Early pubic hair, breast, or genital development may result from normal but early maturation or from several abnormal conditions. Early puberty which is normal in every way except age is termed idiopathic central precocious puberty. It may be partial or transient. Central puberty can also occur prematurely if the inhibitory system of the brain is damaged, or a hypothalamic hematoma produces pulsatile gonadotropin-releasing hormone (GnRH). Secondary sexual development induced by sex steroids from other abnormal sources (gonadal or adrenal tumors, congenital adrenal hyperplasia, etc.) is referred to as peripheral precocious puberty or precocious pseudopuberty.

Clinical significance

Early sexual development deserves evaluation because it may :

induce early bone maturation and reduce eventual adult height,
cause significant social problems, or
indicate the presence of a tumor or other serious problem.

Measures

No single age limit reliably separates normal from abnormal processes, but the following age thresholds for evaluation will minimize the risk of missing a significant problem:

Pubic hair or genital enlargement in boys with onset before 9 years.
Breast development in boys before appearance of pubic hair and testicular enlargement.
Pubic hair before 8 or breast development in girls with onset before 7 years.
Vaginal bleeding in girls before 10 years.

Suggested causes: Environmental estrogens, sedentary lifestyle, and obesity

Other notes

Medical evaluation is sometimes necessary to recognize the few children with serious conditions from the majority who have entered puberty early but are still medically normal.

Children (esp. girls) who are obese are more likely to physically mature earlier.

Precocious puberty can make a child able to conceive when very young. Both sexes have become parents before age 10. The youngest mother on record is Lina Medina, who gave birth at the age of 5 years, 7 months and 21 days.

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Early Puberty in Girls - Shorts - Brief Article
From Townsend Letter for Doctors and Patients, 1/1/02 by Jule Klotter

According to a study published in Pediatrics (April 1997), nearly half of black American girls and 15% of white girls begin to develop breasts and/or pubic hair by age 8. "'I don't think parents, teachers or society in general have been really thinking of children that young -- second-and third-graders -- having to deal with puberty," said the study's lead author, Marcia Herman-Giddens of the University of North Carolina at Chapel Hill. The study involved 17,000 girls, ages 3 through 12. About 1,600 (9.6 percent) were black. Information on the girls came from 65 pediatric clinics throughout the US. The study also noted that the average age for onset of menstruation among black girls (12.16 years) was four months earlier than it was 30 years ago, while the average age for white girls (12.88 years) was unchanged. Although the article mentions that environmental estrogens may be a factor in early puberty nutrition and genetics are also factors. Marcia Herman-Giddens admits that the results maybe distorted if con cern about early puberty was the reason that many of the girls were taken to their doctor.

"Many girls in puberty by age 8, study finds" by Brenda C. Coleman. Seattle post-Intelligencer, April 8, 1997

Return to Precocious puberty

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