Precocious puberty (early puberty) in children

What is precocious puberty (early puberty) in children?

Puberty is activated by certain genes and hormones. An area of the brain known as the hypothalamus activates gonadotropin-releasing hormone, which signals the pituitary gland (at the base of the brain) to release hormones that stimulate the ovaries in  girls or testicles in boys to produce sex hormones.

• In girls the first sign of puberty is usually breast development, followed by hair growth in the pubic area and armpits and then menstruation (a monthly period). Girls grow and develop at different rates, and the normal onset of puberty is sometime between the ages of 10 and 13.

• In boys puberty usually begins with growth of the genital organs, followed by hair growth in the pubic area and armpits and then the development of muscles, facial hair and a deeper voice.

Both boys and girls may experience acne and both will usually have a growth spurt, bringing them closer to their adult height.

Risk factors

Precocious puberty is more common in girls than in boys and occurs more often in African-Americans than in children of other races.

Other risk factors of precocious puberty (early puberty) in children may include:

• Certain medical conditions (e.g., McCune-Albright syndrome, congenital adrenal hyperplasia)

• Exposure to estrogen or testosterone hormones (e.g., pills, ointments)

• Obesity

• Previous radiation to the brain or spinal cord

The changes to your child’s body brought on by precocious puberty may cause your child to feel self-conscious, and may also lead to teasing by peers. Counseling may help your child to work through these issues.

What problems are associated with precocious puberty (early puberty) in children?

Puberty problems occur when these processes and changes don’t occur at the typical time in your daughter’s development.

Precocious puberty (early puberty) in children problems may include:

• Delayed puberty

• Precocious puberty (early puberty) 

• Contrasexual pubertal development

• Premature thelarche (early breast development)

• Premature adrenarche (early puberty changes due to androgens)

What are the signs and symptoms of precocious puberty (early puberty) in children?

Although symptoms may vary from child to child, symptoms of precocious puberty may include:

Girls

• Acne

• Breast growth

• Early menstruation

• Growing pubic and underarm hair

• Rapid growth (girls who go through puberty too early may not reach their full height because growth stops too early)

Boys

• Acne

• Deepening of the voice

• Enlarging penis and testicles

• Growing pubic, underarm and facial hair

• Rapid growth (boys who go through puberty too early may not reach their full height because growth stops too early)

Other characteristics of precocious puberty may include:

• Increased aggression

• Moodiness associated with the hormonal changes

How is precocious puberty (early puberty) in children diagnosed?

There are several methods used for diagnosing precocious puberty. Your child’s doctor may use a combination of these methods to diagnose precocious puberty (early puberty):

• Family history

• Physical exam

• X-rays

• Blood tests

• Ultrasound

What are the causes of precocious puberty (early puberty) in children?

In many cases, there is no known cause for precocious puberty but it may be caused by:

• Central nervous system abnormalities

• Family history 

• Tumors or growths in the ovaries, adrenal glands, pituitary gland or brain

• Other genetic conditions

How is precocious puberty (early puberty) in children treated?

Treatments for precocious puberty may include:

• Medications (GnRH analogs) to block the hormones that are bringing on puberty

• Treating any contributing medical conditions (e.g., tumor)