Talk:Precocious puberty/Archive 1

Archive 1

Archive 2

Genetics?

Isn't this sort of thing genetic in some cases? I know precocious puberty (menstruation at around 8 or 9) runs in my family, without sedentary lifestyles, environmental causes or childhood obesity.

It can certainly be familial. An expanded version of this article should include some of the familial forms. alteripse 23:42, 12 August 2006 (UTC)

Dr Gangino

Thanks for your additions, but the citation is incomplete-- no journal info, and the info is simply wrong. GnRH is not available in the US and is not essential in the evaluation of precocity. Dependence on gonadotropins is one of several ways to categorize precocity. The indications for treatment of central precocity are to preserve height or to prevent/alleviate intolerable psychosocial problems arising from the early puberty. Psychologists are not needed for the care of simple precocity unless there are unusual psychological problems. Sorry, just too many errors. Please propose changes on talk page and learn to do citations correctly. alteripse 17:22, 21 November 2006 (UTC)

Alteripse, thanks for your corrections, but ...

>>>no journal info, and the info is simply wrong.

• agree, that citiations aren't correct, but cann't agree with you, that "info is simply wrong"

>>Also, since some of the info isnt correct, perhaps you could offer it on the talk pages first to avoid reversion.

• Check it, please
• There are many causes of precocious sexual development and these are probably best categorised into those that are gonadotrophin dependent and independent. Such a classification helps both in understanding the aetiology the condition, and also in deciding the treatment options.

Health.am Gyneco

• In the diagnosis of disorders of premature sexual maturation, there are two investigative procedures of significance, which are simple and relatively easy to interpret: the GnRH test and pelvic ultrasound assessment.

Pelvic ultrasound is a non-invasive technique which gives two important pieces of information. The uterine volume (and the endometrial thickness) is a measure of oestrogen secretion. The ovarian morphology can be used as an index of gonadotrophin secretion. The initial hormonal events of normal puberty are predominantly LH, rather than FSH, dependent.

Source: Health.am complete partial. Thank you, Dr Gangino.

To address your points more fully:

1. Gonadotropin dependent or independent is one of several categorizations (e.g., pathologic vs physiologic) but I probably would not have objected to that assertion if it not been accompanied by clearer errors and the messed-up citations.
2. In diagnosing precocious puberty the most valuable tests are certainly not the GnRH and pelvic ultrasound. GnRH is not even available in the US and we only do pelvic ultrasounds when other evidence suggests the probability of pelvic pathology. If I had to choose the two essential tests for most cases it would be ultrasensitive gonadotropins and a bone age x-ray, but many other tests may be important depending on the clinical context (e.g., MRI of head, adrenal steroids, testosterone). My objection was to the idea that those 2 tests are more important, more essential, or more routinely done than many others, which is simply not true. If you simply want to mention GnRH or pelvic ultrasound as useful, or routinely done in some areas, I would not object. alteripse 03:27, 27 November 2006 (UTC)

Incorrect word?

should the sentance in this article, "Early pubic hair, breast, or genital development may result from normal but early maturation or from several abnormal conditions." read insted, "Early pubic hair, breast, or genital development may result from normal but early menstruation or from several abnormal conditions."

I am unsure as to wether this is an error or a word I am not aware of. Skellious (not signed in) 19:09, 25 November 2006 (UTC)

Your version makes no sense. What word is unfamiliar? The sentence is correct and concise but if it is misleading or assumes too much from our readers we could change it. Is this clearer? "In most children, early pubic hair, breast development, or penile enlargement results from normal but early maturation. In a few, these changes may reflect diseases or abnormal hormone exposures or processes." alteripse 21:18, 25 November 2006 (UTC)

References

Refs are completely messed up in this article. I'm going to try to fix them over the next day or so. All the Pubmed stuff needs linkage and proper journal cites - Alison^✍ 19:36, 27 February 2007 (UTC)

New research

New research was just published about obesity and puberty. The study found that obesity at age 3-5 predicted early puberty, even controlling for other factors. I will add this info as soon as I have the time. Drzuckerman

Is it this? Lee J, Appugliese D, Kaciroti N, Corwyn R, Bradley R, Lumeng J (2007). "Weight status in young girls and the onset of puberty". Pediatrics. 119 (3): e624-30. PMID 17332182.{{cite journal}}: CS1 maint: multiple names: authors list (link) --Arcadian 02:19, 11 March 2007 (UTC)

Pimples

I've get zits since I was eight(8). --151.200.159.202 20:34, 19 March 2007 (UTC)

User:Dancimamma

Welcome to wikipedia. I don't mean this to be unfriendly as your intentions are clearly to improve the article, but most of your additions are wrong (e.g., that there is a high rate of organic disease in cpp), unrelated to the article (hypopituitarism after brain trauma), put in the wrong section (environmental chemical exposures), or ungrammatical or fragmentary sentences (most). Your reference format is incompatible with the others in the article. How about if we start over? Can you add your statements here and we can shape and correct them first, one at a time? Thanks. alteripse 13:22, 26 March 2007 (UTC)

Risk of alcohol & drug use?

"(Early puberty) is no longer considered abnormal, although it may be upsetting to parents and can increase the risk of alcohol and drug use as well as other social problems." I'm wondering about this statement - is there evidence for this? Does early puberty increase an individual's predisposition to become addicted, or (probably more likely) has it been linked with social problems, which can lead to alcohol/drug use? Can the link between the two be clarified? Rockdozen 03:07, 3 April 2007 (UTC)

It is a statistical link and the nature of the connection is not clear, nor is it overwhelmingly strong. Search medline under precocious puberty and alcohol and add some references to this if you are so inclined. This is a reference for girls showing that early menarche is assoc with a slightly less than twofold higher risk of later depression and substance abuse. PMID 11552757 Authors Stice E. Presnell K. Bearman SK. Title Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls. Source Developmental Psychology. 37(5):608-19, 2001 Sep. alteripse 10:29, 3 April 2007 (UTC)

"May" problem: Pedophilia or adult sexual interest

Early sexual development deserves evaluation because it may: 3. cause the child to become an object of pedophilia I suggest this part be taken down. First off, does it have a source? Secondly, despite a source, I don't think this statement makes any sense. Firstly, because pedophilia, a sexual preference for prepubertal features, would not be stimulated by someone who has pubertal features. If anything, I would think it would be dissuading. I would think it more likely to attract attention from people with ephebophilia/hebephilia considering that they respond to pubertal features.

Besides this complaint, in general #3 just seems to be very badly worded. Like, the phrase 'object of X' seems very out of place. We don't say gold is 'an object of kleptomania'. Furthermore, having physical features does not make you an object of something. Rather, it is a person mentally objectifying someone that makes them an object of that something that person's got. It is hardly the cause of any preference someone else may have, but rather, that person's preference causes that person to be attracted. It is independant of the process. It needs to be reworded to be less indicative than it currently is. Something along the lines of "cause the child to be more sexually attractive to some older people, some of whom may molest them in some way". I do not feel comfortable deleting this entry myself due to concerns of being accused of being a vandal or something, so I request someone else change it to what they feel is appropriate. I can understand wanting to directly quote a source, but sometimes sources are wrong and inaccurate statements need to be deleted or altered to remain accurate. Tyciol (talk) 08:24, 20 July 2008 (UTC)

I think the wording should reflect the more general problem of early initiation of sexual activity, with another child or with an adult. Either situation would be distressing to the parents of the child. Also, due to early increase of libido the precocious child might be the initiator, not just the object. I think a phrase like "cause early initiation of sexual activity" covers all the bases neutrally and economically. Laughingyet (talk) 09:54, 3 August 2008 (UTC)

I agree with all of you. Apart from the wording, this is has nothing to do with being clinically significant. Since this statement was supposed to be an example for exactly that, it should be taken down. The source itself is highly opinionated. Apart from the fact that the cited doctor is clearly biased by stating that he doesn't support sex education, he's also no expert on psychology which is the the trigger for considering a child before or during puberty attractive. Even if this was a clinical issue it should be proven before these claims are made. I removed the sentence since it rather lowers wikipedia's standards by supporting an unproven opinion instead of just sticking to hard facts. Also, no one seems to see how illogical this statement is in relation to the article itself. It says "Early sexual development deserves evaluation because it may...". This implies that treatment is necessary to lessen or cure the listed problems. However, pedophile motivations of unidentified pedophiles can hardly be treated by seeing a doctor about precocious puberty. And what about girls who undergo puberty at normal ages, for example at 12? No one suggests to go to a doctor with them, even though they could be just as well a sexual object for a pedophile. All in all this was a very poor addition to the article. I traced it back to a guy named Jmak, a retired radiologist if you can trust his user page. Apparently, one of the admins, Alteripse, reverted my edit without even giving an explanation. Congratulations on the great discourse Alteripse. As an admin, you should be encouraged to remove claims, assumptions and opinions and not re-insert them, especially not without explanation. Since I'm not the only one who feels negatively about this line, you should explain your actions and expose them to public discussion, unless you feel the need to push your own agenda here. After checking your revert actions for this article I find it highly suspicious that you revert seemingly valid data while backing up wild speculations as long as they seem to come from people who are somewhat related to the medical sector. I have a hard time seeing how a poor statement by a retired radiologist, who is neither an expert on sexual behaviour, psychology, or precocious puberty is defended by you despite the lack of valid sources.--92.78.82.35 (talk) 00:33, 13 December 2009 (UTC)

You have a point (partially). I reverted without reading the reference. I also agree that pedophilia references are unnecessary here. The article was on my watch list because i had provided the bare bones several years ago and never got around to finishing it right; it just seems to attract dumb insertions by people who didn't know much about the topic. and perhaps the whole topic should simply be omitted until someone wants to do it right. If you want to acquire the background to do so, the best recent review of the psychosocial issues that provides references to most of the published research is Dorn LD, Psychological and social problems in children with premature adrenarche and precocious puberty, chapter 14 in Pescovitz OH and Walvoord EC, eds. When Puberty is Precocious: Scientific and Clinical Aspects (Totowa NJ: Humana Press 2007). However, I would remind you that had you explained your concerns on the talk page first I would have responded to your rather than reverting. And had you actually looked through the talk page above you would have seen that your accusation that i treat misinformation by medical people differently than non medical is not true. alteripse (talk) 03:55, 13 December 2009 (UTC)

The recent formatting of that entry mentions nothing of pedophilia; it simply mentions that precocious puberty may cause the child, particularly a girl, to become the object of adult sexual interest; this was backed up by a source, and is now backed up by more sources (thanks to my expansion of that section). I also point out that pedophilia should not be confused with child sexual abuse, though they do often overlap. As the Pedophilia and Child sexual abuse articles note, not all people who have sexually abused prepubescent children are pedophiles. The IP has made some valid points, but has also made some invalid ones; for example, a true pedophile, as Tyciol pointed out, would not be sexually interested in clearly pubescent people. Pedophilia is about the sexual preference for prepubescent children. Unless the pubescent 12-year-old girl looks prepubescent, the pedophile is not truly sexually interested in her.

Just a few minutes ago, I retitled the Clinical significance section to Clinical and social significance, and reverted that statement the IP removed (which, as I mentioned above, is now backed up by more sources). Now that statement fits perfectly there. I additionally expanded that section with more information about the devastating effects early puberty may have on girls, and with some information about the negative effects it may have on boys. Flyer22 (talk) 02:33, 16 December 2009 (UTC)

Things that can initiate this

"Early puberty may be a variation of normal development, or may be a result of a disease or abnormal hormone exposure." I am curious, I read an article in I think 'LiveScience' once that reported girls who spend childhood in proximity to nonrelated males (not brother/father) sometimes experience this. Would this be classed under 'abnormal hormone exposure' or could it rather be a variation of normal development which occurs through some other kind of cause? Is it possible that the brain's recognition of unrelated males (presumably through scent or visual cues) somehow initiate a natural hormonal process? I guess that actually could be called abnormal hormones but I'm not sure if 'exposure' would correctly describe it. Tyciol (talk) 08:24, 20 July 2008 (UTC)

Breast development in boys?

Under "Diagnostic criteria" it says, "Breast development in boys before appearance of pubic hair and testicular enlargement." Boys don't normally develop breasts at all unless they have gynecomastia, right? Should this read "Penile development"? Or something else altogether? —Angr 14:40, 19 December 2008 (UTC)

The word "breasts" does not only pertain to females. By "breast development," they likely mean chest development. The male chest does change during puberty, as we know. Flyer22 (talk) 02:55, 17 January 2010 (UTC)

No. Breasts means breasts. Many boys get breast development as a normal part of puberty; we call it pubertal gynecomastia but very few have any disease. On the other hand, when breast development precedes other signs of puberty, the chance of an abnormal condition is considerably higher and a diagnostic workup is warranted. alteripse (talk) 15:33, 17 January 2010 (UTC)

If your response was also to me, I said the word "breasts" does not only pertain to females. Yes, breasts means breasts. Men also have breasts, which is why breast cancer does not only pertain to women; it is just that men's breasts are not developed to the same extent as women's breasts are. And most people do not state "breasts" in relation to human males. They state "chest." This is why I said whoever wrote that entry likely meant "chest development," whether the editor wrote it up himself or herself or it was copy and pasted. Many boys get breast development as a normal part of puberty? Why not say all boys do, unless you were speaking of woman-like breast development or also taking into consideration boys whose physical growth has been seriously stunted. The current line in the article shows breast development in boys as normal, as worded this way: "Breast development in boys before appearance of pubic hair and testicular enlargement." Flyer22 (talk) 00:39, 19 January 2010 (UTC)

Breasts are breasts. Chest, unless one is speaking in 1950s euphemisms, means thorax, especially the ribs, the attached muscles, and the heart and lungs inside. While the thoracic skeletons and chest muscles of young men and women are different by the end of puberty, they are not distinctively different in the early stages of puberty and are irrelevant to diagnostic guidelines for what is precocious or what warrants a medical evaluation. And I can assure you for the best reason you can possibly imagine that "the person who wrote that entry" did not mean chest-- he meant what he wrote. Not all pubertal boys get breast development (statistical surveys typically report 40%-60%), but for nearly all boys who get it, it occurs after other signs of puberty have occurred, not before. In other words, breast development can be a normal part of male puberty, but it is so rarely the first sign that it deserves a medical evaluation if it occurs first. I wouldn't dream of disputing your mastery of daytime TV shows but this is clearly not your area of expertise. alteripse (talk) 04:43, 19 January 2010 (UTC)

Are you not familiar with words that are used interchangeably or colloquially? I suspect not, since you say "[c]hest, unless one is speaking in 1950s euphemisms, means thorax, especially the ribs, the attached muscles, and the heart and lungs inside." Wrong! People, including medical experts, use the words "chest" and "breasts" interchangeably, especially in regards to women. I have various medical journals which do so. And, again, men also have breasts. When men get breast cancer, it is called breast cancer, not chest cancer. Can you correctly conclude why this is? Could it be because men also have breasts? Yep. Does the Breast article also make clear that men have breasts? Yep. Can I gather sources which say that men also have breasts? Yes...such as this one (though it says "breast tissue"). Would you rather I say "breast tissue"? No, wait, I do not really care what you prefer. As for "disputing [my] mastery of daytime TV shows" (though I really only have "mastery" of two, and rather their characters), no, you cannot. Just as you cannot dispute my mastery of medical, sexual and scientific topics. But I appreciate you reading my user page. It is an honor, really. But you must have missed my other fields of expertise. Out of the two of us, I am the one taking care of articles such as Pedophilia, Rape, Sexual intercourse, Adolescence, etc. The Puberty article was locked from IPs for a year thanks to me; it was facing severe vandalism before that. Where were you to keep that from happening, since it is one of the articles you have largely contributed to? And you could have done more with the Precocious puberty article. It has only now gotten its needed expansion, upon my edits. And it definitely needs more; reliable references on this topic are not difficult to find. Your talk page shows that you have edited various medical topics, and yet all I have seen you do is add back unsourced information, to the Puberty article, and then bitch about it when a citation is requested (because that is how Wikipedia works).

You can continue to act like an expert on things that I am quite sure I have more knowledge (than you) on, but you have shown me nothing to believe you are one. You don't even show sources when you debate. My record on the other hand? Is all throughout Wikipedia, and can be backed up by various editors. My expertise and active editing on popular culture topics does not take away from my expertise in other fields. And I would not pretend to be experienced in a field if I was not. I do not have time for your rude and condescending behavior. If you are going to continue to be WP:UNCIVIL and inject your need to prove "your superiority," refrain from speaking to me. You may also want to read up on Wikipedia policies and guidelines, especially sourcing. Flyer22 (talk) 10:42, 19 January 2010 (UTC)

Among the things of which your knowledge is apparently imperfect is the history and policies of Wikipedia. In first years after the earth cooled and the hands of Sanger and Wales moved upon the face of the internet and created Wikipedia, it was without much form, lacking something called content. Many editors labored many unpaid, unthanked hours to contribute this content, the basic ur-substance of an encyclopedia, mainly for the satisfaction of seeing better information where it had been poor or absent. Citations are nice but content precedes citations. Most of the lengthy high-quality articles here were initially written with few citations. Citations became increasingly asked for to settle arguments about contentious topics. They are also appreciated pointers to more information, and as corroboration for surprising information. However, sentence-by-sentence citation has never been either customary or required in order to write articles, especially about non-controversial topics. As wikipedia has matured and the quality of articles has improved the desirability of citations, and the demand for them, has increased. So has the number of editors who whine about how much nicer it would be if all the sentences in every article were properly cited, but don't seem drawn to contribute them. Astonishingly, some of you seem to have assumed the responsibility for specifying what others of us spend our time doing here! And every so often some idiot threatens to remove accurate but unreferenced material because someone else isn't willing to hunt down citations, something almost indistinguishable from simple vandalism as well as an appalling display of self-important contempt toward those who actually have done much of the real work here. And you wonder why some of us take wiki-breaks or respond with annoyance? If you would really like to display your expertise and show me up, help provide the missing citations or provide the citations to show the material is inaccurate (now THAT should be an incentive for you!). I'll even offer you a deal: if you put some effort where your mouth is and start contributing some citations to this article or the puberty article, I will match your contributions, citation for citation, and the articles will be better than ever. I will even throw in some respect for your expertise and a revision of my opinion of you at no extra charge. Could be win-win-win. What do you say? alteripse (talk) 19:04, 19 January 2010 (UTC)

Alteripse, calm down. I am aware of Wikipedia's history, and how most of its articles started out with few or even no citations. Not only have I read the Wikipedia article, but I have come across articles which became featured at a time when Wikipedia's referencing policies were not as strict. That told me right then and there how much Wikipedia has changed. The citation issue? I have never been for all sentences in every article being cited; no paragraph needs that, especially when coming from the same source. That is over-referencing. I basically made the same points you have about over-referencing and laziness on the part of editors when it comes to referencing at Talk:Titanic (1997 film)#Plot bloat and cleanup. But I also accept that Wikipedia now demands that likely to be contested information be sourced, reliably sourced, and that the burden lies with the editor. If the editor adds something unsourced, it is his or her job to find a source for it when asked. I have come across plenty of things that I know are true, but that stuff should still be cited for other people...and for Wikipedia's reputation. I personally never request a citation, though, because I find it ugly, I hate sourcing tags on Wikipedia, and often source things myself when I feel it needs a source. I did not even request a citation to you on the Puberty article. I basically removed the nubility sentence after the IP did...because it linked to a non-existent article and was not something too important, in addition to being unsourced and having been removed by that IP partly because there was no nubility article. I stated that it should be sourced, which it should, and would not have been removed by the IP in the first place if it had been sourced. This site already has a bad reputation where accuracy is concerned, which is the main reason referencing standards are so strict these days. Yes, I mainly edit popular culture topics, but that is because they are easier for me to enjoy. Editing medical, scientific, sexual, social, and mathematical topics reminds me too much of when I was growing up and having extensively studied these matters so much, either due to passion or being pushed into studying them, that it became too much and too boring. My user page hints at this. Editing the Pedophilia and Child sexual abuse articles are painful for me (due to some things I experienced growing up, and naturally caring about the pain such horrors cause), but I still edit them...because I know what I am talking about on those matters. To cut back on some of my heated feelings about those topics, I mainly regulate myself to the talk pages of those two articles. Basically, I am saying that I would not pull an Essjay; I am completely honest about what I have knowledge of and what I have little knowledge of. And I do not appreciate people acting or assuming that I do not know what I am talking about because my views differ from theirs or because I have fixed up more soap opera character articles than I have contributed to any other topic. There are doctors, for example, who may have vastly different opinions on a subject, but it does not make the medical field any less the area of expertise for any of those doctors.

I definitely feel that you and I should start over. We obviously are going to be crossing paths on Wikipedia, and I prefer not to have any enemies at this site. I have put some effort where my mouth is and contributed citations to this article, as essentially noted above. What else do you feel needs to be cited in this article? The second half of the Diagnostic criteria section? The Treatment section? I have also contributed citations to the Puberty article, but am definitely willing to add more. Flyer22 (talk) 20:22, 19 January 2010 (UTC)

Bisphenol A

Many assertions here need to be backed up with source citations, or weasel words removed. I've added indicators where I think this is the case. Krazychris81 (talk) 21:09, 26 May 2009 (UTC)

Treatment

One possible treatment is with anastrozole. Histrelin acetate (Supprelin), a GnRH-specific drug, may also be used. Although anastrozole (Arimidex) may have been used in the past, it isn't (or shouldn't be) anymore. What it's used for is when there is a need to delay the closing of the epipheses (growth plates) WITHOUT affecting the normal course of puberty, at least in boys. Here's one article discussing it: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2266949 I'm also seeing the same incorrect information in the page on Anastrozole. I will be posting this same discussion over there on the discussion page. CathyinTX (talk) 04:47, 18 June 2009 (UTC)CathyinTX

Good job on restructuring the lead

Good job on restructuring the lead, Alteripse. As I stated in my edit summary, I added back the exact wording of "early puberty" in the way that I did...because that term redirects here and this article also covers it. Therefore, it seems important to specifically address that wording so that people do not automatically think the terms are necessarily the same thing. For example, every time they see the wording "early puberty" in the lower body of the article, they may think we are talking about the common medical definition of precocious puberty. Right now, this article mainly covers the broader definition of precocious puberty (early puberty)...because what is considered precocious puberty now by medical experts is rarer. Flyer22 (talk) 21:50, 9 March 2010 (UTC)

Thanks but you misunderstood my wording so I will try to make it clearer. The final sentence does not refer to early normal puberty but to other conditions involving early sex hormone manifestations such as premature thelarche, premature adrenarche, late onset CAH, LH receptor mutations, etc, often lumped together in older medical books as "precocious pseudopuberty", "peripheral precocious puberty", etc. Some of the contexts in which "precocious puberty" is used in a broader sense to include all these conditions is medical textbook chapters, as a presenting complaint to a ped endocrine clinic, as a billing diagnosis code (insurance companies do not recognize the distinctions), in papers describing social or psychological aspects without regard to cause, or in imprecise discussions of early sex hormone effects associated with environmental chemicals by nonendocrinologists. They are not precocious puberty strictu sensu, and not addressed in detail in this article, but deserve their own articles. alteripse (talk) 22:57, 9 March 2010 (UTC)

Alteripse, that sentence, which has pretty much remained the same, even after your edit to it, was previously written by you as well? Even before your edit to it, I believed that sentence to address early normal puberty. I am sure that others would take it to mean that as well. But my point is that the term "precocious puberty" is also used to refer to early normal puberty, which is why Early puberty redirects to this article. This article also covers early normal puberty. Because of this, it seems especially needed to also address that the term "precocious puberty" is used to refer to early normal puberty. All the significant definitions of this term should be presented in the lead. We do the same thing in regards to the Pedophilia article, the Gender article, the Vegetarianism article, etc. I do not want people thinking that every time they read "early puberty" in the lower body of this article, such as in the Clinical and social significance section, we are referring to the abnormal/unusual onsets of puberty. That section is largely talking about normal early puberty...which used to not be all that normal. I am asking that we address "precocious puberty" also referring to early normal puberty. With Early puberty redirecting here, I do not want people thinking that early puberty and precocious puberty automatically mean the same thing. Flyer22 (talk) 23:50, 9 March 2010 (UTC)

But they are the same thing in most children-- the only difference being that it is being labeled a disease and treatment is considered. The following is one of the earliest versions of this article. Note that it leads with the assertion that they are exactly the same thing in the most general sense, and then goes on to describe unusual pathologic causes in a minority, and a variety of conditions which involve early sex hormone effects. Would it be clearer simply to revert to this intro, which has been gradually degraded into muddy and erroneous conflation by 3 years of changes?

START OF QUOTE Precocious puberty means early puberty. Early pubic hair, breast, or genital development may result from normal but early maturation or from several abnormal conditions. Early puberty which is normal in every way except age is termed idiopathic central precocious puberty. It may be partial or transient. Central puberty can also occur prematurely if the inhibitory system of the brain is damaged, or a hypothalamic hamartoma produces pulsatile gonadotropin-releasing hormone (GnRH). Secondary sexual development induced by sex steroids from other abnormal sources (gonadal or adrenal tumors, congenital adrenal hyperplasia, etc.) is referred to as peripheral precocious puberty or precocious pseudopuberty.

Early sexual development deserves evaluation because it may induce early bone maturation and reduce eventual adult height, cause significant social problems, or indicate the presence of a tumor or other serious problem.

No single age limit reliably separates normal from abnormal processes, but the following age thresholds for evaluation will minimize the risk of missing a significant problem:

Pubic hair or genital enlargement in boys with onset before 9 years. Breast development in boys before appearance of pubic hair and testicular enlargement. Pubic hair before 8 or breast development in girls with onset before 7 years. Vaginal bleeding in girls before 10 years. Medical evaluation is sometimes necessary to separate the few children with serious conditions from the majority who are early-but-normal.

END OF QUOTE alteripse (talk) 00:26, 10 March 2010 (UTC)

It's the difference I'm talking about -- it being labeled a disease or unusual by medical experts. An 8 or 9-year-old girl hitting puberty, for example, would be considered unusual by a lot of people...but not by medical experts (unless due to some unnatural cause) because girls hitting puberty at those ages is not abnormal these days. From what I gather, precocious puberty first and foremost is supposed to be about an unusual onset of puberty in the medical sense. Not what is unusual puberty to just any person. A 10-year-old boy hitting puberty would be considered early puberty to a lot of people, but would it be called precocious puberty by the medical community? That is what I am getting at. The two terms do not necessarily mean the same thing, even though they are often used interchangeably. I simply feel that it would be best to somehow briefly address this in the lead. You even distinguished precocious puberty from normal early puberty in your first reply to me about this.

As for your proposal of inserting the old lead, I prefer your new lead to that. The other stuff is better left in the article as it is than in the lead. The lead should simply summarize, and not be too complicated, per WP:LEAD. Flyer22 (talk) 01:21, 10 March 2010 (UTC)

Okay, the old version is concise but no better. I am still not sure i understand what you think it should say about distinguishing early and precocious. In the first paragraph the two key sentences are Precocious puberty is a medical term for puberty occurring at an unusually early age. and but in most children the process is normal in every respect except the unusually early age, and simply represents a variation of normal development. One practical distinction is that if I am emphasizing the normalcy of the condition and that we do not need to treat it as such I will use the term early puberty, whereas if a parent and I are deciding to treat it with an expensive drug we call it precocious puberty in preparation for getting insurance coverage for the treatment. In other words applying the term precocious usually signifies that we are medicalizing the condition for purposes of justifying the evaluation or the treatment. Is that the distinction you are looking for? alteripse (talk) 02:31, 10 March 2010 (UTC)

Somewhat. That is the line of thinking I briefly went for with the medical experts part. But more specifically, I am pointing out the "unusually early age" part. Early puberty is not always at an unusually early age. We note this in the Diagnostic criteria section, for example, when we say Studies indicate that breast development in girls and pubic hair in girls and boys are starting earlier than in previous generations. As a result, "early puberty" in children, particularly girls, as young as 9 and 10 is no longer considered abnormal, although it may be upsetting to parents. Puberty at these ages is still considered early puberty by a lot of people, especially in the case of boys, but it is no longer unusual in the medical sense. That is what I am saying. We should note in the lead how the term "precocious puberty" is used to refer to any puberty deemed "early." Early puberty does not always mean that it is "precocious puberty" in the medical sense is what I am saying. Since Early puberty redirects here, and this article covers early puberty in general (not just in the unusual-age-for-it sense), there should be some mention of this in the lead.

We could work on a proposed version for this piece of information together. It seems it would best fit in or near the debated (last) line of the lead. Flyer22 (talk) 23:50, 11 March 2010 (UTC)

Any ideas? I could bring in a third opinion. Flyer22 (talk) 21:01, 14 March 2010 (UTC)

No third opinion until I understand what you are trying to say. I think I am having trouble with your assertion that "early puberty is not always at an unusually early age", which is to my mind a denotatively meaningless proposition. If you mean to say something like Many parents think that their daughter's puberty is occurring too early, even when it is a bit ahead of average, but well within the wide range of normal puberty I suppose we could say that. Is that your point? alteripse (talk) 00:30, 15 March 2010 (UTC)

Alteripse, I feel that I explained why it is not a meaningless proposition. And, yes, that is what I am saying -- "Many parents think that their child's (boy or girl's) puberty is occurring too early, when it is a bit ahead of average but well within the wide range of normal puberty." But I do not feel that it should be worded that way in the lead. It should be worded a lot like the last line of the lead. The terms "precocious puberty" and "early puberty" often refer to any puberty that is perceived as being too early. Yes, that is what I am saying. Even when puberty is not occuring at an unusually early age by today's medical standards, it is still considered precocious/early puberty to many people. For example, I came across an elderly woman not too long ago who felt that it was unusual that her granddaughter had hit puberty at age 9. She considered this early puberty. As you and I know, while this may still be considered early puberty to a lot of people, it is not precocious puberty in the medical sense; there is nothing unusual about a girl hitting puberty at ages 9 or 10 these days. The general use of the terms "precocious puberty" and "early puberty" should be in the lead for the same reason we put the general use of the term "pedophilia" in the lead of the Pedophilia article, how the term "vegetarian" is used commonly to refer to people who eat fish in addition to vegetables in the lead of the Vegetarianism article, etc. We do this because it is important to note all the significant ways a term is used right off the bat. And as I stated before, this article also covers early normal puberty -- as in puberty that is a bit ahead of average but well within the wide range of normal puberty. Flyer22 (talk) 07:31, 15 March 2010 (UTC)

I think I get your point now: you want to specify 3 meanings of PP in the intro:

1. Strict medical definition of CPP, including both (a) idiopathic and (b) due to intracranial disease
2. Broad lay definition of CPP, anything earlier than average, not pathologic
3. Broader medical usage of PP as a term encompassing the whole diagnostic problem of early sex hormone effects in children, both CPP and other conditions

Is that it? You want to make explicit the difference between 1(a) and 2? I thought the second paragraph makes clear that the difference between 1(a) & 2 is arbitrary and a result of social negotiation, but we can spell it out even more clearly. alteripse (talk) 11:27, 15 March 2010 (UTC)

Yes, I think we are just about on the same page now. By "anything earlier than average," though, I mean "anything perceived as earlier than average" (for example, the elderly woman who thought it was unusual that her granddaughter had hit puberty at age 9). I would prefer you put specific mention of how the terms "precocious puberty" and "early puberty" are used to refer to puberty perceived as earlier than average. But I am open to any way you want to word it. Flyer22 (talk) 21:59, 19 March 2010 (UTC)

The changes are nice. Even changing the section Types to Varieties of early sexual development seems helpful (though my first thought of that change was that it was unneeded). Thanks. Flyer22 (talk) 21:35, 22 March 2010 (UTC)

on reversion tools

On a side note, Alteripse, would you mind not reverting my edits with the same tool used for vandalism? I know that it is a quick way to revert, but it usually offends experienced editors such as myself...since it is supposed to be used for vandals. Flyer22 (talk) 23:50, 9 March 2010 (UTC)

Sorry, no disrespect intended. The key difference between reverting vandalism and correcting an error is not which tool is used but whether a polite explanation is provided for the reversion, which I attempted to do above. But if it bothers you i will not use rollback to do it. alteripse (talk) 00:26, 10 March 2010 (UTC)

Thank you. I appreciate that. I also appreciate that we are on better terms, interaction-wise. You are a good editor, and your expertise in this field also helps. Flyer22 (talk) 01:28, 10 March 2010 (UTC)

citations

many citations are not specific enough, don't exist or are not acceptable sources —Preceding unsigned comment added by 173.17.184.148 (talk) 08:55, 22 May 2010 (UTC)

The citations do exist. The only one that no longers exists is the fox4kc.com reference, but that is only because it became a dead link. I will replace it with another source. As for sources like Tanner, do you want that source or sources like it to specify exactly where it is from? Either way, two sources being an issue does not call for the tags you placed on the article (which is why I removed them). I will try to take care of your concerns, however. 17:51, 22 May 2010 (UTC)

Okay, I'ved tackled the concerns you identified with your edits, along with other improvements I felt this article needed. Let me know what else you feel needs tweaking. Flyer22 (talk) 19:42, 22 May 2010 (UTC)

http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2011.02805.x/full In this introduction, it states that zens from toxic fungi are a cause for this. Lucy346 (talk) 13:59, 27 October 2012 (UTC)

lack of pictures

pictures of cases should be uploaded so that people can se what it looks like. —Preceding unsigned comment added by 84.208.75.209 (talk) 10:30, 14 August 2010 (UTC)

People know what a prepubescent child looks like. They also know what a youth who has just hit puberty looks like -- not too different than a prepubescent child. Flyer22 (talk) 19:34, 19 August 2010 (UTC)