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Precocious Puberty

Last updated Dec. 27, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Puberty can be termed as a biological and physical process when a child turns into an adult. Generally, girls attain puberty after 8 years of age and boys attain it after 9 years of age. Early-onset puberty is known as Precocious Puberty, when it occurs before the age of 8 years in girls and before the age of 9 years in boys, due to several factors.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Accelerated Sexual Maturation
  • Pubertas Praecox
  • Sexual Precocity, NOS

What is Precocious Puberty? (Definition/Background Information)

  • Puberty can be termed as a biological and physical process when a child turns into an adult
  • During puberty, physical and sexual characteristics develop in a child. The muscles and bones grow at a fast rate, changes in body shape and size are seen, and the ability to reproduce is achieved
  • Generally, girls attain puberty after 8 years of age and boys attain it after 9 years of age. Early-onset puberty is known as Precocious Puberty, when it occurs before the age of 8 years in girls and before the age of 9 years in boys, due to several factors
  • Treatment of Precocious Puberty depends upon the underlying cause. The prognosis is generally good with appropriate treatment

Who gets Precocious Puberty? (Age and Sex Distribution)

  • Precocious Puberty is pubertal development at a very young age, usually occurring before 8 years in girls and 9 years in boys
  • Girls are generally more susceptible to Precocious Puberty than boys

What are the Risk Factors for Precocious Puberty? (Predisposing Factors)

The risk factors associated with Precocious Puberty include:

  • Female gender
  • African American race
  • Obesity
  • Positive family history of the condition
  • Exposure to sex hormones: Exposure to cream or ointments containing sex hormones (estrogen or testosterone) can increase the risk for Precocious Puberty

Other medical conditions associated with Precocious Sexual Development include:

  • Congenital adrenal hyperplasia - inherited disorder of the adrenal gland
  • McCune-Albright syndrome: A genetic disorder of the bones, with skin pigmentation and Precocious Puberty
  • Spina bifida: Incomplete development of the spinal cord
  • Hydrocephalus: Abnormal accumulation of the cerebrospinal fluid

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider

What are the Causes of Precocious Puberty? (Etiology)

Precocious Puberty can occur due to a variety of medical conditions and factors. These include:

  • Brain and spinal cord related conditions:
    • Infections such as meningitis
    • Cancers and tumors
    • Radiation to the brain and spinal cord
    • Injuries to the brain and spinal cord            
  • Abnormality of the pituitary glands: The pituitary gland is responsible for the production of various hormones in the body. In some cases, instructions are provided to the ovaries and testicles to commence hormone production, earlier than usual
  • Abnormalities of the ovary or testicles such as ovarian or testicular tumors
  • Obesity

Other medical conditions may include:

  • Congenital adrenal hyperplasia
  • McCune-Albright syndrome (a genetic disorder)
  • Spina bifida
  • Hydrocephalus

The types of Precocious Puberty include:

  • Central Precocious Puberty, which is caused by the earlier than expected production of GnRH (gonadotropin releasing hormone)
  • Peripheral Precocious Puberty, which is caused by excess estrogen and testosterone in the child’s body

What are the Signs and Symptoms of Precocious Puberty?

The signs and symptoms of Precocious Puberty in girls include:

  • Early growth of breasts
  • Onset of menstruation and ovulation

The signs and symptoms of Precocious Puberty in boys include:

  • Growth of the testicles and penis
  • Facial hair growth
  • Hair growth on the upper lip
  • Voice changes

Common signs and symptoms of Precocious Puberty in both boys and girls include:

  • Growth of public hair, underarm hair
  • Increase in growth rate
  • Acne
  • Developing an adult body odor

How is Precocious Puberty Diagnosed?

The diagnosis of Precocious Puberty includes:

  • Complete evaluation of medical history
  • Physical examination of the child
  • Blood tests to check hormone levels
  • X-rays of the child’s hands and wrist to determine bone age
  • Gonadotropin-releasing hormone (Gn-RH) stimulation test
  • Magnetic resonance imaging (MRI) of the brain to detect any abnormality
  • Thyroid testing, to exclude thyroid-related conditions
  • Pelvic ultrasound scan to check the uterus and ovaries

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Precocious Puberty?

Precocious Puberty can cause the following complications:

  • Short height: The condition can stop the child’s growth earlier than normal; hence, children with Precocious Puberty are shorter in stature when compared to other children
  • Social and emotional problems: The child may suffer from an embarrassment about their body changes (girls may be embarrassed about the growing breast, or getting their periods before other girls)
  • Girls can become moody and irritable
  • Boys can become aggressive and develop a sex drive that is unusual for their age

How is Precocious Puberty Treated?

  • The treatment of Precocious Puberty depends upon the underlying medical condition that is responsible for it. If Precocious Puberty is caused by a tumor that is secreting excess hormones, then a surgical removal of the tumor is beneficial
  • Treatment of Central Precocious Puberty:
    • When no other underlying medical condition is observed, it can be treated with Gn-RH analogue therapy
    • An injection of leuprolide is given  every month to delay the process of puberty  

How can Precocious Puberty be Prevented?

Certain measures that could be adopted to reduce the risk of Precocious Puberty, which include:

  • Avoiding the use or exposure to substances containing estrogen and testosterone (at an early age)
  • Educating the child to maintain a normally healthy weight
  • Early diagnosis and treatment of underlying medical conditions

What is the Prognosis of Precocious Puberty? (Outcomes/Resolutions)

With correct diagnosis and appropriate treatment, the prognosis of Precocious Puberty is generally good.

Additional and Relevant Useful Information for Precocious Puberty:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/kids-zone/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: July 30, 2015
Last updated: Dec. 27, 2018