Diagnosis of Early Puberty
The diagnosis of early puberty involves evaluating physical signs, hormone levels, and growth patterns to determine whether a child is developing too soon. Doctors begin by gathering a detailed medical history, noting when symptoms first appeared and how quickly they’ve progressed. In most cases, a physical examination provides the first clues that early puberty may be occurring.
A child’s growth chart is an essential part of the evaluation. Children going through early puberty often show a sudden acceleration in height or development. The doctor will assess secondary sexual characteristics—such as breast growth in girls or testicular enlargement in boys—and compare them against age-based norms.
Blood tests are usually ordered to check hormone levels, including luteinising hormone (LH), follicle-stimulating hormone (FSH), oestrogen (in girls), or testosterone (in boys). These results help determine whether puberty has begun due to early activation of the brain’s hormonal control system.
In cases of suspected central precocious puberty, a GnRH stimulation test may be performed. This test measures how the body responds to a hormone that triggers puberty. If the body reacts as it would in normal puberty, it confirms that puberty has started prematurely due to central activation.
Doctors may also use imaging to rule out other causes. An MRI of the brain is often done to check for tumours, abnormalities, or lesions affecting the hypothalamus or pituitary gland. A pelvic ultrasound may be used in girls to assess the size of the uterus and ovaries. For boys, testicular ultrasound may help exclude cysts or hormone-producing growths.
Bone age X-rays are another common tool. By comparing a child’s hand and wrist bones to those of other children the same age, doctors can see whether the skeleton is maturing too quickly—an important marker of early puberty.
Diagnosis of Early Puberty
In South Africa, accessing all these diagnostic tools may not be possible in under-resourced public clinics or rural hospitals. Many children are diagnosed based on physical signs and referred to paediatric specialists at urban hospitals for further testing. Delays in referral or limited awareness among frontline healthcare workers can lead to missed or late diagnoses.
Psychological assessment may also be included, particularly if the child is struggling emotionally or socially. Early puberty often has a strong impact on self-esteem, behaviour, and relationships with peers.
Accurate diagnosis of early puberty ensures children receive appropriate monitoring, emotional support, and treatment if needed. It also helps families understand what is happening and plan how to support their child through these unexpected changes.
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