Puberty: Guide for Parents – Early and Late Development

developmental changes don’t always occur

developmental changes don’t always occur at the same time for all boys and girls

at the same time for all boys and girls

at the same time for all boys and girls but how do we account for early and late

but how do we account for early and late

but how do we account for early and late bloomers hi I’m Rebecca Brayton and

bloomers hi I’m Rebecca Brayton and

bloomers hi I’m Rebecca Brayton and welcome to watchmojo.com and today we’re

welcome to watchmojo.com and today we’re

welcome to watchmojo.com and today we’re speaking with dr. Preetha Krishnamoorthy

speaking with dr. Preetha Krishnamoorthy

speaking with dr. Preetha Krishnamoorthy a pediatric endocrinologist at the

a pediatric endocrinologist at the

a pediatric endocrinologist at the Montreal Children’s Hospital about

Montreal Children’s Hospital about

Montreal Children’s Hospital about hormones and how these might affect the

hormones and how these might affect the

hormones and how these might affect the speed of a child’s development what’s

speed of a child’s development what’s

speed of a child’s development what’s really going on during puberty for boys

really going on during puberty for boys

really going on during puberty for boys and girls I think there’s a lot that’s

and girls I think there’s a lot that’s

and girls I think there’s a lot that’s going on during puberty and I guess they

going on during puberty and I guess they

going on during puberty and I guess they the easiest way to think about it

the easiest way to think about it

the easiest way to think about it conceptualize it is that there’s the

conceptualize it is that there’s the

conceptualize it is that there’s the physical changes that are occurring and

physical changes that are occurring and

physical changes that are occurring and there are the psychological changes that

there are the psychological changes that

there are the psychological changes that are occurring so physically what’s

are occurring so physically what’s

are occurring so physically what’s happening during puberty is that

happening during puberty is that

happening during puberty is that hormones are activated the pituitary

hormones are activated the pituitary

hormones are activated the pituitary gland in our head is turned on and gets

gland in our head is turned on and gets

gland in our head is turned on and gets the process rolling and the hormones

the process rolling and the hormones

the process rolling and the hormones their job is to help a child reach their

their job is to help a child reach their

their job is to help a child reach their adult sexual function and fertility and

adult sexual function and fertility and

adult sexual function and fertility and all the physical changes that go on are

all the physical changes that go on are

all the physical changes that go on are help in that process so that’s the

help in that process so that’s the

help in that process so that’s the physical side of it the psychological

physical side of it the psychological

physical side of it the psychological side of it I think is a little more

side of it I think is a little more

side of it I think is a little more complicated and there’s lots of things

complicated and there’s lots of things

complicated and there’s lots of things that are going on but I think

that are going on but I think

that are going on but I think essentially that’s the stage at which a

essentially that’s the stage at which a

essentially that’s the stage at which a child of discovering who they are and

child of discovering who they are and

child of discovering who they are and and learning more about themselves by

and learning more about themselves by

and learning more about themselves by what age should boys and girls be

what age should boys and girls be

what age should boys and girls be starting puberty if a girl doesn’t start

starting puberty if a girl doesn’t start

starting puberty if a girl doesn’t start showing signs of puberty by age 13 then

showing signs of puberty by age 13 then

showing signs of puberty by age 13 then that’s that’s usually something that

that’s that’s usually something that

that’s that’s usually something that warrants medical attention and if a boy

warrants medical attention and if a boy

warrants medical attention and if a boy hasn’t shown signs of puberty by age 14

hasn’t shown signs of puberty by age 14

hasn’t shown signs of puberty by age 14 again that’s that’s that’s a little bit

again that’s that’s that’s a little bit

again that’s that’s that’s a little bit late on that same token if a girl starts

late on that same token if a girl starts

late on that same token if a girl starts puberty before age 7 then we should be

puberty before age 7 then we should be

puberty before age 7 then we should be seeing a doctor for that or if a boy

seeing a doctor for that or if a boy

seeing a doctor for that or if a boy start signs at puberty before age 9 are

start signs at puberty before age 9 are

start signs at puberty before age 9 are there any health concerns associated

there any health concerns associated

there any health concerns associated with early or delayed development I

with early or delayed development I

with early or delayed development I always like to think of it as if puberty

always like to think of it as if puberty

always like to think of it as if puberty starting early it may be a variant of

starting early it may be a variant of

starting early it may be a variant of normal and there are variants of normal

normal and there are variants of normal

normal and there are variants of normal that we look at but otherwise what we

that we look at but otherwise what we

that we look at but otherwise what we have to determine is the problem could

have to determine is the problem could

have to determine is the problem could be coming from one of two places I

be coming from one of two places I

be coming from one of two places I always say it’s either coming from up

always say it’s either coming from up

always say it’s either coming from up here so the pituitary gland in the head

here so the pituitary gland in the head

here so the pituitary gland in the head which kind of sets the ball rolling and

which kind of sets the ball rolling and

which kind of sets the ball rolling and gets things in motion so it could be a

gets things in motion so it could be a

gets things in motion so it could be a problem up there where it’s turned on

problem up there where it’s turned on

problem up there where it’s turned on too quickly or it could be a problem

too quickly or it could be a problem

too quickly or it could be a problem from down here so it could be either the

from down here so it could be either the

from down here so it could be either the ovaries and girls or the

ovaries and girls or the

ovaries and girls or the testicles and boys that have for some

testicles and boys that have for some

testicles and boys that have for some reason turned on early and there’s a

reason turned on early and there’s a

reason turned on early and there’s a whole slew of causes from both places

whole slew of causes from both places

whole slew of causes from both places that can actually make puberty start

that can actually make puberty start

that can actually make puberty start early so we have to make sure there’s no

early so we have to make sure there’s no

early so we have to make sure there’s no underlying cause now if we find no cause

underlying cause now if we find no cause

underlying cause now if we find no cause and we that’s when we call it idiopathic

and we that’s when we call it idiopathic

and we that’s when we call it idiopathic or no cause we often depending on the

or no cause we often depending on the

or no cause we often depending on the age of the child they’ll treat early

age of the child they’ll treat early

age of the child they’ll treat early puberty and the reason we do that is

puberty and the reason we do that is

puberty and the reason we do that is because if you have a five or six year

because if you have a five or six year

because if you have a five or six year old girl who’s going through major

old girl who’s going through major

old girl who’s going through major changes and a growth spurt and

changes and a growth spurt and

changes and a growth spurt and everything but we run the risk that

everything but we run the risk that

everything but we run the risk that their final adult height would actually

their final adult height would actually

their final adult height would actually be shorter so even though there may be

be shorter so even though there may be

be shorter so even though there may be six years old and look taller because

six years old and look taller because

six years old and look taller because they’re having a growth spurt the height

they’re having a growth spurt the height

they’re having a growth spurt the height at which they’re starting off is lower

at which they’re starting off is lower

at which they’re starting off is lower so they’ll have their growth spurt

so they’ll have their growth spurt

so they’ll have their growth spurt earlier and they’ll finish growing

earlier and they’ll finish growing

earlier and they’ll finish growing sooner so we may decide to treat them to

sooner so we may decide to treat them to

sooner so we may decide to treat them to preserve their final adult type to make

preserve their final adult type to make

preserve their final adult type to make sure they reach their genetic potential

sure they reach their genetic potential

sure they reach their genetic potential in terms of height and another reason we

in terms of height and another reason we

in terms of height and another reason we treat them is also psychological no it’s

treat them is also psychological no it’s

treat them is also psychological no it’s it would be imagine you know having a

it would be imagine you know having a

it would be imagine you know having a young girl in grade 2 or 3 who already

young girl in grade 2 or 3 who already

young girl in grade 2 or 3 who already has to deal with having her period

has to deal with having her period

has to deal with having her period but we don’t treat everybody we really

but we don’t treat everybody we really

but we don’t treat everybody we really look at each patient and what’s in the

look at each patient and what’s in the

look at each patient and what’s in the best interest of that patient in that

best interest of that patient in that

best interest of that patient in that same way their risk having Lakeview

same way their risk having Lakeview

same way their risk having Lakeview Bertie and once we’ve ruled out any

Bertie and once we’ve ruled out any

Bertie and once we’ve ruled out any other underlying cause we want to make

other underlying cause we want to make

other underlying cause we want to make sure they have enough hormones number

sure they have enough hormones number

sure they have enough hormones number one for the body changes that’ll make

one for the body changes that’ll make

one for the body changes that’ll make them feel like everybody else around

them feel like everybody else around

them feel like everybody else around them but also secondly because those

them but also secondly because those

them but also secondly because those hormones the sex steroids estrogen and

hormones the sex steroids estrogen and

hormones the sex steroids estrogen and girls and testosterone and boys they’re

girls and testosterone and boys they’re

girls and testosterone and boys they’re really really important for establishing

really really important for establishing

really really important for establishing bone mineral density so puberty is way

bone mineral density so puberty is way

bone mineral density so puberty is way too late then we run the risk of getting

too late then we run the risk of getting

too late then we run the risk of getting osteoporosis later on how is early or

osteoporosis later on how is early or

osteoporosis later on how is early or delayed puberty treated if they have

delayed puberty treated if they have

delayed puberty treated if they have early puberty like I said we’ll see what

early puberty like I said we’ll see what

early puberty like I said we’ll see what the cause is where’s it coming from is

the cause is where’s it coming from is

the cause is where’s it coming from is it coming from the pituitary gland is it

it coming from the pituitary gland is it

it coming from the pituitary gland is it coming from the ovaries the adrenals or

coming from the ovaries the adrenals or

coming from the ovaries the adrenals or the testicles and boys and if there’s a

the testicles and boys and if there’s a

the testicles and boys and if there’s a certain treatment depending on the cause

certain treatment depending on the cause

certain treatment depending on the cause we’ll we’ll treat it otherwise if we

we’ll we’ll treat it otherwise if we

we’ll we’ll treat it otherwise if we don’t know the cause and we think for

don’t know the cause and we think for

don’t know the cause and we think for some unknown reason the pituitary gland

some unknown reason the pituitary gland

some unknown reason the pituitary gland has turned on too early there is a

has turned on too early there is a

has turned on too early there is a treatment and it’s called loop on and

treatment and it’s called loop on and

treatment and it’s called loop on and it’s injections that are given once a

it’s injections that are given once a

it’s injections that are given once a month to slow down the process for late

month to slow down the process for late

month to slow down the process for late puberty if we have someone who’s a late

puberty if we have someone who’s a late

puberty if we have someone who’s a late bloomer and we really sometimes we have

bloomer and we really sometimes we have

bloomer and we really sometimes we have kids who are

kids who are

kids who are it’s just a variant of normal they don’t

it’s just a variant of normal they don’t

it’s just a variant of normal they don’t actually need treatment but some young

actually need treatment but some young

actually need treatment but some young men particularly will want to speed up

men particularly will want to speed up

men particularly will want to speed up the process and we can offer them

the process and we can offer them

the process and we can offer them testosterone injections but it’s

testosterone injections but it’s

testosterone injections but it’s temporary because we we don’t want to

temporary because we we don’t want to

temporary because we we don’t want to give them testosterone long term we just

give them testosterone long term we just

give them testosterone long term we just want to jumpstart the process and help

want to jumpstart the process and help

want to jumpstart the process and help things going and let mother nature take

things going and let mother nature take

things going and let mother nature take its course ideally but in late puberty

its course ideally but in late puberty

its course ideally but in late puberty if things are just a little bit late we

if things are just a little bit late we

if things are just a little bit late we often don’t treat as long as they are

often don’t treat as long as they are

often don’t treat as long as they are psychologically feeling okay with it and

psychologically feeling okay with it and

psychologically feeling okay with it and we follow them closely make sure we’ve

we follow them closely make sure we’ve

we follow them closely make sure we’ve ruled out any underlying causes like I

ruled out any underlying causes like I

ruled out any underlying causes like I said but sometimes to jumpstart the

said but sometimes to jumpstart the

said but sometimes to jumpstart the process we do have options of treatment

process we do have options of treatment

process we do have options of treatment thank you very much thank you