Early Puberty (Precocious Puberty)

When a child has signs of puberty at an early age, it’s known as precocious puberty. Puberty is the onset of sexual development. Puberty before age 8 in girls and before age 9 in boys is called precocious. The growth of pubic hair is often, but not always, the first sign of puberty.  Most children with precocious puberty grow fast at first. But they also finish growing early and may not reach their full height.

Types and causes of early puberty

There are 2  types of early puberty:

  • Gonadotropin-dependent. Also known as central precocious puberty, this is the most common type in both boys and girls. It is caused by the early release of sex hormones (called gonadotropins) by the pituitary gland at the base of the brain. These hormones regulate puberty and sexual function. 

  • Gonadotropin-independent. This is a type of early puberty that is not caused by the release of gonadotropins.

Early puberty may be caused by:

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

  • Central nervous system abnormalities, especially brain damage

  • Family history of the condition

  • Certain rare genetic syndromes

In many cases, no cause can be found.

Symptoms of early puberty

The symptoms can vary in each child. Common symptoms for girls include:

  • Breast budding

  • Pubic hair and underarm hair

  • Menstruation

  • Ovulation

Common symptoms for boys include:

  • Enlarging penis and testicles

  • Pubic and underarm hair

  • Facial hair

  • Spontaneous erections

  • Production of sperm

  • Acne

  • Deepening of the voice

Other signs can include:

  • Moodiness

  • Increased aggression

  • Being taller than other children of the same age

Diagnosis of early puberty

Your child’s healthcare provider will ask about your child’s medical history. Your child will have a physical exam, and may have tests, such as:

  • X-ray. An X-ray of your child's left hand and wrist (called a radiograph) may be taken. This uses a small amount of radiation to create pictures of bones, and other tissues. An X-ray of the hand can estimate your child's "bone age." With precocious puberty, bone age is often advanced relative to calendar age.

  • Blood tests. These tests may be done to measure levels of hormones. These may include gonadotropins (LH and FSH), gonadotropin-stimulating hormone (GnRH), estradiol, testosterone, and thyroid hormones.

  • Ultrasound. This uses sound waves and computer to create pictures of the body. Ultrasound scans of the pelvis or abdomen may be done to look at the adrenal glands and gonads (ovaries or testes).

  • Magnetic resonance imaging (MRI).  This uses large magnets and a computer to create pictures of organs and other body tissues. MRI of the brain may be done to look for possible causes of precocious puberty.

Treatment of early puberty

The goal of treatment is to stop or slow the process of  early puberty and related symptoms. The most common treatment is with a synthetic hormone called a GnRH agonist. A GnRH agonist can stop the pituitary gland from releasing gonadotropin hormones. Other treatments will depend on the type of precocious puberty and its cause, such as a tumor. Your child’s healthcare provider can tell you more about the risks and potential benefits of specific treatments.

Helping your child cope with early puberty

Early puberty will cause a child's body to change much sooner than other children or his or her age. This may make your child feel awkward or embarrassed. He or she may be teased by other children. You can help your child cope by talking with him or her about the condition, and helping boost his or her self-esteem. Ask your child’s healthcare provider to refer you to a child counselor or licenses pediatric psychologist to learn other coping tips.