Girls enter puberty between the ages of 8-14. Boys enter this stage between the ages of 9-14. Sometimes the physical changes may happen earlier. This is called precocious sexual development or premature puberty.
For girls, this means that before the age of eight they may:
Develop breastsHave armpit or pubic hairHave mature sex organsExperience their first period
For boys, this means before the age of nine they may have:
Enlarged sex organsArmpit, pubic, or facial hair
In about 25%-75% of affected boys, this condition is due to an underlying medical conditions. However, for many girls and some boys there is no known cause.
Some known causes of premature sexual development include: Hormone-secreting tumor (gonadotropin-secreting tumor)
hypothyroidismCongenital adrenal hyperplasiaMcCune-Albright syndrome
Tumor or lesion
Central nervous systemPituitary gland
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Causes specific to girls:
Having ovarian tumor or
Causes specific to boys: Having tumors on the testiclesTaking male sex hormones (androgens)
head traumaCentral nervous system infectionRadiation
Factors that increase the risk of precocious puberty include: Sex: girls are 2 to 5 times more likely to experience premature puberty than boysFamily history—some cases may run in familiesTaking sex hormonesHead injuryRadiation of headInfection in brain
Some studies have suggested a link between
and premature puberty
One symptom common to both boys and girls is a premature growth spurt in height. Children with this condition may be taller than their peers. As an adult, they may be shorter. The rapid growth also makes their bones stop growing sooner than normal. Other symptoms include:
In girls, early arrival of:
Breast developmentPubic hairArmpit hairOnset of periodOvary enlargementCysts on ovaries
In boys, early arrival of:
Facial hairArmpit hairPubic hairPenis growthIncreased masculinityTesticle enlargement
In both girls and boys, early arrival of:
Body odorAcneBehavior changesGrowth spurt
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. An
of the left wrist bone may also be taken. This will help to assess if the bone growth is normal for your child’s age.
Depending on these results, other tests may be ordered, including:
—images of kidneys and sexual organs created by sound waves
Testicular ultrasound if testicular enlargement is unevenMRI
of the brain—detailed images of the brain
Blood tests to measure
the levels of hormones such as:
In girls: follicle-stimulating hormone (FSH), luteinizing hormone (LH)In boys: testosteroneHuman chorionic gonadotropin (hCG) levels—hormone that affects growthThyroid hormone levels—if hypothyroidism suspectedGrowth hormone-releasing hormone (GHRH) stimulation testDehydroepiandrosterone (DHEA) levels—early form of sex hormones
The treatment depends upon the cause.
If the bone age is about the same as the child's actual age and there is no known cause, there is no treatment. The child will continue to be monitored. Psychological support may be recommended if a child is struggling.
Other children may require treatment. This may include medication or surgery.
Medication is often used in children whose bone age is older than their actual age. These medications stop or slow sexual development. They also halt the rapid bone growth and encourage normal growth.
These medications called
hormone suppressors may include: Leuprolide acetateHistrelinNafarelin
has also been shown to be effective in delaying puberty.
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.
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.
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.
Most precocious development cannot be prevented. To help reduce the chance, make sure your child is kept as healthy as possible. This includes making sure they are eating well and getting all the nutrients they need. Help your child maintain a healthy weight. Avoid exposure to sex hormones.
Cesario SK, Hughes LA. Precocious puberty: a comprehensive review of literature.
J Ob Gyn Neonatal Nurs.
Himes JH, Obarzanek E, Baranowski T, et al. Early sexual maturation, body composition, and obesity in African-American girls.
Ibanez L, Valls C, Ong K, et al. Metformin therapy during puberty delays menarche, prolongs pubertal growth, and augments adult height: a randomized study in low birth weight girls with early-normal onset of puberty.
J Clin Endocrinol Metab
Papathanasiou A, Hadjiathanasiou C. Precocious puberty.
Ped Endocr Rev
Wang Y. Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls.
Last reviewed September 2012 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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