Central Precocious Puberty

What is central precocious puberty?

Puberty is the time of life when boys’ and girls’ bodies begin to develop or mature. Puberty involves sexual, physical, and emotional changes. Children go through puberty on their own time. Normally, it begins for girls between the ages of 8 and 13. In boys, it begins between the ages of 9 and 14.

Precocious puberty refers to early onset puberty symptoms. Central precocious puberty (CPP) is the more common type. Medically, it is known as gonadotropin-dependent precocious puberty. The other type is peripheral (gonadotropin-independent) precocious puberty. A girl younger than 8 years old or a boy younger than 9 years old who has puberty symptoms may have CPP.

Symptoms of central precocious puberty

The symptoms of CPP are the same as normal puberty. The difference is that they occur at a younger age.

Common puberty symptoms for girls are:

• Breast development
• Pubic or body hair
• Growth spurt
• Acne
• Body odor
• First menstrual cycle (period)

Common puberty symptoms for boys are:

• Growth of penis and testicles
• Pubic, facial, or body hair
• Growth spurt
• Muscle development
• Acne
• Body odor
• Voice change (deepening)

What causes central precocious puberty?

In most cases of CPP, the cause is unknown. Potential causes involve health problems that occur in your child’s brain. These include:

• Brain tumor
• Infection of the brain
• Radiation to the brain, such as cancer treatment
• Trauma to the brain
• Other brain defects

How is central precocious puberty diagnosed?

Talk to your child’s doctor if you notice early signs of puberty. The doctor will do a physical exam. Blood and urine tests check hormone levels. High levels suggest the onset of puberty. After diagnosis, other tests can be done to determine a cause. The doctor can check your child’s hormones to see if precocious puberty is central or peripheral. MRIs and CT scans scan the brain for any problems. An X-ray checks your child’s bone growth to see if it’s normal.

Can central precocious puberty be prevented or avoided?

You cannot prevent CPP. Children who are genetically female are at greater risk for CPP. Those who are overweight or have obesity also carry a greater risk.

Central precocious puberty treatment

Treatment for CPP depends on how early it occurs. If puberty begins slightly before the normal age, your child may not need any treatment. If puberty begins much earlier, the doctor may want to stop it. This can be done with medicines, such as gonadotropin-releasing hormone agonists (GnRHa). They lower your child’s sex hormone levels to stop puberty.

Any underlying cause of CPP also needs to be treated. Your doctor will explain options for tumors, infections, trauma, or other causes.

Living with central precocious puberty

The following complications are possible for children who do not get treatment for CPP:

• Unable to reach full height because body growth stops early.
• Social problems because they go through puberty before kids their age. These include anxiety from being different, depression, and bullying.
• Emotional problems, such as moodiness, defiance, and aggression.
• Early sex drive. Children are not mentally prepared for sex at a young age. This can become a problem if kids act on their impulses.

Questions to ask your doctor

• How can I tell if my child’s symptoms are due to CPP?
• Does CPP run in families?
• Does my child have to take medicine to stop puberty?
• Can you recommend a support group for my child and I?
• Are there any disorders related to CPP?

Resources

National Institute of Child Health and Human Development, Puberty and Precocious Puberty