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Worried About Precocious Puberty? How to Talk to Your Pediatrician

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 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 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 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 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.

Treating Precocious Puberty

Many parents of children with precocious puberty choose to put their child on a treatment that lowers the level of sex hormones and slows puberty to a crawl.

Delaying puberty can give the child’s bones a chance to grow at their own pace for a longer period of time. It also gives the child’s mind, emotions, and social skills a chance to come up to speed. Puberty can then happen later, when all systems are ready to take it on together.

Questions for the Doctor

When children have precocious puberty, parents and doctors need to work together to determine the best course of action. The following questions can help parents get the conversation started.

  • What tests are you going to use to determine if my child has precocious puberty?
  • Do you see any signs to suggest this is caused by a tumor or some other medical condition?
  • What options are available to treat this condition?
  • What are the side effects?
  • How long do you recommend my child stay on this treatment?
  • How will I know if the treatment is working or not working?
  • What local services are available to help me support my child’s emotional well-being?

By working closely with medical professionals who understand precocious puberty, parents can make sure their children have the best possible childhood. 

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WebMD Medical Reference

Reviewed by Roy Benaroch, MD on August 02, 2012

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