In girls, precocious puberty is defined as beginning breast development at an age younger than 8 years old, followed 2-3 years later by starting to menstruate. In boys, precocious puberty occurs when penile and testicular enlargement begin younger than age 9, followed by muscular development, body hair, a growth spurt and deepening of the voice. Most of the time, for both girls and boys, precocious puberty is not a medical problem but simply the result of an accelerated developmental timetable. However, if the culprit is an underlying medical or health issue, it’s generally an abnormality in the pituitary gland or exposure to creams or medications that contain the hormones estrogen or androgen.
Both boys and girls can have delayed puberty. For girls, this is defined as not having started breast development by age 13. For boys, puberty is considered delayed if their testicles have not become enlarged, followed by growth of the penis and pubic hair by age 14.
Usually, delayed puberty is not a health concern, and merely the result of genetics. Usually, adolescents who are late bloomers, have one or both parents who were as well. These children eventually catch up with their peers. In some cases, however, delayed puberty is an indication of an underlying health or medical issues. In girls, that’s typically, either:
Too little body fat. This is often seen in athletic girls, especially those who are gymnasts and ballet dancers.
For boys, medical issues that can cause delayed puberty, include:
In addition to a physical examination, certain tests may be performed, such as a blood test to evaluate hormone levels. Also, an x-ray of the left hand and wrist may be ordered. Referred to as a bone age test, this imaging offers a better indication as to how far along puberty has progressed, and at what rate.