Precautious puberty

Book an Appointment

Overview

Puberty is a complex transitional phase in children generally comprising of growth acceleration and development of secondary sexual characteristics. It is a period of physical and psychosocial development. Several genetic, environmental and nutritional factors play an important role in the onset and progression of puberty.[1]

Physiology of puberty

Puberty results from the activation and maturation of the hypothalamic-pituitary-gonadal (HPG) axis. At birth, there is a brief activation of the HPG axis that results in the increased production of steroidal hormones. This activation may result in breast development in females and pubic hair in males. This phenomenon is known as the “mini-puberty of the infancy” usually regresses over the first two years of life. Although it is considered to be benign, there is very little information on its etiology as well as clinical significance.

The HPG axis then becomes dormant until its subsequent activation in adolescence. The pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates the secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary gland. FSH and LH initiate spermatogenesis and the release of testosterone in males, and oogenesis and the release of estradiol in the females, respectively. Activation of the gonads is known as gonadarche.

It is important for a clinician to be familiar with the terminology of pubertal progression. Thelarche is the development of breasts, which is a response to estrogen. Pubarche is the development of pubic hair, which is a response to androgens. Adrenarche is the onset of adrenal androgen production, which contributes to pubarche.

Definition

The traditional definition of precocious puberty is the development of secondary sexual characteristics before 8 years of age in girls and 9 years in boys.

Symptoms

Breast growth and first period in girls.

Enlarged testicles and penis, facial hair and deepening voice in boys.

Pubic or underarm hair.

Rapid growth.

Acne.

Adult body odor.

Causes

Being a girl. Girls are much more likely to develop precocious puberty.

Being African-American. ...

Being obese. ...

Being exposed to sex hormones. ...

Having other medical conditions. ...

Having received radiation therapy of the central nervous system.

Risk factors

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


Being a girl. Girls are much more likely to develop precocious puberty.

Being African-American. Precocious puberty appears to affect African-Americans more often than children of other races.

Being obese. Children who are significantly overweight have a higher risk of developing precocious puberty.

Being exposed to sex hormones. Coming in contact with an estrogen or testosterone cream or ointment, or other substances that contain these hormones (such as an adult's medication or dietary supplements), can increase your child's risk of developing precocious puberty.

Having other medical conditions. Precocious puberty may be a complication of McCune-Albright syndrome or congenital adrenal hyperplasia — conditions that involve abnormal production of the male hormones (androgens). In rare cases, precocious puberty may also be associated with hypothyroidism.

Having received radiation therapy of the central nervous system. Radiation treatment for tumors, leukemia or other conditions can increase the risk of precocious puberty.

Calendar Schedule

Have a medical question?

We are available to help you with all your questions and concerns.

Complications

Possible complications of precocious puberty include: Short height. Children with precocious puberty may grow quickly at first and be tall, compared with their peers. But, because their bones mature more quickly than normal, they often stop growing earlier than usual.

Prevention

Much of the risk of precocious puberty is associated with gender, race, and family history, as well as other causes that are largely unavoidable, so you’re limited in what you can do to prevent this condition.

Keeping your child’s weight in a healthy range may help lower their risk of precocious puberty and other conditions associated with obesity and being overweight, such as type 2 diabetes.

You should also avoid giving your child prescription hormone medications, dietary supplements, or other products that may contain estrogen or testosterone, unless prescribed or recommended by their doctor.