Download The first sign of puberty

GROWTH AND PUBERTY
Puberty - Females
Breast development:
First sign occurs at 8.5-12.5 years. Pubic hair growth and a rapid
height spurt. Menarche – occurs on average 2.5 years after the start of
puberty.
Female breast (STAGES):
 (1) Pre-pubertal
 (2) Breast bud
 (3) Juvenile smooth contour
 (4) Areola and papilla project above breast
 (5) Adult
Puberty - Males
The first sign of puberty:
 Pubic hair growth
 Testicular enlargement to 4ml
o (Measured using an Orchidometer)
 Testicular volume grows to 12-15ml
 Height spurt occurs between 10 and 14 years of age
Pubic Hair (STAGES) – Female/Male
 Pre-adolescent no sexual hair
 Sparse, pigmented, long, straight, mainly along labia or at base
of penis
 Dark, coarser, culier
 Filling out towards adult distribution
 Adult in quantity and type with spread to medial thighs in male
Development of:
 Acne
 Axillary hair
 Body odor
 Mood changes
Age Determination:
 X ray of wrist and hand
Short Stature
Height = below the second centile
Etiology:
 Hypothyroidism
 Growth hormone deficiency
 Corticosteroids excess,
 Cushing syndrome
 Chronic illness:
o Crohn disease
o Chronic renal failure
 Chromosomal disorder:
o Down syndrome
o Turner syndrome
o Noonan syndrome
o Russell-Silver syndrome
Tall Stature
Etiology:
 Familial obesity
 True gigantism
 Marfan syndrome
 Klinefelter syndrome
 Sotos syndrome
Precocious Puberty
Definition:
 Development of secondary sexual characteristics before 8
years (female)/9 years (male)
 Accompanied by a growth spurt
 Premature breast development (thelarche)
 Premature pubic hair development (pubarche)
Categorization: (according to FSH and LH levels)
 Gonadotropin-dependent: Central, (True PP)
 Gonadotropin-independent: Pseudo, (False PP)
Central Precocious Puberty - Etiology
 Idiopathic/Familial CNS abnormalities
 Hydrocephalus
 Post-irradiation
 Infection
 Tumors
Pseudo Precocious Puberty - Etiology
 Adrenal disorders
 Tumors
 Congenital Adrenal Hyperplasia
 Ovarian tumor
 Testicular tumor
Delayed Puberty
Definition:
Absence of pubertal development by 14 years (male) / 15 years
(female)
Etiology:
 Constitutional delay of growth and puberty
 Hypogonadotropic hypogonadism
 Hypergonadotropic hypogonadism
 Cystic Fibrosis
 Severe asthma
 Crohn disease
 Anorexia nervosa
 Intracranial tumours
 Kallmann syndrome
 Klinefelter syndrome
 Turner syndrome