Precocious Puberty

In general, girls begin puberty – the age when their bodies start changing and they begin menstruating –some time between the ages of 8 and 13.

While precocious puberty affects both males and females, it is more common in girls.

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

Factors that increase a child's risk of precocious puberty include:

• Gender – precocious puberty occurs more often in girls
• Race – it occurs more often in African-Americans than other races
• Obesity
• Exposure to sex hormones – such as estrogen or testosterone creams or ointments, or other substances that contain these hormones
• Other medical conditions

Symptoms & Types

Common symptoms include:

• Breast development
• First period (menstruation)
• Pubic or underarm hair
• Sudden and rapid growth in height
• Acne
• Body odor 

There are 2 types of precocious puberty:

• Central precocious puberty istriggeredby the early release of hormones (called gonadotropins) from the brain that is responsible for puberty. This is the most common form of precocious puberty and the type that affects most girls.  
• Peripheral precocious puberty istriggeredby the early release of hormones from the ovaries that are responsible for puberty (estrogen and testosterone).

Diagnosis & Tests

Diagnosis starts with a thorough medical history and physical exam.

Additional tests may include:

• Blood tests – to measure hormone levels
• Urine tests
• X-rays of the child's hand and wrist – to determine if bones are growing too quickly
• MRI (magnetic resonance imaging) or CT scan – to rule out abnormalities in the brain or pituitary gland
• Thyroid testing
• Ultrasound – to examine the health of the ovaries and adrenal glands, and rule out ovarian cysts or tumors
• A hormone stimulation test – to identify the type of precocious puberty

Treatment & Care

Treatment depends on the individual and the cause of the early puberty. The goal is to stop the child’s development from progressing and treat any underlying condition causing the precocious puberty, such as a tumor.

Treatment may include:

• Hormone medications – to stop the body from producing the hormones responsible for early puberty and sexual maturity. The medications delay further development until the girl reaches the normal age for puberty, at which point she can stop taking the medication
• Counseling – to help children and families deal with the emotional and social challenges of precocious puberty

Living & Managing

When puberty ends, bone growth stops. Children that go through puberty too early may stop growing too soon, preventing them from reaching their full height. As a result, they will be shorter than normal as an adult.

Children with precocious puberty must also deal with the emotional and social challenges of maturing at a much earlier age than their peers, and the unwanted attention that may bring.