A teen girl brushes her hair as she experiences precocious puberty
A teen girl brushes her hair as she experiences precocious puberty
A teen girl brushes her hair as she experiences precocious puberty

Precocious Puberty

What is Precocious Puberty? 

Precocious puberty means sexual development that begins prematurely, before age 8 in girls and before age 9 in boys. It happens when the pituitary gland releases sex hormones called gonadotropins, which stimulate the development of the ovaries in girls and testes and boys, which in turn triggers the female sex hormone estrogen in girls and the male sex hormone testosterone in boys. In some cases, precocious puberty is a symptom of another disorder, such as congenital adrenal hyperplasia or tumors of the testes or ovaries or tumors of the adrenal gland that cause the release of sex hormones. Tumors in the pituitary gland or hypothalamus can also cause precocious puberty. 

A similar disorder is pseudo-precocious puberty in which estrogen and testosterone are secreted by tumors in the adrenal gland or in the testis or ovaries. However, unlike true precocious puberty, the ovaries or the testes themselves do not mature. 

Sometimes, no cause can be found for early puberty. 

Symptoms 

  • Development of adult features and characteristics 

  • Adult body odor 

  • Pubic hair and underarm hair 

  • Facial hair and voice changes in boys 

  • Acne 

  • Breast development and menstruation in girls 

  • Rapid height growth that abruptly stops at an early age 

Diagnosis 

  • Blood tests to determine levels of sex hormones 

  • X-rays of the hand to determine bone age 

  • Ultrasound of the pelvis and adrenal glands 

  • CT or MRI imaging of the head to rule out tumors in the hypothalamus or pituitary gland 

When to Call for Help

If your child starts to exhibit any of the above signs at an abnormally early age, call a health-care provider. 

Treatment 

Most cases of precocious or pseudo-precocious puberty are treated with synthetic hormones or certain medications that inhibit the release and effects of sex hormones. When the premature production of sex hormones is caused by a tumor, surgical removal of the tumor is the preferred treatment. 

Pediatric Endocrinology & Diabetes Care at Johns Hopkins

  • The Division of Pediatric Endocrinology at Johns Hopkins Children's Center

    Experts in the Division of Pediatric Endocrinology and Diabetes see patients in locations throughout Maryland, offering expertise in areas such as growth disorder, puberty, sex differentiation, glucose metabolism and more.

  • Johns Hopkins All Children's Hospital Endocrinology & Diabetes Care

    The endocrinology and diabetes program at Johns Hopkins All Children's Hospital in St. Petersburg, Florida, provides diagnosis, treatment and follow-up care for children, teens and young adults with endocrine and diabetes disorders. Our team of experts consists of physicians, nurses, diabetes educators, dietitians and social workers who work closely with patients and caregivers to create an individualized treatment plan.

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