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Precocious puberty

Definition

Puberty is the time during which a person's sexual and physical characteristics mature. Precocious puberty is when these body changes happen earlier than normal.

Alternative Names

Pubertas praecox

Causes

Puberty usually begins between ages 8 and 14 for girls and ages 9 and 16 for boys.

The exact age a child enters puberty depends on a number of factors, including family history, nutrition, and gender.

Most often there is no clear cause for precocious puberty. Some cases are due to changes in the brain, genetic problems, or certain tumors that release hormones. These conditions include:

  • Disorders of the testicles, ovaries, or adrenal glands
  • Tumor of the hypothalamus (hypothalamic hamartoma)
  • Tumors that release a hormone called human chorionic gonadotropin (hCG)

Symptoms

In girls, precocious puberty is when any of the following develop before age 8:

  • Armpit or pubic hair
  • Beginning to grow faster
  • Breasts
  • First period (menstruation)
  • Mature outer genitals

In boys, precocious puberty is when any of the following develop before age 9:

  • Armpit or pubic hair
  • Growth of the testes and penis
  • Facial hair, often first on the upper lip
  • Muscle growth
  • Voice change (deepening)

Exams and Tests

The health care provider will perform a physical exam to check for signs of precocious puberty.

Tests that may be ordered include:

  • Blood tests to check hormone levels.
  • CT or MRI scan of the brain or of the abdomen to rule out tumors.

Treatment

Depending on the cause, treatment for precocious puberty may include:

  • Medicines to stop the release of sexual hormones, in order to delay further development of puberty. These medicines are given by injection or shot. They will be given until the normal age of puberty.
  • Surgery to remove a tumor.

Children with early sexual development may have psychological and social problems. Children and adolescents want to be the same as their peers. Early sexual development can make them appear different. Parents can support their child by explaining the condition and how the doctor plans to treat it. Talking to a mental health worker or counselor may also help.

Possible Complications

Children who go through puberty too early may not reach their full height because growth stops too early.

When to Contact a Medical Professional

See your child's provider if:

  • Your child shows signs of precocious puberty
  • Any child with early sexual development appears to be having problems in school or with peers

Prevention

Certain medicines that are prescribed as well as certain supplements may contain hormones and should be avoided.

Your child should maintain a healthy weight.

References

Garibaldi L, Chemaitilly W. Disorders of pubertal development. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 562.

Haddad NG, Eugster EA. Precocious puberty. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 121.


Review Date: 9/5/2017
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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