Precocious puberty

Definition

Puberty is the time when 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 sex.

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, to help delay puberty. These medicines are given as a shot (injection). 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

Adult prescription medicines and dietary supplements that contain hormones should not be consumed by children.

Your child should maintain a healthy weight.

Gallery

Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

Male and female reproductive systems — Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

References

Garibaldi LR, Chemaitilly W. Disorders of pubertal development. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 578.

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.

Last reviewed August 10, 2021 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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