Precocious puberty
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Precocious puberty means early puberty.
Early pubic hair, breast, or genital development may result from normal but early maturation or from several abnormal conditions. Early puberty which is normal in every way except age is termed idiopathic central precocious puberty. It may be partial or transient. Central puberty can also occur prematurely if the inhibitory system of the brain is damaged, or a hypothalamic hamartoma produces pulsatile gonadotropin-releasing hormone (GnRH). Secondary sexual development induced by sex steroids from other abnormal sources (gonadal or adrenal tumors, congenital adrenal hyperplasia, etc.) is referred to as peripheral precocious puberty or precocious pseudopuberty.
Early sexual development deserves evaluation because it may :
- induce early bone maturation and reduce eventual adult height,
- cause significant social problems, or
- indicate the presence of a tumor or other serious problem.
No single age limit reliably separates normal from abnormal processes, but the following age thresholds for evaluation will minimize the risk of missing a significant problem:
- Pubic hair or genital enlargement in boys with onset before 9 years.
- Breast development in boys before appearance of pubic hair and testicular enlargement.
- Pubic hair before 8 or breast development in girls with onset before 7 years.
- Vaginal bleeding in girls before 10 years.
Medical evaluation is sometimes necessary to separate the few children with serious conditions from the majority who are early-but-normal.