Definition

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

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

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 about 25%-75% of affected boys, this condition is due to underlying medical conditions. However, for many girls and some boys the cause is unknown.

In rare cases, 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

Other causes:

• Acute head trauma
• Central nervous system infection
• Radiation therapy
• Taking estrogen in girls
• Taking male sex hormones in boys

Risk Factors

Precocious puberty is more common in girls, and in Black or Hispanic populations. Other factors that may increase your child’s chance of precocious puberty include:

• Family history—some cases may run in families
• Head injury
• Infection in brain
• History of radiation therapy to the brain
• Taking sex hormones
• Some studies have suggested a link between obesity and premature puberty

Symptoms

Symptoms of precocious puberty in girls may include:

• Development of breasts, pubic hair, and underarm hair
• Ovary enlargement
• Cysts on ovaries
• 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
• Facial hair

Symptoms in both boys and girls include:

• Body odor
• Acne
• Behavior changes
• Growth spurt

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. An assessment of puberty milestones and growth will be done. Your child may be referred to an endocrinologist, a doctor who specializes in hormonal, glandular, and metabolic disorders.

Imaging tests are used to evaluate bodily structures. These may include:

• X-ray
• Abdominal ultrasound
• Testicular ultrasound
• MRI scan

Your child’s bodily fluids may be tested. This can be done with blood tests.

Treatment

Talk with your child’s doctor about the best treatment plan. Treatment options include:

Prevention

There are no current guidelines to prevent precocious puberty.

Nemours Kid’s Health http://www.kidshealth.org

Health Canada http://www.hc-sc.gc.ca

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