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Early Puberty: Causes and Consequences

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For a parent, discovering that your child is entering puberty early can be alarming. Why is it happening? Can your child really handle the effects -- both physical and psychological?

Many kids who have early puberty don't need treatment. In those who do, treatment usually works well in halting the process. Here are some basic facts about the causes of early puberty and the ways it might affect your child.

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What Is Early Puberty?

Puberty starts on average in girls between ages 8-13 and in boys between ages 9-14.

Doctors diagnose early puberty when this normal process starts early and continues to progress through growth spurts and bone maturation, usually for reasons we don't understand. Girls who show significant signs of puberty and its progression before age 7 and boys before age 9 are considered precocious. About 1 out of 5,000 children are affected.

There are two types of precocious puberty, central and peripheral.

  • Central precocious puberty is the more common type. The process is identical to normal puberty, but happens early. The pituitary gland is prompted to produce hormones, called gonadotropins. These hormones in turn stimulate the testicles or ovaries to make other hormones, testosterone or estrogen. It's these sex hormones that cause the changes of puberty, like breast development in girls.
  • Peripheral precocious puberty or precocious pseudo-puberty is a different condition. It's also rarer. The hormones estrogen and testosterone trigger the symptoms. But the brain and pituitary gland are not involved. It's usually a local problem with the ovaries, testicles, adrenal gland, or a severely underactive thyroid gland.

There are other conditions that might look like early puberty to parents -- and sometimes even to pediatricians -- but aren't.

  • Premature thelarche is early breast development at a young age. It often appears in girls who are just a few years old. While troubling for parents, it resolves on its own and is not true early puberty. It does not require treatment but should be evaluated.
  • Premature pubarche is the early development of some pubic or underarm hair at an early age. It can be caused by premature adrenarche, when the adrenal glands start releasing hormones early. Again, while it might seem alarming, it's generally not a problem and not an early sign of puberty. However, because this may represent the first sign of an abnormal and excess release of adrenal hormones, it should be evaluated.

Many experts say that, on average, puberty is starting earlier in the U.S. than it did in the past. The average age of menstruation has stayed roughly the same. Yet studies suggest that early signs -- like breast development -- are happening a year earlier than they did decades ago.

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