Doctors know how to treat central precocious puberty (CPP), an early start of puberty that affects one in every 5,000-10,000 kids. But before they can treat it, your pediatrician and other health care professionals have to make sure that your child has it.
When puberty starts can depend on many things, including family history, genetics, and race. But if you have a girl younger than 8 years old or a boy younger than 9 who shows signs of early puberty, it's worth a trip to your pediatrician to see what's up.
CPP can be serious. Kids with it are more likely to have early sexual activity and substance abuse. They can struggle in school, too. If CPP is left untreated, those who go through early growth spurts often end up much shorter as adults than they would have been.
Seeing Your Pediatrician
The first step for your pediatrician will be to get your child's health history.
Often, the cause of CPP is unknown. But experts think it can be the result of an injury or other issue with your child's brain. That problem forces the brain to send signals to your child's body to secrete hormones that prompt puberty.
Your pediatrician will ask you and your child about possible injuries -- both to your child's brain and elsewhere.
Genetics may play a part, too, so the doctor will want to get a complete health history of everyone in your family.
A physical exam will follow, and then probably some tests. Those tests can include:
X-rays. They'll usually want a look at your child's hand and wrist to figure out if their bones are growing too quickly.
Ultrasound of the pelvis. Doctors will sometimes order this both as a way to diagnose CPP and later to see if treatment for it is working. Ultrasounds can find any possible issues. On girls, they measure things like the size and placement of the uterus and ovaries.
Brain scans. When there is a cause, it's usually a tumor or other issue inside the head. Your pediatrician can order an MRI of your child's brain to see if something there could cause your child's body to make the hormones that trigger puberty.
Blood tests. Maybe the most important test to determine if a child has CPP is the gonadotropin releasing hormone (GnRH) stimulation test. The doctor will put an IV in your child's arm. They'll use it to give medicine, and also to take blood samples at different intervals after the medicine. The medication, called leuprolide (Lupron Depot), helps the doctor figure out if your child's body is making hormones prematurely.
Seeing Other Experts
Your pediatrician might bring in some help to reach a diagnosis, including from a pediatric endocrinologist. An endocrinologist studies the endocrine system. It's where your body makes hormones that control things like sexual maturity and growth.
For girls, a pediatric gynecologist might help, as well.
After the Diagnosis
If your team thinks that your child has CPP, treatment can begin. Before that, though, you might want a mental health expert to help with some of the unique problems that your child may face from maturing too early. Youngsters who look physically different than their peers can be very self-conscious. What's more, grown-ups often expect more of kids who look more mature.
If a tumor causes your child's CPP, a surgeon could be called in to remove it.
Medicine is an effective treatment for most kids with CPP. Your child's health care team can prescribe one that stops growth and allows your child's peers to catch up. About 16 months after your child stops the medicine, the process of puberty begins again, naturally.
National Organization for Rare Disorders: "Precocious Puberty."
National Institute of Child Health and Human Development: "Puberty and Precocious Puberty: Condition Information," "What causes normal puberty, precocious puberty, & delayed puberty?"
Mayo Clinic: "Precocious puberty," "Precocious puberty -- Diagnosis and treatment,"
Indian Journal of Endocrinology and Metabolism: "Contemporary issues in precocious puberty."
Pediatric Drugs: "Central Precocious Puberty: Update on Diagnosis and Treatment."
Cedars-Sinai: "Precocious Puberty."
National Cancer Institute: "Puberty."
Pediatrics: "Age at Menarche, Depression, and Antisocial Behavior in Adulthood."
Human Reproduction Update: "Precocious puberty and statural growth."
Frontiers in Pharmacology: "Pelvic Ultrasound in Diagnosing and Evaluating the Efficacy of Gonadotropin-Releasing Hormone Agonist Therapy in Girls With Idiopathic Central Precocious Puberty."
Biomedical Imaging and Intervention Journal: "Precocious puberty in children: A review of imaging findings."
McLaren Health Care: "Glossary of Medical Terms."
The Korean Journal of Laboratory Medicine: "Gonadotropin-releasing Hormone Stimulation Test for Precocious Puberty."
Nationwide Children's: "Gonadotropin Stimulation Test (GnRH)."
Endocrine Society: "The Endocrine System."
Pediatric Endocrine Society: "About PES."
Columbia Doctors: "Precocious Puberty (Pediatric)."
Texas Children's Hospital: "Pediatric and Adolescent Gynecology."
American Psychological Association: "The risks of earlier puberty."
Cleveland Clinic: "Precocious (Early) Puberty: Management and Treatment."