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Children's Health

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Worried About Precocious Puberty? How to Talk to Your Pediatrician

What Precocious Puberty Looks Like

Early puberty looks like “normal” puberty, except it starts at a younger age. The signs include breast development, penis and/or testicle growth, rapid jumps in height, pubic or underarm hair, and acne. Suddenly a teenager’s body odor may fill the air. All familiar signs, except for the timing.

Early Puberty In Girls

Puberty starts for girls with the development of breast buds. Later changes include the development of pubic hair, underarm hair, and acne. During puberty, girls typically grow 2 to 3 inches each year, but have their largest growth spurt on average around age 12 1/2. Puberty ends for girls when menstruation starts. If a girl shows any sign of beginning puberty -- the onset of breasts -- before turning age 7, she may have precocious puberty.

Early Puberty in Boys

The first sign of puberty in boys is the enlargement of the testicles and scrotum. That is followed by pubic hair, penis growth, underarm hair, and voice change. The typical growth spurt for boys occurs later -- usually closer to age 14. Boys younger than age 9 who show signs of puberty should be seen by a doctor.

How Doctors Diagnose Early Puberty

Your pediatrician will probably start out asking a lot of questions about the child’s development and both parents’ medical history. A physical exam allows the doctor to compare the child’s development to his or her actual age.

Blood and urine tests help detect abnormal hormone levels. Doctors sometimes use imaging and scanning tests (CT scans, MRIs, and ultrasound) to look for tumors that could have set off early puberty. In most cases, however, there is no apparent anatomical cause.

An X-ray of the child's wrist can help determine how quickly the bones are maturing. If the bone age is far ahead of the child’s actual age -- for instance, if a child of age 6 has a bone age of 11 -- the child is in danger of not growing to his or her full height.

Your pediatrician may refer you to a pediatric endocrinologist for evaluation and treatment.

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