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What Is Premature Adrenarche?

Medically Reviewed by Poonam Sachdev on April 28, 2022

The term adrenarche refers to the point when your adrenal cortex matures. This maturation typically occurs around five years of age and causes an increase in certain hormones. 

There are usually no physical signs of adrenarche, though, until eight or nine years old – these visible manifestations of adrenarche are called pubarche. Premature adrenarche, when hormones are elevated before eight or nine years old, causes puberty-like symptoms at a young age.

Symptoms of Premature Adrenarche

If your child is experiencing signs of early puberty, they may have premature adrenarche. Remember that this is not a serious condition, but your child’s body is following its own maturation schedule. 

The most common premature adrenarche symptoms include:

  • The presence of pubic or underarm hair in boys younger than nine years old or girls younger than eight years old.
  • Strong underarm smells that require deodorants.
  • Lack of breast development in girls or genital growth in boys. If they reach this stage of maturation, they’re likely experiencing puberty rather than premature adrenarche.
  • Greater-than-average height, typically above the 90th percentile.

Hormones from your adrenal cortex spur the growth of pubic hair, but they don’t cause breast enlargement or penis growth. This growth occurs when the ovaries produce estrogen and the testes produce testosterone, respectively. This means that a young female with premature adrenarche shouldn’t expect her period. Menstruation typically starts a few years after the ovaries begin producing estrogen.

This condition isn’t typically dangerous or harmful to your child but can cause complications. Girls with premature adrenarche are more likely to develop polycystic ovary syndrome (PCOS) as teens. PCOS can cause missed or irregular periods, heavier than normal facial hair, and weight gain.

There is a small chance that premature adrenarche is a sign of an enzyme problem or tumor. For this reason, you should get in touch with your healthcare provider if your child exhibits signs of premature adrenarche before age eight (for girls) or nine (for boys).

Causes of Premature Adrenarche

Premature adrenarche happens as a result of an increase of certain hormones before they would normally increase. These products, including a well-known hormone called DHEA, come from the adrenal glands located on top of the kidneys. It’s typical for the adrenal glands to produce these hormones around or after age ten, but if it happens before then, it is classified as premature.

On the plus side, your child’s adrenal gland is not producing more hormones than normal, it is simply making the correct amount earlier than expected. Adrenarche will occur at some point as a normal part of development, and with it, the symptoms listed above. 

In other words, the symptoms shouldn’t be more intense than expected; they will just show up sooner. For example, if your child has premature adrenarche, they shouldn’t grow an extreme amount of pubic or underarm hair; they’ll just grow the hair unexpectedly. 

Exact premature adrenarche causes are unknown, though it’s possible that being overweight increases the likelihood. Note, however, that many children have this condition without being overweight. 

Premature adrenarche is also more likely to occur in children who were born smaller than average or are of African descent. Otherwise, genetics don’t seem to play a significant part in premature adrenarche.

If your child has come into contact with creams or medications that contain hormones, this can cause premature adrenarche.

Diagnosing Premature Adrenarche

If you think your child may have premature adrenarche, reach out to their healthcare provider. While there aren’t tests that can indicate positive results for this condition, the healthcare provider may want to keep an eye on your child’s progression by seeing them more regularly. Your child may also undergo certain diagnostic procedures, including:

  • Monitoring growth to ensure they are growing at a reasonable rate
  • Doing bloodwork to check on hormone levels
  • Taking an X-ray of a hand to measure bone age, which is a sign of premature puberty

If your child’s only symptom is early pubic hair, it’s likely that your healthcare provider won’t see a need for extensive testing. Your child probably has premature adrenarche and isn’t at risk of experiencing complications. 

On the other hand, if your child is also experiencing rapid growth and development in their breasts or genitals, there may be cause to explore the possibility of another condition.

Treating Premature Adrenarche

There is no treatment for premature adrenarche. There are medications that slow down early puberty, but these have no effect on premature adrenarche.

Instead of trying to treat the condition’s symptoms, you may want to focus on your child’s emotional wellbeing. Their body is changing sooner than those of their peers, and this can cause self-conscious feelings. Make sure your child knows that the changes happening in their body are totally normal even though other children may not be experiencing them at the moment. If they are teased by peers, find ways to boost their self-esteem and help them adjust.

Premature Adrenarche vs Puberty

While premature adrenarche is simply the maturing of your child’s adrenal gland, puberty is a phase during which your child’s body develops sexual reproduction capabilities. Puberty differs from premature adrenarche because the brain will also send signals to the testes and ovaries to start the production of sperm or eggs and trigger secondary sexual characteristics like breast development and voice deepening.

Think of adrenarche and puberty as two distinct processes that your child goes through. It’s possible for them to happen at the same time, but one may occur before the other.

Visiting a Healthcare Provider for Premature Adrenarche

As you prepare to visit a healthcare provider with your child, gather information that could help them diagnose your child correctly, including:

  • Your child’s growth charts
  • Maturation history for your child’s parents, if possible (when mom started her first period, when dad began shaving, etc.)

During the appointment, your child’s healthcare provider will perform an examination to see if they have started puberty yet using some of the methods described above. You may need to make a follow-up appointment in addition so that your child can be monitored for puberty changes.

Show Sources

Sources:

Boston Children’s Hospital: “Premature Adrenarche.”

Cincinnati Children’s: “Premature Adrenarche.”

Healthychildren.org: “Premature Adrenarche: Information for Parents.”

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