Precocious Puberty

(Early Puberty)

Definition

Precocious puberty is the unusually early onset of puberty. Typically this is before:

  • Age 7-8 years in girls
  • Age 9 years in boys

If you think your child is beginning puberty too early, talk to the doctor.

Causes

Puberty is a complex process of brain, body, and hormonal development. If your child begins puberty at an early age, it may just be a variation in the range of what is considered "normal."

In rare case, precocious puberty may be caused by conditions, such as:

  • Congenital adrenal hyperplasia
  • McCune-Albright syndrome
  • Tumors or disorders of the testicles, ovaries, or adrenal gland
  • hCG-secreting tumors
  • Hypothalamic hamartoma (HH)—a rare benign brain tumor near the hypothalamus
  • Severe hypothyroidism

Abnormalities in Adrenal Glands or Hypothalamus May Lead to Precocious Puberty

Kidney and adrenal
Copyright © Nucleus Medical Media, Inc.

Hypothalamus
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

A risk factor is something that increases your chance of getting a disease or condition.

The following factors may increase your risk of a precocious puberty:

  • Gender: female
  • Ethnicity: Black, Hispanic
  • History of radiation therapy to the brain

Symptoms    TOP

Symptoms of precocious puberty in girls may include:

  • Development of breasts, pubic hair, and underarm hair
  • Increased growth rate
  • Menstrual bleeding

Symptoms of precocious puberty in boys may include:

  • Growth of penis and testicles
  • Development of pubic and underarm hair
  • Muscle growth
  • Voice changes
  • Increased growth rate
  • Acne

Diagnosis    TOP

Your doctor will ask about your child's symptoms and medical history, and perform a physical exam. Your child may be referred to an endocrinologist, which is a doctor who specializes in hormonal, glandular, and metabolic disorders. Other tests may include:

  • Tanner staging may be used to assess the degree of pubertal development
  • Blood tests (eg, hormone, insulin tests)
  • Brain imaging tests

Treatment    TOP

Talk with your doctor about the best treatment plan for you. Treatment options include:

Medications

Different medications can be used to treat precocious puberty depending on the type. Treating precocious puberty can help children reach their full height potential and avoid the psychological reproductions of puberty-associated physical and hormonal stages occurring too early.

Treatment of Underlying Conditions

If an underlying condition is the cause of precocious puberty, treatment will revolve around treating the specific medical problem.

Prevention    TOP

There is no known way to prevent precocious puberty.

RESOURCES:

National Institute of Child Health and Human Development
http://www.nichd.nih.gov/
Nemours Foundation
http://www.kidshealth.org/

CANADIAN RESOURCES:

Pediatric Endocrinology and Rheumatology, University of Alberta Stollery Children's Hospital
http://www.pediatrics.ualberta.ca/Home/Divisions/

References:

Baron J, Barnes K. Regulation of skeletal growth. National Institute of Child Health and Human Development: Annual report of the Division of Intramural Research; 2004. Accessed June 27, 2007.
Kleigman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics .18th ed.Saunders: Philadelphia, PA; 2007.
Precocious puberty. DynaMed website. Available at: http://dynamed101.ebscohost.com/Detail.aspx?id=114717 . Accessed June 27, 2007.
Precocious puberty. National Institute of Child Health and Human Development website. Available at: http://www.nichd.nih.gov/health/topics/precocious_puberty.cfm .
VN Brito, AC Latronico, IJP Arnhold, BB Mendonca. Update on the etiology, diagnosis and therapeutic management of sexual precocity. Arq Bras Endrocrinol Metab 2008; 52(1):18-31.
12/13/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Biro FM, Galvez MP, Greenspan LC, et al. Pubertal assessment method and baseline characteristics in a mixed longitudinal study of girls. Pediatrics. 2010;126(3):e583-90.
Last reviewed September 2012 by Michael Woods, MD
Last Updated: 09/30/2012

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