stated that the "normal" earliest age for pubarche for white girls is seven years old and six years for black girls. The new definition wasn't universally accepted. A study questions the appropriateness of these new recommendations.
To understand why diagnosing precocious puberty is important, you need to understand why puberty occurs and what can go wrong. Puberty begins when children undergoes certain hormonal changes. Precocious puberty may be caused by potentially serious endocrine abnormalities.
In a study of 223 six to eight year old girls referred to a pediatric endocrine clinic for precocious puberty, 105 (47.1%) were found to actually have precocious puberty. The others didn't really have changes of pubarche.
Of the 105 with true precocious puberty, 26 (12%) were found to have potentially serious endocrine disorders such as adrenal gland problems, growth hormone deficiency, hypothyroidism (low thyroid function), and hyperthyroidism (overactive thyroid function). Left untreated, any of these abnormalities can be a health risk.
Under the new recommendations, none of these girls would have been referred to a specialist for tests and the diagnosis of these potentially serious medical problems would have been delayed.
The authors conclude that girls six to eight years old who show two or more signs of puberty should be referred to a pediatric endocrinologist and be examined for potentially serious endocrine problems.
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