Studies indicate that breast development in girls and the appearance of pubic hair in both girls and boys are starting earlier than in previous generations. As a result, "early puberty" in children as young as 9 and 10 is no longer considered abnormal, particularly with girls. Although it is not considered as abnormal, it may be upsetting to parents and can be harmful to children who mature physically at a time when they are immature mentally. No age reliably separates normal from abnormal processes in children, but the following age thresholds for evaluation are thought to minimize the risk of missing a significant medical problem: * Breast development in boys before appearance of pubic hair or testicular enlargement * Pubic hair or genital enlargement (gonadarche) in boys with onset before 9.5 years * Pubic hair (pubarche) before 8 or breast development (thelarche) in girls with onset before 7 years * Menstruation (menarche) in girls before 10 years Medical evaluation is sometimes necessary to recognize the few children with serious conditions from the majority who have entered puberty early but are still medically normal. Early sexual development warrants evaluation because it may: * induce early bone maturation and reduce eventual adult height * indicate the presence of a tumour or other serious problem * cause the child, particularly a girl, to become an object of adult sexual interest.
Precocious puberty
Delayed puberty
Late-onset hypogonadism
Prognathism
Hypogonadism
Adipomastia
Oncofertility
Hirsutism