How Doctors Diagnose and Treat Precocious Puberty
Early Puberty: Treatment Options
For central precocious puberty, medications called GnRH analogs are the standard treatment. They work by blocking the hormones coming from the pituitary gland that trigger puberty. Most children who need treatment get these medicines as injections or implants.
- Injections are given as monthly shots into muscles or daily shots given just under the skin.
- Implants are tiny tubes -- a little over an inch long -- that are placed under the skin, usually in the upper arm. They gradually release medicine into the body.
- Nasal sprays are given daily.
GnRH analogs work quite well. During the first month of treatment, the signs of puberty might actually become more pronounced. But after that, they will go away. "In girls, the breasts will have shrunk after 6-12 months of treatment," says Kaplowitz. "In some cases, they almost disappear."
Side effects from GnRH analogs are generally mild. They include headaches, menopausal symptoms (like hot flashes), and abscesses at the injection site. There's no evidence that these drugs cause any long-term problems.
Other treatments for central precocious puberty include:
- Progestin. Injections of progestin used to be the standard treatment for central precocious puberty. They are less effective than GnRH analogs.
- Other treatments. Surgery and radiation might be necessary in cases where central precocious puberty has been triggered by a brain tumor. Removing the tumor won't always resolve all the symptoms.
These treatments delay puberty as long as your child takes them. How long does treatment for central precocious puberty last? That depends on the individual child and how well he or she is growing. Some studies have suggested that kids don't benefit from treatment beyond age 11.
Treatment for peripheral precocious puberty is quite different. It depends on the cause. In some cases, surgery might be necessary to remove a tumor or cyst from the ovaries or testicles. Medicines may help in some cases.
Central Precocious Puberty: Treatment Considerations
While treatment for central precocious puberty works well, not all kids may need it. How would a doctor decide? Here are some things he or she might consider.
- Time since diagnosis. After seeing a child with signs of early puberty, a doctor might wait up to six months before deciding on treatment. In some children with apparent early puberty, the symptoms slow down or stop on their own.
- Age. The younger the child, the more likely a doctor will suggest treatment. A 7 1/2-year-old girl with signs of early puberty might not need it. She's already close to the normal age of puberty. Treatment could have a bigger benefit for a 5- or 6-year-old.
- Rate of development. The rate that puberty is progressing is key. If a girl has some breast development, but it's happening slowly, a doctor might recommend holding off. But rapid changes -- even in an older child -- might mean treatment is a good idea.
- Current height. Without treatment, most kids with central precocious puberty attain an average height as adults, Kaplowitz says. However, some kids are at a higher risk of being short adults -- specifically, kids who are under 6 and kids who are substantially shorter than average when they start having symptoms. For these children, a doctor is likely to recommend treatment.
- Emotional maturity. This is related to age, but it's a distinct issue. Some kids have a harder time with the physical and emotional changes of puberty. Menstruation can be confusing or even frightening for some very young girls.