Bilatzailea
The puberty clock
Puberty is the beginning of physical, psychic and hormonal changes to achieve reproductive potential: the implementation of a clock that controls the journey from childhood to adulthood.
Many young people in puberty pass through Elizabeth Blarduni’s office every day. She believes it is important for parents to respond confidently and naturally to changes that children notice.
ELIZABETH BLARDUNI; Hospital of Zumarraga: In the face of any physical change, parents tend to think that menstruation is present, but it is not. the first changes in girls can begin at the age of 8, and the first change that is noticed is the teat lump: a small beginning of the change in the structure of the breast. In boys, the volume of the testicles increases. And that sets the mechanism in motion. But from there it can take two to six years to have full puberty and menstruation in girls. I mean, there's a very wide margin.
There are many reasons why puberty occurs sooner or later. Genetic factors, for example, are very important because there are genes that determine when the pubertal clock will start. Boys, for example, tend to resemble their father at the beginning of pubertal changes. And the girls belong to their mother.
ELIZABETH BLARDUNI; Hospital of Zumarraga: Daughters may be very similar to mothers at the beginning of their first menstrual period, and by the same mechanisms, they may end their last menstrual period on a similar date. However, there are some standard averages: The average first menstrual period in European women is about twelve and a half years, and the average menopause or last menstrual period is about 51 years. But that's the average, I mean, there are big differences.
But in addition to genetics, there seem to be more factors that cause puberty to start sooner or later. For example, in countries with warmer and brighter climates, puberty begins earlier than in other countries. The most notable cases are the countries around the equator, where they have the most hours of sunshine and the warmest temperatures.
Some doctors and researchers believe that a tendency to anticipate puberty is lately observed due to external factors, although there are no clear results in this regard.
For example, environmental chemical pollution in Europe and the United States may play a role in this: some studies suggest that chemicals with estrogen-like effects may be responsible for slowly advancing the onset of puberty.
Another factor could be nutrition and, more specifically, obesity. In fact, weight gain appears to trigger the clock and trigger the hormonal mechanism that triggers physical changes.
For this reason, girls with obesity may reach physiological maturity three years earlier than girls with normal weight, according to data from the Obesity Research Association, which indicates that overweight can significantly advance menstruation in girls. In fact, previously it was thought that fat was merely a reserve, but now it has been discovered that it is an endocrine organ that produces certain hormones.
That’s why it can happen that premature babies start puberty earlier.
ELIZABETH BLARDUNI; Hospital of Zumarraga: It may happen that premature babies gain weight quickly at first, meaning that weight gain is too fast, which seems to affect the early onset of puberty.
A similar effect occurs with children adopted from developing countries: when the original quality of life and the condition of the environment is not good, or there is a previous malnutrition, and when changing for the better, weight gain triggers early puberty.
The opposite can also happen: poor nutrition can lead to a delay in puberty.
ELIZABETH BLARDUNI; Hospital of Zumarraga: In anorexia, girls with eating disorders stop menstruating or do not menstruate unless, of course, they gain weight. The clock to start puberty requires a certain weight, and these girls don't get it. It is similar to what happens with elite athletes: due to the demand for a very low weight, these girls for years are without menstruation, they do not have the onset of menstruation.
Precocious puberty is defined as puberty that begins in girls before 8 years of age and begins in boys before 9 years of age. In these cases, experts recommend going to a child endocrinologist to identify the mechanism that has accelerated puberty in these people. In fact, in addition to the above-mentioned external causes, physical, hormonal or sickness reasons may prevent this person from growing properly and reaching the corresponding height.
ELIZABETH BLARDUNI; Hospital of Zumarraga: Then there is a group of girls - mostly girls - who start puberty between the ages of 8 and 9. They are early in the onset of puberty, but in addition, the development of this puberty is usually rapid. They're going fast. So, puberty catches up with the fact that these girls are still psychologically very young and are not prepared for this change. In this case, medication is used to stop the development, but not to stop the growth. In other words, they grow up the same and, in the meantime, the girls reach psychological maturity to cope with the change.
The treatment consists of injections every three months to stop the production of estrogen-producing hormones. This is how the development of puberty is stopped. It is a treatment that has been applied for more than 30 years and, according to studies carried out, it does not appear that long-term negative effects appear in patients.
ELIZABETH BLARDUNI; Hospital of Zumarraga: Examination of the girls several years after the end of the treatment - they were examined at 18, 20 and 22 years of age - showed that they had an adequate hormonal function. They were also subjected to bone densitometry to measure the amount of calcium in the bone. The results were completely normal. I mean, their reproductive function and all their biological function was fine.
According to a study at the Riget Hospital in Denmark, the average age of the first menstrual period in the last 15-20 years has progressed by about three months. But as for the reasons, experts believe that there is still much to investigate: puberty involves many unknown issues, and the many factors involved make it very difficult to obtain definitive and conclusive data.
Buletina
Bidali zure helbide elektronikoa eta jaso asteroko buletina zure sarrera-ontzian
