What to Expect with Central Precocious Puberty

When puberty starts can vary. Genetics, family history, environment, and race can all play a part. But central precocious puberty (CPP) is a very early start of puberty. How early? For girls, it's any time before 8 years old. For boys, it's before 9 years old.

Experts believe that CPP happens because an abnormality in the brain causes it to signal the body to start puberty. When that happens, glands secrete different growth and sex hormones -- estrogen for girls, testosterone for boys.

The abnormality may be because of things like:

• Tumors
• Infection
• Brain injury

In rare cases, it may be genetic. Other times, doctors don't know the cause.

Symptoms

Girls who have CPP may start menstruating. They may grow breasts, as well. Boys with the condition may notice that their penis and testicles get larger.

Other symptoms common with both boys and girls include:

• Accelerated growth
Acne
• Body odor, like that from an adult
• Pubic and underarm hair

Diagnosis

If your child shows signs of early puberty, visit a pediatrician.

They'll go over your child's health history, and look into the family health history. From there, the doctor will do a physical exam to look for signs of early puberty.

They may order tests, too. These can include:

• X-ray (to look at bones)
• Ultrasound of the pelvis
• Scans of the brain, pituitary gland, ovaries, and testes
• Blood tests to check levels of certain hormones

Your pediatrician may suggest adding other doctors and experts to your health care team. A pediatric endocrinologist treats kids with disorders of the endocrine system, which makes hormones that regulate things like sexual maturity and growth. If your team believes that a tumor or some other mass may be the cause of early puberty, you may meet with a surgeon. For girls with CPP, a pediatric gynecologist might be appropriate.

Complications

Kids who reach puberty too quickly because of CPP can face several challenges. One of the biggest: Bones that grow too quickly can stop growing earlier than usual. This can result in shorter height as adults.

In addition to the physical, youngsters who look more grown-up can be self- conscious about their appearance. They can struggle with the expectations that others put on them because they look and sometimes sound older. Girls can be at risk for problems linked to early sexual activity. They may have anxiety or eating disorders that may last into adulthood.

Your child's pediatrician may refer you to a mental health expert to help with the unique pressures that your son or daughter may face as they deal with all of that.

Treatment

The primary goal of treatment for CPP is to slow or stop the maturation process. One concern is that bone growth that happens too early can affect a child's height.

For girls, another important goal is to stop the first menstrual period.

Medication is an effective treatment for most kids with CPP. Your team may prescribe a type of hormonal treatment to pause the maturation process. It's often a monthly shot. Sometimes, your doctor can implant medicine under the skin, which would be good for up to a year. That could save your child the pain and inconvenience of regular shots.

In some cases, treatment actually may be able to reverse the start of early puberty. Your kid will stay on the medicine until the normal age of puberty. About 16 months later, on average, puberty will kick in again.

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