Growth and Puberty Disorders

Is your child much shorter than other kids their age? Maybe they’re showing signs of puberty earlier than expected, or they haven’t started developing when their friends have. It’s natural to wonder if something is wrong.

Children grow and develop at different rates. But sometimes, growth and puberty disorders can affect when and how their bodies change. These conditions may involve hormones that control growth and development.

At Diabetes & Glandular Disease Clinic in San Antonio, TX, our endocrinology team can evaluate hormone-related concerns about your child’s growth and puberty.

A growth disorder affects how quickly a child grows. Some children grow much more slowly than expected, while others grow too quickly.

Doctors look at your child’s growth over time, not just their height at one visit. Some kids are naturally shorter than others. But if your child stops growing as quickly as they used to, it may be a sign that something needs attention.

Several conditions can affect your child’s growth or when puberty begins.

Short Stature and Slow Growth

Short stature means a child is much shorter than other children of the same age and sex. Slow growth means they’re not gaining height as quickly as expected.

Possible causes include:

• Growth hormone deficiency: The body doesn’t make enough growth hormone.
• Constitutional growth delay: A child grows and reaches puberty later than average.
• Familial short stature: A child is naturally short, like other family members, but grows at a normal rate.
• Idiopathic short stature: A child is much shorter than expected, but testing doesn’t find a clear cause.

Early Puberty

Precocious puberty happens when puberty begins before age 8 in girls or age 9 in boys.

Signs may include:

• Breast development at an early age
• Enlargement of the testes
• A sudden growth spurt

Some children show early changes without actually starting puberty. These include:

• Premature adrenarche: Pubic or underarm hair, body odor, or acne appears early.
• Premature thelarche: A young girl develops breast tissue without other signs of puberty.

Delayed Puberty

Some children develop later than their friends. But doctors usually recommend an evaluation if:

• A girl hasn’t started developing breasts by age 13.
• A boy’s testes haven’t started growing by age 14.

Delayed puberty can run in families. Other possible causes include poor nutrition, long-term illness, or hormone problems.

One condition, called hypogonadism, happens when the ovaries or testes don’t make enough sex hormones. This may be caused by a problem with these organs or the signals they receive from the brain.

Excessive Growth

Gigantism is a rare condition that causes a child to grow unusually fast and become very tall. It happens when the body makes too much growth hormone before the bones finish growing. A noncancerous tumor in the pituitary gland is usually the cause.

Some genetic conditions can also affect how children grow and develop.

Turner Syndrome

Turner syndrome affects girls who are born with a missing or changed X chromosome. Girls with this condition are often shorter than expected, and puberty may start late or not begin on its own.

Noonan Syndrome

Noonan syndrome can affect a child’s growth, heart, and other parts of the body. Children with this condition may be shorter than average and reach puberty later.

Klinefelter Syndrome

Klinefelter syndrome affects boys who are born with an extra X chromosome. Their testes may not make enough testosterone, which can affect puberty.

Your child’s doctor will start by reviewing their growth chart to see how their height and weight have changed over time. They’ll also examine your child for signs of puberty.

Your doctor might also ask about:

• Parents’ heights
• Birth history
• Diet and nutrition
• Medications
• Long-term health problems
• When family members went through puberty

Depending on what the doctor finds, your child may need additional tests, such as:

• Blood tests to check thyroid, growth, and sex hormone levels
• Bone age X-ray of the hand and wrist to see how the bones are developing
• Growth hormone stimulation testing to check for growth hormone deficiency
• Genetic testing to look for genetic or chromosomal conditions
• Ultrasound or MRI to get a closer look at certain organs or glands when needed

Not every child needs all these tests. Your doctor will recommend testing based on your child’s symptoms and growth history.

Treatment depends on what’s causing the problem. Some children are healthy but simply grow or reach puberty later than others. In these cases, the doctor may recommend watching their growth over time.

When treatment is needed, options may include:

• Growth hormone treatment for certain growth conditions
• Medication to slow puberty when it starts too early
• Estrogen or testosterone therapy to help puberty begin or continue
• Treatment for health problems affecting growth, such as thyroid or pituitary conditions

The goal is to address the cause and support your child’s healthy growth and development.

If you’re concerned about your child’s height, growth, or signs of puberty, you don’t have to wait and wonder. An evaluation can help determine whether hormones or another health condition may be affecting their development.

Contact Diabetes & Glandular Disease Clinic in San Antonio to ask about an evaluation for growth and puberty disorders.

1. When Should I Worry About My Child’s Growth?

Talk to your child’s doctor if they:

• Grow much more slowly than expected
• Fall behind on their growth chart
• Grow unusually fast
• Develop much earlier or later than expected

One height measurement doesn’t tell the whole story. Changes in your child’s growth over time are often more important.

2. Does Early Pubic Hair Mean My Child Has Started Puberty?

Not always. Pubic hair, underarm hair, and body odor can appear early because of hormones made by the adrenal glands.

These changes don’t always mean puberty has started. Breast development in girls and enlargement of the testes in boys are more reliable signs of puberty.