What is Precocious Puberty?

Precocious puberty is defined as the onset of true puberty before 8 years of age in girls or 9 years of age in boys. Puberty is a natural part of the maturation process and we all go through it, the difference between normal puberty and precocious puberty is the age at which it starts. Some signs and symptoms of precocious puberty are girls develop breasts and start having monthly periods, for boys their penis and testicles grow larger, in both sexes you may notice behavioral changes they may become moody or aggressive, they grow pubic hair, their hair and skin may become oily or acne may develop, they may go
through a massive growth spurt like the one you would expect to see in adolescence.

How is precocious puberty diagnosed? First your doctor will perform a thorough physical examination. Then the doctor will probably order a bone age x-ray which is an x-ray of the hand and wrist, by determining the bone age your doctor can tell if your child's bone age matches his or her chronological age. The doctor will also order blood tests to determine the child's hormone levels. A pelvic and adrenal ultrasound may be done to ensure there are no abnormalities in the ovaries, testicles or adrenal glands. An MRI or a CAT scan may be done to check the pituitary gland and the hypothalamus. The ultrasound, MRI or CAT scan are used to rule out tumors which can be a cause of precocious puberty but it is very rare. Last a GnRH (gonadotropin stimulating hormone) stimulation test may be performed, this involves injecting the child with a GnRH stimulant and then checking blood hormone levels at predetermined intervals. This test will determine if the cause of the hormones in
the bloodstream is coming from the brain. If the answer is yes then it is quite probable that the child has precocious puberty.

How is precocious puberty treated? The goal in treating precocious puberty is to stop the advancement of puberty and possibly reverse the symptoms of early onset of puberty. The first course of action would be to treat any underlying causes such as a pelvic mass or pituitary tumor. When that is not an option GnRh Antagonists are used such as Nafarelin
nasal spray, Supprelin once yearly implant or most commonly Lupron Depot monthly injection. These medications are generally given until the child is approximately 11 to 13 years old. Once the medications are stopped the child will rapidly progress through puberty.