Precocious Puberty
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Precocious Puberty

(Early Puberty)

En Español (Spanish Version)

Definition

Precocious puberty is the unusually early onset of puberty. Typically before age eight in girls and before age nine in boys. Precocious puberty can be treated. If you think your child is beginning puberty too early, talk to his or her physician.

Causes

Precocious puberty has been classified into two general types:

  • Gonadotropin-dependent precocious puberty due to early activation of the hypothalamic-pituitary-gonadal glands
  • Gonadotropin-independent precocious puberty which caused by abnormal steroid production somewhere in the body
The first type acts like typical puberty but at an abnormally early age. The second type may cause abnormal pubertal development. Each of these forms has a variety of causes, among them the following disorders:
  • 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

© 2008 Nucleus Medical Art, Inc.

Hypothalamus

© 2008 Nucleus Medical Art, Inc.

Risk Factors

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
  • History of radiation therapy to the brain

Symptoms

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

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

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

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:

Children's Health Canada
http://www.childrenshealthcanada.com

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

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.



Last reviewed April 2008 by Kari Kassir, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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