Early puberty, also known as precocious puberty, is when a child’s body begins changing into that of an adult (puberty) too soon. Puberty normally begins between ages 8 and 13 in girls and ages 9 and 14 in boys. Early puberty is on the rise, and girls are more frequently affected than boys.
What is early puberty?
Early puberty is the onset of signs and symptoms of puberty before age 8 in girls and before age 9 in boys. These signs and symptoms include:
- Breast development and first period in girls
- Enlarged testicles and penis, facial hair and deepening voice in boys
- Pubic or underarm hair
- Rapid growth spurt
- Acne
- Body odor
Early maturation of the reproductive system is known as central precocious puberty. Early breast and pubic hair development without other signs of puberty is called premature thelarche and premature pubarche, respectively.
What causes early puberty?
The exact causes of early puberty are often unknown, but several factors may influence its development:
Obesity
Excess body fat and obesity have been strongly linked to early puberty, especially in girls. The rising obesity rates are thought to play a major role in the increase in precocious puberty.
Body fat produces higher amounts of the hormone leptin, which signals the start of puberty. Girls today are entering puberty at younger ages, possibly due to increased obesity rates.
Genetics
Genes likely play a role in the timing of puberty. For example, a girl who had her first period before age 12 is more likely to have a daughter who starts puberty early.
Other medical conditions
Several medical conditions are associated with early puberty, including:
- Tumors in the brain, ovaries or testes
- Hypothyroidism and other hormone conditions
- Infections
- Head injuries
- Chromosomal abnormalities, such as Turner syndrome
Environmental and lifestyle factors
Chemicals in the environment and diet may affect hormone levels and the timing of puberty. For example, chemicals like pesticides, phthalates and BPA can mimic estrogen in the body and potentially influence growth and development.
Stress and unstable family environments may also prompt puberty to start earlier.
Diagnosis of early puberty
If your child is showing early signs of puberty, see a doctor to determine the underlying cause. The doctor will do a physical exam and ask about your family history.
Other tests may include:
- Blood tests to check hormone levels
- Imaging tests like an ultrasound or MRI scan to look for abnormalities
- Bone age x-ray to see if the bones are maturing too quickly
Based on the results, the doctor can confirm if your child has early puberty and recommend the best treatment options.
Treatment for early puberty
The main goals of treating early puberty are to:
- Slow the signs of puberty
- Allow more time for growth and development
- Prevent short stature as an adult
- Prevent psychological issues due to starting puberty too soon
The most common treatment is medication to suppress puberty. The two main options are:
GnRH analogs
Gonadotropin releasing hormone (GnRH) analogs suppress puberty by decreasing the production of sex hormones. They are given as injections every 1 to 3 months. The drugs halt breast development and menstruation in girls and delay facial hair growth and voice changes in boys.
Aromatase inhibitors
These drugs prevent the conversion of androgens to estrogen, helping to slow early puberty in girls. They may be used alone or with GnRH analogs.
Treatment generally continues until the normal age of puberty. Your child will be monitored closely during this time.
If an underlying condition like a tumor is causing early puberty, treating the underlying problem may resolve the precocious puberty as well.
Outlook and concerns with early puberty
When treated properly, early puberty will not affect a child’s fertility in the future. However, without treatment, starting puberty too early can impact growth and development.
Potential concerns include:
- Short stature as an adult – Puberty stops linear growth. Early puberty may result in a shorter adult height.
- Weak bones – Puberty accelerates bone maturation, so bones may be weaker later in life.
- Social and emotional issues – Developing earlier than peers can affect self-esteem and increase the risk of depression, anxiety, eating disorders and substance abuse.
- Early sexual activity and teen pregnancy
- Increased risk for adult diseases like obesity, diabetes, heart disease and cancer
While early puberty was once brushed aside as a normal variation of development, health professionals now recommend evaluation and treatment to ensure the best long-term outcomes.
Takeaways
Key points about early puberty in girls:
- It is defined as the onset of breast development and first period before age 8.
- Obesity, genetics, medical conditions and environmental factors may trigger early maturation.
- Treatment with GnRH analogs or aromatase inhibitors can temporarily suppress the signs of puberty.
- Early puberty impacts growth and psychosocial functioning. Seeking treatment helps ensure healthy development.
Talk to your daughter’s doctor if you notice signs of puberty before age 8. Early evaluation and management can get puberty back on track.
