Precocious Puberty

Updated: Jun 04, 2024
  • Author: Paul B Kaplowitz, MD, PhD; Chief Editor: Robert P Hoffman, MD  more...
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Overview

Practice Essentials

Precocious puberty refers to the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. For many years, puberty was designated as precocious in girls younger than 8 years; however, studies have come to indicate that signs of early puberty (breasts and pubic hair) are often present in girls (particularly Black girls) between ages 6-8 years. For boys, onset of puberty before age 9 years is still considered precocious.

In central precocious puberty (CPP), which is gonadotropin-dependent, early maturation of the entire hypothalamic-pituitary-gonadal (HPG) axis occurs, with the full spectrum of physical and hormonal changes of puberty.

Premature adrenarche and premature thelarche are two common, benign, normal variant conditions that can resemble true precocious puberty but that progress slowly or not at all. Premature thelarche refers to the isolated appearance of breast development, usually in girls younger than 3 years; premature adrenarche refers to the appearance of pubic hair without other signs of puberty in girls or boys younger than 7-8 years. A thorough history, physical examination, and growth curve review can help to distinguish these normal variants from true sexual precocity. A review of this topic was published as an

 
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