Central precocious puberty (CPP) is when your child's body releases certain hormones too soon. This causes early physical growth and sexual development (aka precocious puberty) in girls before age 8 and boys before age 9. Left untreated, CPP may lead to below average height (short stature) as well as social and emotional problems.
Treatment for central precocious puberty typically includes medication to slow or delay early puberty. Your care team may recommend other therapies or surgery if another medical condition or factor is causing your child's CPP.
Who Might Be on My Child's CPP Care Team?
When your child experiences symptoms of CPP, you need a care team that goes beyond your pediatrician. Your child's specialists may include:
Pediatrician. Your child's pediatrician is a type of primary care doctor -- and your first stop for care. Your pediatrician reviews your child's health history along with the medical history of your family.
Your doctor also performs a physical exam of your child's body, checking for signs of early growth. Your pediatrician may recommend monitoring (wait-and-see) or tests, including bone X-rays or blood tests, to confirm the diagnosis or find the cause of your child's CPP.
Radiologist. A radiologist is a doctor who specializes in diagnosing conditions and monitoring treatment using medical imaging techniques. These technologies make detailed pictures of your child's body and organs. Your pediatrician or specialist may recommend imaging tests to confirm a diagnosis of CPP or look for an underlying medical condition.
A radiologic technologist, who is not a doctor, controls the imaging equipment. They assist your child during tests that may include:
- CT scan
- MRI
- Pelvic ultrasound
- X-ray
Your radiologist reviews the images and sends a report to your child's care team. They may also consult with your child's doctor about additional exams or treatments.
Pediatric endocrinologist. Endocrinologists are trained to diagnose, treat, and manage diseases related to hormones. Pediatric endocrinologists look specifically at how hormones made by the body affect children. A pediatric endocrinologist can help confirm the diagnosis and decide if a hormone disorder is causing your child's CPP.
Your endocrinologist may recommend a gonadotropin stimulation test to see how well your child's pituitary gland is working. The pituitary gland makes and releases hormones needed for proper growth.
Your endocrinologist also helps decide what type of treatment may be best for your child. This may involve hormone therapy to stop or reverse your child's early sexual development while allowing your child to reach a taller adult height.
Medications may be provided through regular injections or an implant, which can stay in place for about 1 year. Your endocrinologist or an endocrine clinical nurse specialist may do the injections. If your child needs an implant, your care team refers you to a pediatric surgeon. Medication continues until your child reaches an age when it is appropriate to begin puberty.
Pediatric surgeon. Pediatric surgeons specialize in operations on children. Using surgery, they treat medical conditions that cause CPP, including tumors. Pediatric surgeons who operate on the brain are called pediatric neurosurgeons.
Your pediatric surgeon can also use a minimally invasive procedure to place an implant that delivers medication under the skin of your child's upper arm. This type of minor surgery is performed without your child having to stay in a hospital. It results in fewer, small incisions and a faster recovery than traditional surgery.
Pediatric gynecologist. Pediatric gynecologists are specially trained in providing children with reproductive system health care (vagina, uterus, ovaries, fallopian tubes, and breasts). If your female child develops symptoms of CPP, a pediatric gynecologist can help you understand how much your child has developed beyond the typical range.
This specialist can also support you and your child as you navigate treatment. It is not known how long-term CPP treatment affects hormone and reproductive function, including menstruation and fertility. A pediatric gynecologist can work with your pediatrician to monitor your child's development during and after treatment.
Pharmacist. A pharmacist is a skilled health care professional who specializes in the use, preparation, and dosage of medication. Your pharmacist can help you learn more about prescription medication your child may take to treat central precocious puberty.
Your child's pediatrician or endocrinologist works closely with the pharmacist to review potential side effects and interactions with other medications your child may take. Your pharmacist can also answer questions about dosages and how to give your child the medication.
Getting Additional Support
Mental health professional. Children with central precocious puberty may feel emotional or social distress. Some children may be self-conscious about having a mature appearance caused by early development. Others may experience poor self-esteem, anxiety, depression, or substance use.
Talking to a counselor, therapist or mental health expert can help your family work through the non-medical complexities of CPP. These health care professionals are trained to support you and your child. They can provide tools to help your child learn how to manage and overcome challenges related to central precocious puberty.
Genetic counselor. If you suspect CPP runs in your family, you may choose to talk to a genetic counselor. Genetic counseling is a confidential service that can give you information about conditions that may be passed down in families.
A genetic counselor collects your personal and family health history and helps you decide if a genetic test might be right for you or another family member. This may be especially helpful if you plan to have children or have more than one child.
A Team Approach Matters When Treating CPP
When your child is diagnosed with central precocious puberty, it's important to get a team of health care providers on your side. Together with you and your child's pediatrician, they use specialized expertise to confirm diagnosis and establish a treatment plan that fits your child's specific needs.
Effective treatment can put your child back on track for proper growth and development, while compassionate mental health specialists can help support your child's emotional needs as they age. By working together, your care team ensures that your child can live an active, full life.
