Growth & Development Concept: Precocious puberty

Precocious Puberty

Early sexual development

• In assigned male at birth (AMAB) XY <9 years

• In assigned female at birth (AFAB) XX <8 years

• More common in females

95 % Idiopathic

Precocious Puberty Patho

Hypothalamus releases GnRH for Pituitary Gland to release LH and FSH stimulating sex organs to produce estrogen and testerostone

Tanner Stages of Sexual Development

1: Pre-pubertal

2: Breast bud

3: Further enlargement

4: Areola and papilla- secondary mound

5: Adult

Female Manifestations

• Chest/ Breast development

• Pubic/axillary hair

• Enlargement of vagina, uterus, and ovaries

• Acne

• Adult body odor

• Growth spurt

• Moodiness

• Onset of menses

Male Manifestations

• Testicular enlargement

• Penile enlargement

• Pubic hair

• Axillary/chest hair

• Facial hair

• Acne

• Adult body odor

• Deepening of voice

Precocius Puberty Diagnosis

• History

• Physical Exam

• GnRH stimulation test

• X-ray (detect premature epiphyseal plates closure)

• Pelvic US (ultrasound)

• MRI (detects tumor, cyst, or cranial lesions)

GnRH stimulation test

give GnRH IV and draw serial blood levels (q 2 hrs) of LH, FSH, and estrogen or testosterone – a + (positive) result is defined as pubertal or adult levels of these hormones in response

Precocious Puberty Treatment

• to improve body image and avoid fertility issues

• can be treated with surgery, radiation, or chemotherapy

• Leuprolide acetate (halt puberty by stopping production of puberty hormones)

• Medroxyprogesterone (can suppress menstruation)

Nursing Care for Precocious Puberty

Anticipatory guidance

Educating the family about physical changes

 Self-esteem issues

 Anxiety related to body image disturbances

 Impaired social interactions

 Medication administration