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Dr. Patrick Nesbitt M.D. Family Physician, Vancouver B.C. ..................................Medicine and Fun .........drpat@ live . ca ................NOW BOOKING PATIENTS AT CAULFEILD 604 922 1544

Puberty is coming prematurely...

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Oct. 20, 2012 -- American boys are starting puberty up to two years earlier than decades ago, new data show.

Boys are entering puberty at an average age of 10 among whites and Hispanics, and at an average age of 9 among African-Americans. About a third of boys start to mature sexually up to two years earlier than average.

The findings come from a study of 4,131 boys examined at doctors' offices across the U.S. by Marcia Herman-Giddens, DrPH, and colleagues. The same team found a year-earlier shift in first puberty for girls.

"Contrary to what has been the popular belief of medical professionals as well as parents, boys are changing earlier, just as girls do," says Herman-Giddens, adjunct professor of public health at the University of North Carolina at Chapel Hill.

While earlier sexual maturity now is common, Herman-Giddens does not think it is necessarily healthy.

"Earlier puberty is a very important public health indicator. It is like the canary in the coal mine," she says. "Now the age of first puberty is getting lower and we have to ask why. And it is obviously important, for medical as well as social and psychological reasons, for parents and providers to know what is going on."

It's not clear why there's been a shift toward earlier puberty. The new study does not provide answers to this question.

"I suspect this is a combination of environmental factors: things like overweight, junk food, too much computer and screen time," Herman-Giddens suggests. "I want there to be questions about whether this is healthy and why this is happening."

First Signs of PubertyHerman-Giddens and colleagues looked for two signs that boys had begun puberty: sparse pubic hair growth and an increase in the size of the testicles to 4 millimeters (at full sexual maturity, the testicles measure 25 millimeters).

Individual boys (and girls) vary widely in the time it takes them to develop from the earliest stage of puberty to full sexual maturity. Herman-Giddens says that while some boys fully mature in as little as two and a half years, others may take as long as six years. Those who start puberty soonest aren't always the first to finish.

In the Herman-Giddens study, the average age of full sexual maturity for boys of all races and ethnicities was about the same -- late in the 15th year. About a third of these boys reached full maturity two years sooner. But those who started earliest were not always the first to fully mature.

Parents, Boys, and PubertyOnce puberty starts, a boy will begin to change.

"Most parents think this puberty onset will happen at age 12 or 13. But for white boys, it's 10 years old -- this is fifth grade," Herman-Giddens says. "Now they are having to grapple with changes in their body and soon-to-develop sexual feelings at a younger age. And they are not at all ready to deal with this."


You need to talk to your kids early 

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Julia A. Graber, PhD, associate chair of psychology at the University of Florida, is one of the few researchers to study puberty in boys. She says early puberty can be both good and bad for a boy's social and psychological adjustment.

On the positive side, boys become taller and stronger as they mature sexually. They are more athletic and look more masculine.

"But as boys look older at younger ages, they may get into situations more appropriate for older individuals," Graber says. "And at a chronological age where they are not prepared for that, where they don't have the psychological skills, they may be at increased risk."

In girls, puberty onset is obvious: Their breasts begin to develop, and later they begin to menstruate. In boys, more subtle signs, such as sparse pubic hair and a slight increase in testicle size, are easy to miss -- for parents and for the boys themselves.

Yet with normal puberty come changes in behavior. As boys enter puberty sooner than their parents expect, Graber says, their behavior is "out of synch with what parents, teachers, and other adults think they need to prepare for." These grownups may see a boy's normal behavior as problematic.

"We need to help parents understand this is happening earlier, and that they should be talking to their kids earlier than they had planned to," Graber says. "If parents look at WebMD articles and think, 'Oh my gosh, my kid may be experiencing these things,' then they can think of things they may need to do to help their kid deal with it. Things like nocturnal emissions or masturbation. Arousal increases as these hormones increase, and that can be confusing if kids are not mentally prepared for the notion of sexuality."


​Dr. Patrick  Nesbitt, Vancouver, Canada ....www.drpat.ca ........ drpat@live.ca