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 there is no known cause.

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 treatment
  • Taking estrogen in girls
  • Taking male sex hormones in boys

Abnormalities in Adrenal Glands or Hypothalamus May Lead to Precocious Puberty

Kidney and adrenal

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Hypothalamus

Copyright © Nucleus Medical Media, Inc.

Risk Factors

Factors that may increase your child's risk of a precocious puberty include:

  • Gender: female
  • Ethnicity: Black, Hispanic
  • 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, which is a doctor who specializes in hormonal, glandular, and metabolic disorders.

Images may be taken of your child's bodily structures. This can be done with:

Your child's bodily fluids may be tested. This can be done with blood 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. These medications stop or slow sexual development. They also halt the rapid bone growth and encourage normal growth.

Psychological Support

Developing before their peers may cause social challenges in some children. Psychological support may be helpful. Talk to your child's doctor about what options are available.

Treatment of Underlying Conditions

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

Surgery

Surgery may be needed if the early puberty is caused by a tumor or other lesions. The procedure will depend on the location and size of the tumor.

Ongoing Monitoring

The doctor will continue to check your child’s height, weight, and sexual development. This will help to note any changes or show if the treatment has been effective.

Prevention

There is no known way to prevent precocious puberty.