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Precocious puberty

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.

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 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 doctor 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:

  • Medications to stop the release of sexual hormones
  • Surgery to remove a tumor

Possible Complications

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

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.

When to Contact a Medical Professional

See your health care 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

References

Garibaldi L, Chemaitilly W. Disorders of pubertal development. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 556.

Styne DM, Grumbach MM. Puberty: ontogeny, neuroendocrinology, physiology, and disorders. In: Kronenberg HM, Melmed, S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Elsevier Saunders; 2011: chap 25. 24.

Updated: 8/22/2013

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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