Qilu Evening News Qilu One Point Reporter Han Hongli Correspondent Wu Wei
Every child will experience a special period of growth and development--- adolescence, which is the transition period from adolescence to adulthood.
In this process, the child will have secondary sexual characteristic development, sexual organ development, accelerated physical development, psychological and behavioral changes, etc., and eventually have reproductive ability and bone maturity.
What would have happened if this process had occurred in advance?
In recent years, the incidence of precocious puberty has increased significantly, and its most direct harm is to shorten the growth time of children and affect the lifelong high. Premature development may also affect the child's mental health, with corresponding psychological problems or social behavior abnormalities such as sexual behavior, sexual assault, etc. "It is generally believed that precocious puberty can be diagnosed if a girl develops sexual characteristics before the age of 8, before the age of 9 in a boy, or when a girl develops menstruation before the age of 10." Li Ling, director of the Children's Health Care Institute of the Children's Hospital Affiliated to Shandong University, told the Qilu Evening News Qilu One Point reporter that not only that, the premature effect of sex hormones can produce some long-term effects such as the incidence of tumors such as the uterus, breast, testicles and other tumors in adulthood is higher than that of normal people. Therefore, precocious puberty must be detected early and treated early.
How to tell if a child has secondary sexual characteristics and is beginning to develop?
"The first symptom of pubertal development in girls is breast development, sometimes parents accidentally find local induration of the breast when bathing their children, and sometimes they are found because the child feels locally uncomfortable. The first manifestation of adolescent development in boys is an enlarged testicle, which is more likely to be ignored if parents do not pay attention to observation. Li Ling said.
Once children enter puberty, their pubertal development has a certain pattern.
Girls develop in the order of breast development, followed by changes in pubic hair and external genitalia, then armpit hair growth, and finally menstrual cramps.
Sexual development in boys is first manifested by an increase in testicular volume, when the testicular volume ≥ 4 ml, it marks the beginning of puberty, followed by penis growth and thickening, and then pubic hair, armpit hair growth, low voice, beard, and finally sperm.
Of course, there are obvious individual differences in the rate of sexual development.
In general, Chinese girls develop breast development at the age of 9-10, pubic hair development after about 2 years, and menarche after about 3 years. Boys develop testicles at 10-11 years of age, then pubic hair development occurs after about 2 years, and the first spermatozoa appears after about 3 and a half years.
"In the process of pubertal development, children can have accelerated growth, generally girls 9-10 years old, boys 11-12 years old growth acceleration, but there are individual differences, there are differences between different races, and it is also related to the staging of puberty development." Li Ling said.
The incidence of precocious puberty has gradually increased in recent years, what are the possible reasons?
First, the long-term acceleration trend of growth and development.
Li Ling said that in recent years, due to the role of environmental factors such as improved nutrition, superior family living conditions, and disease reduction, children's potential for growth and development can be fully expressed, resulting in an accelerated trend of growth and development, resulting in this generation of children and adolescents generally increasing their height significantly compared with the previous generation, and their sexual development and sexual maturity are ahead of schedule.
The second is the influence of environmental endocrine disruptors.
In recent years, a large number of foreign literature has reported that substances and their decomposition products emitted into the environment by detergents, pesticides and plastics industries can produce a series of environmental endocrine disruptors in nature.
Such as detergents in the alkylated phenols, additives used in the manufacture of plastic products, plasticizers (phthalates) and bisphenols, as many as more than 70 kinds. In addition, although organochlorine pesticides are rarely used at present, the amount of pesticide residues in soil, water and plants is still high in the past. In nature, the chemical structure of these endocrine disruptors is broken down to a certain extent and they are found to have estrogen-like activity. If it is absorbed by children through certain routes such as contaminated water, food or skin, or ingested by children, it can bind to estrogen receptors on the reproductive organs, causing abnormal development of the reproductive organs and bones.
Thus, environmental endocrine disruptors can be a direct cause of pseudoprecocious puberty. For children with true precocious puberty who initiate hypothalamic pituitary-gonadal axis function in advance, environmental endocrine disruptors can become an important promoter of their incidence and one of the main factors in the current significant increase in the incidence of precocious puberty in children. If subjected to such substances in the early embryo, it can also lead to disorders of sex differentiation.
The third is the intake of foods or drugs containing sex hormones.
In recent years, various "nutritional products" and "tonics" have been rushing to the market, and their applicable objects should be adults, especially middle-aged and elderly people. "However, many parents mistakenly use it as a health investment for young children for a long time." Li Ling also reminds parents here that it has been confirmed that there are more sex hormones in preparations such as royal jelly, pollen, chicken embryos, silkworm pupae, etc., and even gonadotropin-like substances. If taken in large quantities for a long time, it can cause a rise in sex hormone levels, leading to pseudoprecocious puberty.
For children with true precocious puberty who initiate hypothalamic pituitary-gonadal axis function in advance, it can also be an important promoter of their onset. In addition, in recent years, cases of pseudo-precocious puberty due to mistaken use of contraceptives have become clinically common.
The fourth is the influence of social and psychological factors.
At present, the variety of gender-related content in society has increased significantly more than in the past, and children are involuntarily affected and generally "civilized" earlier than the previous generation. Because of the rich neural connections between the cerebral cortex and the hypothalamus that governs puberty, it may cause the hypothalamus-pituitary-gonadal axis to start correspondingly earlier.
What should parents do to avoid precocious puberty?
Li Ling suggested that prevention can be started from 5 aspects:
(1) Reasonable diet, balanced nutrition, refusal of tonics, avoid excessive obesity.
(2) Do not turn on the night light to sleep: the environment with the night light will reduce the amount of melatonin secretion in the child's body, resulting in a weakening of the inhibitory effect on gonadotropins, resulting in precocious puberty.
(3) Stay away from endocrine disruptors in the environment. At present, it is widely studied including organochlorine residues in agriculture and bisphenol A and phthalates in the plastics processing industry. These substances may be present in detergents, bottles, toys, food packaging bags, plastic products incineration products, insulation materials, flame retardants, insecticides, herbicides, fungicides and the like.
(4) Cultivate the right way of behaving. Do not expose children to adult film and television works, books, etc., and do not encourage children to imitate some of adult behaviors, such as makeup.
(5) Regular physical examination. Many parents bring their children to the outpatient clinic for examination because their height is not long after puberty development, and it turns out that the child develops early and the epiphyseal line is close to closure. Therefore, outpatient routine physical examination is very important, which can detect developmental problems early and intervene early.