When puberty is a problem

Precocious puberty and other puberty problems

You may remember the post I wrote that was a very basic introduction to puberty. A couple of our readers wanted something with more in-depth information, and I admit their suggestions were very good. Thanks to both of you.

For a more detailed look at puberty, I asked pediatrician Amanda Harding, MD, for her perspective. As always, this is merely informational, so remember to seek your doctor’s advice for any concerns.

Question: What should a parent do when puberty becomes overwhelming for the child and parents?

Dr. Harding: Reach out to your pediatrician to discuss various aspects of puberty. Keeping an open conversation about the natural process of puberty is important, as well as using the correct terminology.

“Every child’s body is different and will go through changes at different rates,” says Harding. “Supporting and understanding these changes makes it easier for both parents and children.”

Q: Are there cases when a parent should seek medical advice or intervention when a child goes through puberty?

Dr. Harding: If puberty changes occur early, such as before the age of 9 in boys and 8 in girls, or if they are delayed beyond the age of 14, be sure to see your pediatrician. Anytime you have questions, even if it’s about the normal process of puberty, talk to your pediatrician. Definitely seek medical help if the emotional changes become difficult to cope with.

Q: Are there medical issues puberty may bring about? What are they? Are they common?

Dr. Harding: Precocious puberty, also known as early puberty, occurs in about 1 in 160 children, according to the American Academy of Pediatrics. Of these, 90 percent of girls and 50 percent of boys have no underlying disease as a cause for early start of puberty and go on to have a normal expected puberty course.

If the child is not progressing through the Tanner Stages as expected, there may be concern for rare hormonal issues or tumors that need to be further evaluated.

Additionally, a child may develop eating disorders or an increased use of anabolic steroids because of societal pressures about ideal appearances. It is important to recognize and address these concerns early.

Q: Are there specific concerns for boys and girls that parents need to know about?

Dr. Harding: Girls usually start puberty sooner than boys. Often girls are concerned regarding breast development because one breast bud may start before the other, and they can be concerned it’s a lump. Boys may be concerned about differences in where their testicles lay if one is higher than the other. Reassurance and an examination by pediatrician can help ease this anxiety and concern for being picked on because they are different. This emotional impact worsens due to society’s image of what we should look like, with girls often affected more than boys.

Q: Where can a parent and child go to get help or answers to questions they may have before, during and after puberty?

Dr. Harding: Parents can visit www.healthychildren.org, an evidence-based website from the American Academy of Pediatrics. However, this should never substitute for discussions with their pediatrician.


I think I’ve mentioned this before, but I am one of those over-protective parents. We always have a steady supply of bandages at our house because, as everyone knows, a bandage makes everything better. So, imagine me now that my oldest daughter is almost 9 years old. Puberty has probably already knocked on the door, let itself in and is now making itself at home.

When the hyperventilating begins, I remember one other piece of advice from Dr. Harding: “Create a great rapport with your pediatrician who can help to discuss the changes with puberty and what to expect before the changes start occurring.”

I’ll be scheduling an appointment first thing tomorrow.

Read more: What’s happening to my body?

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