Puberty is a physiological phenomenon that manifests itself by physical changes in children. It usually occurs between 10 and 13 at the time of adolescence.
Statistically, 97% of girls and boys become pubescent respectively before the age of 13 and 14 years. Indeed, girls are generally faster than boys.
The first signs of puberty in girls are in breast development and acceleration of the rate of growth in stature and, in boys, the increase in testicular volume (and later of the penis). Puberty makes possible procreation.
Entering puberty is also marked by the appearance of secondary sexual characteristics:
- pubic and axillary hair, hormonal surge, menarche in girls.
- hair wider (facial and body), change in tone of voice, pushing hormonal onset of the Adam's apple (larynx turns) in boys.
Sometimes, in some children these secondary sexual characteristics do not occur. This is called delayed puberty but only after 14 years in boys (no testicular development) and after 13 years in girls (breast development does not occur).
Delayed puberty occurs more frequently in boys and often results in a slower rate of growth. While this delay is more easily tolerated by the girls, it remains a source of significant social and psychological disturbances.
Multiple causes in delayed puberty can be advanced. Anorexia may be one reason as intestinal malabsorption. It can also be a disease (chronic, genetic) awkward puberty.
Family history may be involved in this delayed puberty: the first rules of the mother appeared late or father grew and late puberty. It may be that puberty takes place quite normally but simply out of step with the average. This delay can also êtrela result of intensive sport (commonly seen in gymnasts or dancers).
A series of examinations should be performed to exclude one or the other because a detailed history, physical examination with measurement of weight, size, determination of bone age, cardiac and pulmonary auscultation, taking a blood pressure, ... These examinations will be compared with the Tanner classification distinguishes different stages of pubertal development sides from 1 (prepubescent stage) to 5 (adult stage).
This diagnostic procedure will of course take into account the psychological, emotional, family and society.
The treatment will in turn depending on the etiology and will aim to alleviate the psychological difficulties of preteens. In cases where organic disease is excluded, we will initiate and / or accelerate the growth rate but also the appearance of secondary sexual characteristics by the administration for a limited period (3-6 months) low doses of sex steroids ( testosterone for boys, estrogen and estrogen + progestin for girls).