Puberty usually starts when kids are between ages 8 and 14. Children with central precocious puberty (CPP) start the process earlier than their peers -- before age 8 in girls, and by age 9 in boys. In boys, the penis grows and the voice deepens. Girls develop breasts and begin to get their period.
Being the first of their friends to enter puberty can cause stress and anxiety. As a result, some kids have problems with their emotions and behavior.
Precocious puberty also affects a child's growth. At first, children grow faster than their peers. But because their bones stop growing sooner than normal, they may end up shorter than they should've been.
Central precocious puberty doesn't always need treatment. Kids who start puberty close to the normal age (7 or 8) may be able to wait, especially if their puberty is moving slowly. They'll have check-ups every few months so that their doctor can see how puberty is progressing.
Younger children can take medicine to slow or stop puberty and keep them on pace with their friends. Sometimes early puberty can be reversed. CPP treatments also help kids grow taller.
When it's time to start puberty, a child's brain releases gonadotropin-releasing hormone (GnRH). This signals their pituitary gland to release two other hormones -- luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
LH and FSH signal a boy's testes to make the hormone testosterone, and a girl's ovaries to make estrogen. These sex hormones cause the changes of puberty -- body hair, acne, growth, menstrual periods in girls, and a deeper voice in boys. In children with CPP, these hormones show up too early.
One group of medicines that treat central precocious puberty are GnRH agonists. They stop the pituitary gland from making FSH and LH. Blocking these hormones prevents the release of testosterone and estrogen, which slows or stops puberty.
Examples of GnRH agonists are:
- Leuprolide acetate (Lupron Depot)
- Triptorelin (Trelstar, Triptodur)
These medicines come as a shot that children get about once a month.
Histrelin (Supprelin LA, Vantas) is another hormone treatment. It comes as an implant that the doctor places under the skin of your child's arm with a minor surgery. Each implant slowly releases the medicine into your child's body for a year. At the end of the year, the doctor replaces the old implant with a new one.
They'll check your child every few months to make sure the treatment is working and that their puberty has slowed or stopped. Kids can stop taking these medicines once they reach the age when puberty is supposed to start.
Treating an Underlying Cause
Often doctors don't know what causes early puberty. But when they do know, they can slow or stop the process with treatments like:
- Surgery to remove a tumor that's releasing the hormones that cause early puberty
- Steroids and other medicines to replace or block hormones in kids with congenital adrenal hyperplasia, a group of disorders that affect the amount of hormones that the adrenal glands can make
- Drugs to stop estrogen or testosterone production in kids with McCune-Albright syndrome (MAS), a disorder that affects tissues that make hormones.
Children who start puberty early may look different than their peers, which can make them feel self-conscious or cause them to be bullied at school. Growing breasts, getting their first period, or having a deep voice before other kids their age can be upsetting.
The flood of hormones released during early puberty can make kids moodier than they'd normally be at their age. Those hormones can also give them a sex drive before they're emotionally ready for sex.
If your child has stress or anxiety from early puberty, see a psychologist or counselor. A mental health professional can teach your child ways to cope with the changes that are happening to their body. Ask the doctor who treats your child's CPP to recommend someone.
Sometimes central precocious puberty runs in families. The gene changes that can cause CPP pass from parents to their children.
You may want to visit a genetic counselor if central precocious puberty runs in your family. The counselor can explain your child's chances of having CPP and recommend genetic tests for your child or other members of your family.
Scientists look for new ways to treat central precocious puberty in clinical trials. These studies test new types of GnRH agonists and other drugs to see if they are safe and if they work better than current medicines.
A clinical trial can be a way for your child to try a new treatment that isn't yet available to everyone. Your child's doctor can tell you if one of these trials might be a good fit.
Best Practice & Research: Clinical Endocrinology & Metabolism: "Central precocious puberty, functional and tumor-related."
Cedars-Sinai: "Precocious Puberty."
Family Doctor.org: "Central Precocious Puberty."
KidsHealth.org: "Everything You Wanted to Know About Puberty."
Mayo Clinic: "Congenital adrenal hyperplasia," "Precocious puberty."
Medscape: "Precocious Puberty Treatment & Management."
National Organization for Rare Disorders: "Precocious Puberty."
National Society of Genetic Counselors: "Who are Genetic Counselors?"
National Center for Biotechnology Information: "Gonadotropin Releasing Hormone (GnRH) Analogues."
Riley Children's Health: "Precocious Puberty."
U.S. National Library of Medicine: "Central precocious puberty."