Precocious puberty is puberty that begins earlier than usual. An underlying condition may cause it, but other people experience early puberty for no apparent reason.

The age that puberty starts has steadily decreased over time. It is typically between 8 and 13 years in females and 9 and 14 years in males. Doctors define precocious puberty as the development of secondary sexual characteristics, such as breasts and pubic hair in females or a beard and pubic hair in males, before the above typical ages.

Even when puberty occurs early without a medical condition, it can cause concern — particularly for transgender and gender nonconforming children.

Read on to learn more about precocious puberty.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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On average, puberty begins earlier than it did a generation or two ago. However, health experts do not consider starting puberty at a slightly early age precocious puberty.

Precocious puberty is a medical diagnosis that means a female starts puberty before the age of 8 years or a male starts puberty before 9 years of age. It may also refer to puberty that occurs on time but happens very rapidly. For example, this can occur when a female develops adult breasts over the course of just a few months.

Precocious puberty may be idiopathic, which means there is no obvious cause. It can also occur when someone has an underlying medical condition.

Precocious puberty falls into two categories: central and peripheral.

Central precocious puberty

Central precocious puberty (CPP) means puberty begins for the same reasons as typical puberty. This means that signaling from a variety of hormones, especially gonadotropin-releasing hormone, causes it.

In most females, central precocious puberty is idiopathic, meaning there is no obvious cause. However, in males, it more commonly has an underlying cause.

Some potential causes of CPP include:

  • tumors affecting the central nervous system
  • brain abscesses
  • tubercular granuloma
  • head injuries
  • rare genetic syndromes such as mutations of the KISS1 gene

Peripheral precocious puberty

Peripheral precocious puberty means that something besides typical hormonal changes causes puberty. This can occur when sources other than gonadotropin-releasing hormone signal the body to release sex hormones.

Some examples of conditions that may cause peripheral precocious puberty include:

  • congenital adrenal hyperplasia
  • Van Wyk and Grumbach syndrome
  • tumors of the adrenals, which are glands that produce hormones
  • tumors on the gonads, which are sex organs involved in reproduction
  • McCune-Albright syndrome

It is important to identify the cause of precocious puberty. This is because it sometimes signals an underlying serious medical condition.

Precocious puberty can cause a person to grow earlier but have overall stunted growth. Without treatment, a child may be shorter than they otherwise would have been.

A limited body of research suggests some children may have behavioral issues if they have precocious puberty, but this conclusion does not have significant scientific support.

The condition can distress children, affecting their social relationships. In gender nonconforming children, it may intensify gender dysphoria.

There are two components to diagnosing precocious puberty.

First, a doctor will use Tanner staging, which rates sexual maturity and looks at development to determine how far into puberty a child is. This can help guide treatment decisions and assess how fast puberty is progressing.

After a doctor determines the stage of puberty, it is important to test for potential medical causes. This may include:

  • bloodwork to test hormone levels
  • abdominal and pelvic ultrasounds to look for tumors
  • MRI scans

No compelling evidence suggests that any specific strategy can prevent precocious puberty, though treatment can usually slow it down or even stop it.

A higher body mass index may increase the risk of precocious puberty. Therefore, a balanced diet and regular physical activity are beneficial.

If a pediatrician recommends weight loss, it is important to approach the process carefully and with medical supervision. There is no evidence that putting children on diets will stop puberty, and urging children to lose weight can undermine well-being.

Treatment for precocious puberty usually involves gonadotropin-releasing hormone agonists. These drugs suppress the natural production of sex hormones, which in turn blocks puberty. This may help preserve adult height and reduce the emotional distress children feel because of early puberty.

When there is an underlying cause, treatment should also target that cause.

A person should contact a doctor if:

  • A child of any age is gender nonconforming or trans and experiences distress about puberty.
  • A female under 8 years or a male under 9 years shows any signs of puberty.
  • Puberty seems to be progressing much faster than is typical.
  • A parent, caregiver, or child has any concerns about puberty.

Precocious puberty can be distressing for children. It may also cause them to end up shorter as adults, and in some cases, it can be a sign of a serious underlying medical condition.

If a child experiences early puberty, very fast puberty, or other signs of atypical development, it is important to consult a doctor.