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Children's Health

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How Early Is Too Early for a Girl to Enter Puberty?


In rare cases, early signs of puberty might indicate a central nervous system problem, if accompanied by other symptoms, such as headaches and seizures.

Jasmine's parents rushed her to the pediatrician when they noticed she was developing pubic hair at age 4. "The doctor ran a couple of tests, did a bone scan, measured her bones, did blood work ... [and] determined it was precocious puberty," Henderson says.

Even in many cases in which a girl under 6 shows signs of puberty, there may be no problem, says Kaplowitz. "It's not at all rare to see children 3 and under with breast development. The majority of the time, it's a normal variant ... different from precocious puberty because it doesn't progress rapidly. Growth is normal, and bone maturation does not advance," he says.

But for some girls, like Jasmine, these signs can signal a hormonal imbalance, says her doctor, John Parks, MD, a pediatric endocrinologist at Emory University School of Medicine in Atlanta. Too much estrogen produced by the ovaries triggers rapid increases in breast development, bone growth, weight gain, appetite -- and menstruation follows a few years later.

The current treatment for precocious puberty involves monthly injections of hormone-like substances (one is marketed as Lupron) that suppress the reproductive hormones. "Hormone therapy will stop the progression of breast development," Parks tells WebMD. "It also slows height and weight increases, and the progression of skeletal maturation."

If precocious puberty is not treated, a child could find herself in the throes of emotions and physical changes more typical of teens, Parks tells WebMD. And ultimately, her bone development -- and adult height -- could be affected.

"Early puberty leads to early growth, so that a child tends to be tall relative to their peers," Parks says. "These children will complete their growth early, so they wind up taller than peers in first through fourth grades. Then, they stop growing and wind up shorter than you would expect from family background."

Children who are well into puberty before their age 6 birthdays will benefit from hormonal treatments in terms of their adult height, Parks tells WebMD. "If puberty appears later, or intervention is later, the height issues become a little more cloudy. Most of those children attain quite a normal adult height. The loss might be 1 or 2 inches [from] what you would expect from parents' heights.

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