Puberty that happens early is called precocious puberty. This means a
child's physical signs of sexual maturity develop too soon. This includes breast growth,
pubic hair, and voice changes. These are known as secondary sexual characteristics.
Precocious puberty happens before age 8 in girls and before age 9 in boys. Most children
with the disorder grow fast at first. But they also stop growing before reaching their
full genetic height potential.
It may be caused by tumors or
growths on the ovaries, adrenal glands, testes, pituitary gland, or brain. Other causes
may include central nervous system problems, family history of the condition, or certain
rare genetic syndromes. In many cases, no cause can be found for the disorder. There
2 types of precocious puberty:
Gonadotropin-dependent. This is also
known as central precocious puberty. This is the most common type of precocious
puberty. Most girls and half of boys with precocious puberty have this type. The
puberty is started by early secretion of hormones called gonadotropins. These include
luteinizing hormone and follicle stimulation hormone. In girls, precocious puberty
may be caused by the early maturity of the hypothalamus, pituitary glands, and
ovaries. But in most cases, no cause can be found.
Gonadotropin-independent. This is a
form of precocious puberty that is not started by the early release of gonadotropins.
Instead it’s caused by early secretion of high levels of sex hormones. These include
the male androgens and female estrogens. Their release can be from testes, ovaries,
adrenal glands, or germ cell tumors.
A child is at risk for precocious
puberty if they have any of these:
- Tumors or growths on the ovaries, testes, adrenal glands, pituitary gland, or brain
- Central nervous system problems
- Family history of the disease
- A rare genetic syndrome, such as
The signs are secondary sexual characteristics that happen early.
Common signs in girls can include:
- Breast growth
- Pubic and underarm hair
Common signs in boys can include:
- Enlarging penis and testicles
- Pubic and underarm hair
- Facial hair
- Spontaneous erections
- Production of sperm
- Deepening of the voice
Other signs of the disorder include:
- Increased aggression
- Growing taller earlier than other classmates
Some of these things can be caused
by other health conditions. Make sure your child sees their healthcare provider for
The healthcare provider will ask
about your child’s symptoms and health history. They may also ask about your family’s
health history. Your child will also have a physical exam.
Your child may have blood tests to
measure levels of hormones, such as:
- Luteinizing hormone
- Follicle stimulation hormone
- A form of estrogen called
- Thyroid hormones
Gonadotropin-stimulating hormone (GnRH) is made by the hypothalamus
in the brain. It causes the pituitary gland to release gonadotropins. These then cause
sex hormones to be made by the ovaries in girls, or the testes in boys. The GnRH blood
test may show the type of precocious puberty.
Your child may also have tests,
X-ray. This test uses a small amount of radiation to make
images of tissues inside the body. An X-ray may be done of the left hand and wrist.
This can estimate your child's bone age. With precocious puberty, bone age is often
older than calendar age.
Ultrasound (sonography). This test uses sound waves and a
computer to create images of blood vessels, tissues, and organs. This may be done
look at the adrenal glands and ovaries or testes.
MRI. This test uses large magnets and a computer to make
detailed images of tissues in the body without the use of X-rays.
The goal of treatment is to stop
the onset of early puberty signs. In some cases, the signs can be reversed. Treatment
will depend on the type of precocious puberty and the cause.
Treatment may be done with
medicines called synthetic gonadotropin-releasing hormone agonists. These can stop
sexual maturity process by stopping the pituitary gland from releasing the gonadotropin
Early puberty will cause a child's body and moods to change much
sooner than their friends and classmates. This may make a child feel self-conscious
embarrassed or be teased by other children.
You can help your child by treating them like normal, boosting their
self-esteem, and seeking a child counselor if more help is needed.
When to Call a Healthcare Provider
Call your child’s healthcare provider if you see signs of sexual development in a
girl before age 8 or in a boy before age 9.
- Puberty that happens early is called
precocious puberty. This means a child's physical signs of sexual maturity develop
too soon. Precocious puberty happens before age 8 in girls and before age 9 in
- Signs can include breast or testicular
growth, pubic hair, and voice changes.
- It may be caused by tumors or growths on the ovaries, adrenal glands, pituitary gland,
or brain. In many cases, no cause can be found for the disorder.
- Treatment may be done with synthetic
gonadotropin-releasing hormone agonists. This can stop the sexual maturity
- Early puberty may make a child feel
self-conscious and embarrassed. Or they may be teased by other children.
- You can help your child by treating
them like normal, boosting their self-esteem, and seeking a child counselor if more
help is needed.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what
information you want to get out of it.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
directions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
healthcare provider after office hours. This is important if your child becomes ill
and you have questions or need advice.