PRECOCIOUS PUBERTY

DEFINITION: -

The term precocious puberty is reserved for girls who exhibit any secondary sex characteristics before the age of 8 or menstruate before the age of 10.

Precocious puberty may be isosexual where the features are due to excess production of estrogen. It may be heterosexual where features are due to excess production of androgens (from ovarian and adrenal neoplasm).

TYPES OR CAUSES: -

• Juvenile primary hypothyroidism
• Intracranial lesions: trauma, tumour, or infection.
• Granulosa cell tumour
• Theca Cell tumour
• Leydig cell tumor

ETIOPATHOLOGY: -

Constitutional: - It is due to premature activation of hypothalamo - pituitary ovarian axis. There is secretion of gonado tropins and gonadal steroids due to premature release of GnRH. Bone maturation is accelerated, leading to premature closure of the epiphysis and curtailed stature. If menstruation occurs, they may be ovulatory. The changes in puberty progress in an orderly sequence.

INTRACRANIAL LESIONS: -

Meningitis, encephalitis, craniopharyngioma, neurofibroma or any tumor—hypothalamic or pineal gland.

Mccune-albright syndrome is characterized by sexual precocity, multiple cystic bone lesions (polyostotic fibrous dysplasia), endocrinopathies and café-au-lait spots on the skin. Sexual precocity is due to early and excessive estrogen production from the ovaries. FSH, LH levels are low. There may be associated hyperthyroidism, hyperparathyroidism, and acromegaly.

Premature thelarche:- It is the isolated development of breast tissue before the age of 8 and commonly between 2 and 4 years of age. Either one or both the breasts may be enlarged.There is no other feature of precocious puberty. It generally requires no treatment.

Premature pubarche:- Premature pubarche is isolated development of axillary and or pubic hair prior to the age of 8 without other signs of precocious puberty. The premature hair growth may be due to unusual sensitivity of endorgans to the usual low level of hormones in the blood during childhood. Rarely, there may be signs of excess androgen production due to adrenal hyperplasia or tumor or androgenic ovarian tumor (Leydig cell tumor, androblastoma, etc.).

Premature menarche :- Premature menarche is an isolated event of cyclic vaginal bleeding without any other signs of secondary sexual development. The cause remains unclear but may be related to unusual endocrine sensitivity of the endometrium to the low level of estrogens.

Chorionic epithelioma, hepatoblastoma are the ectopic sources of human chorionic gonadotropin and may cause sexual precocity.

ROLE OF HOMOEOPATHIC MEDICINES IN MANAGING PRECOCIOUS PUBERTY: -

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach.

There are following remedies which are helpful in management of Central PRECOCIOUS puberty: -

• Antim crud
• Calcarea carb
• Calcarea phos
• Causticum
• Chamomilla
• Phosphorus
• Pulsatilla
• Sabina
• Silicea
• Carbo Veg etc.