Early Puberty (Precocious Puberty)

Early Puberty (Precocious Puberty)

What is early puberty?

Girls who show significant signs of puberty and its progression through growth spurts and bone maturation before age 7, and boys before age 9, are considered precocious. It’s usually for reasons we don’t understand. About 1 out of 5,000 children are affected.

What are the different types of early puberty?

There are two types of precocious puberty, central and peripheral.

  • Central precocious puberty is the more common type. The process is identical to normal puberty but happens early. The pituitary gland is prompted to produce hormones, called gonadotropins. These hormones, in turn, stimulate the testicles or ovaries to make other hormones, testosterone or estrogen. It’s these sex hormones that cause the changes of puberty, like breast development in girls.
  • Peripheral precocious puberty or precocious pseudo-puberty is a different condition. It’s also rarer. The hormones estrogen and testosterone trigger the symptoms. But the brain and pituitary gland is not involved. It’s usually a local problem with the ovaries, testicles, adrenal glands, or a severely underactive thyroid gland.


    What other conditions can look like early puberty?

    There are other conditions that might look like early puberty to parents — and sometimes even to pediatricians — but aren’t.

    • Premature thelarche is early breast development at a young age. It often appears in girls who are just a few years old. While troubling for parents, it resolves on its own and is not true early puberty. It does not require treatment but should be evaluated.
    • Premature pubarche is the early development of some pubic or underarm hair at an early age. It can be caused by premature adrenarche when the adrenal glands start releasing hormones early. Again, while it might seem alarming, it’s generally not a problem and not an early sign of puberty. However, because this may represent the first sign of an abnormal and excess release of adrenal hormones, it should be evaluated.


      Signs of Early Puberty

      In girls, starting before age 7:

      In boys, starting before age 9:

      Growth spurts are another sign of early puberty in both girls and boys.

      • Breast development (often the first sign)
      • Menstruation, typically 2-3 years after earlier symptoms start
      • Growth of the testicles, penis, and scrotum
      • A deepening voice, usually later


        What are the causes?

        In most cases, experts don’t know what causes early puberty, particularly in girls.

        Sometimes, central precocious puberty is triggered by a medical problem. Underlying causes are more common in boys and children under age 6, especially if puberty is advancing rapidly. They can include:

        That probably looks like a worrisome list. Just remember that only in a small number of cases in boys is central precocious puberty caused by a medical problem. In girls, it is extremely rare for a medical problem to be the cause.

        • Tumors and other growths, which are often benign
        • Brain injury, either from surgery or a blow to the head, that affects hormonal balances
        • Inflammation of the brain, sometimes from an infection


          What are the effects?

          While kids with precocious puberty are often tall for their age, some wind up short as adults. And puberty can be a confusing time, even more so for younger kids.

          There’s little evidence to suggest that kids who go through puberty early have behavior problems or start sexual activity early,

          Some studies have found a link between early puberty in girls and a slightly increased risk of breast cancer later in life, but the evidence isn’t clear. More research needs to be done.


          Should parents worry about early puberty?

          Symptoms that might seem like early puberty are often unrelated and resolve on their own.

          But if your child shows signs of early puberty, they should be checked by a pediatric endocrinologist.

          You shouldn’t view precocious puberty as something bad and fearful. When a doctor and parents decide the treatment is necessary, it’s usually quite effective. Most kids with signs of early puberty do fine, medically, psychologically, and socially. Read more…

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