Precocious Puberty

Abstract

Puberty is a time of social, physical, and hormonal changes that follows a predictable path for most adolescents. Abnormal development occurs when the timing or sequence of pubertal events deviates from the typical course. Traditionally, precocious puberty has been defined as the onset of secondary sexual characteristics before the age of 8 years in girls1,2; however, there are some data to suggest that breast development between 6 and 8 years of age, especially in African American girls, may be a variant of normal.3-5 Practitioners should be comfortable recognizing early development of secondary sexual characteristics and starting the evaluation with a thorough history and physical examination. When the diagnosis of precocious puberty is suspected or made, the patient should be referred to a pediatric endocrinologist for further management. Treatment ultimately depends on the underlying cause, the rate of progression, and predicted adult height. We review normal puberty and precocious puberty including causes, evaluation, and treatment options.