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Home , Precocious puberty, Puberty

Pediatric Fact Sheet Precocious : A Guide for Families

What is ? How is precocious puberty diagnosed? Puberty is defined as the presence of secondary sexual When you see the doctor for concerns about early puberty, characteristics: development in , pubic , and in addition to reviewing the growth chart and examining your testicular and penile enlargement in boys. Precocious puberty , certain other tests may be performed, including is usually defined as onset of puberty before age 8 in girls and tests to check the pituitary , which control puberty before age 9 in boys. It has been recognized that, on average, (luteinizing , called LH, and follicle-stimulating hor- African American and Hispanic girls may start puberty some- mone, called FSH) as well as levels ( or what earlier than white girls, so they may have an increased ) and sometimes other hormones. It is possible likelihood to have precocious puberty. that the doctor will give your child an injection of a synthetic hormone called leuprolide before measuring these hormones What are the signs of early puberty? to help get a result that is easier to interpret. Girls: Progressive , growth acceleration, An x-ray of the left hand and wrist, known as age, and early menses (usually 2-3 years after the appearance of may be done to get a better idea of how far along puberty is, ) how quickly it is progressing, and how it may affect the height Boys: Penile and testicular enlargement, increase muscu- your child reaches as an . If the blood tests show that lature and , growth acceleration, deepening of the your child has CPP, an MRI of the may be performed voice to make sure that there is no underlying abnormality in the area of the . What causes precocious puberty? Most times when puberty occurs early, it is merely a speed- How is precocious puberty treated? ing up of the normal process; in other words, the alarm rings Your doctor may offer treatment if it is determined that too early because the clock is running fast. Occasionally, pu- your child has CPP. In CPP, the goal of treatment is to turn berty can start early because of an abnormality in the master off the pituitary gland’s production of LH and FSH, which gland (pituitary) or the portion of the brain that controls the will turn off sex . This will slow down the appearance pituitary (). This form of precocious puberty of the signs of puberty and delay the onset of periods in girls. is called central precocious puberty, or CPP. In some, but not all cases, CPP can cause shortness as an adult Rarely, puberty occurs early because the glands that make by making growth stop too early, and treatment may be of sex hormones, the in girls and the testes in boys, start benefit to allow more time to grow. Because the medication working on their own, earlier than normal. This is called pe- needs to be present in a continuous and sustained level, it is ripheral precocious puberty (PPP). given as an injection either monthly or every 3 months or via In both boys and girls, the adrenal glands, small glands an implant that releases the medication slowly over the course that sit on top of the kidneys, can start producing weak male of a year. hormones called adrenal at an early age, causing pubic and/or axillary hair and before age 8, but Paul Kaplowitz, MD, FAAP, and Lawrence Silverman, MD this situation, called premature , generally does PES/AAP-SOEn Patient Education Committee not require any treatment. Finally, exposure to - or -containing creams or medication, either prescribed or over-the-counter supplements, can lead to early puberty.

Copyright © 2014 American Academy of Pediatrics and Pediatric Endocrine Society. All rights reserved. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. 13