It may seem like kids are growing up faster these days. But central precocious puberty (CPP) is a rare condition. It happens when the body matures sooner -- perhaps years earlier -- than expected.
Puberty usually starts around age 7 1/2 in girls, and around age 9 in boys. In some children, such as those who are African American or Hispanic, normal puberty may happen slightly earlier. But in CPP, signs of puberty, such as budding breasts and body hair, show up much earlier than expected. It's more common for girls.
Puberty is a big change, even when it happens on schedule, and it can take some getting used to. Early puberty can also cause problems with bone growth. Talk with your child's doctor about what's happening. If it's too soon, you can slow or even reverse the changes in their body.
Causes
A part of the brain called the hypothalamus releases a hormone called gonadotropin-releasing hormone (GnRH). GnRH prompts the pituitary gland to release hormones called gonadotropins. They tell the sex organs to make other hormones that cause sexual development.
In central precocious puberty, the hypothalamus releases GnRH at a younger-than-normal age and starts the process. Most of the time, doctors can't pinpoint an exact cause for girls, but researchers have linked childhood obesity to early periods. Boys are more likely to have a specific trigger.
Your child's body might develop earlier than normal because of too many hormones or other chemicals in cosmetics, foods, insecticides, and other things.
Other causes include:
- A family history of CPP
- A rare gene problem
- A noncancerous tumor in the brain or pituitary gland
- A brain injury
- An infection in the brain, like meningitis
- Radiation or chemotherapy for cancer treatment
Symptoms
The signs of CPP are the typical changes you'd expect to see in a maturing preteen or teen.
- Hair in underarms and on private parts, and, for boys, on the face
- Acne
- Adult body odor
- Sexual development
- Emotional changes
For example, girls form breasts and start to have vaginal bleeding or their periods. They may be moody.
Boys' voices deepen and their testicles and penis get larger. They can get more aggressive.
Getting a Diagnosis
Your child's doctor will likely ask you questions before doing an exam or any tests.
- What physical changes have you seen in your child?
- Has your child's behavior changed recently?
- When did you first notice this?
- Is there any history of early puberty in your family?
If symptoms aren't severe, it can be hard to tell if it's CPP. Your doctor may want your child to see a doctor who focuses on children's hormones and growth, called a pediatric endocrinologist. Along with looking for signs of puberty, the doctor may want to measure
:
- Hormone levels
- Bone growth
- How fast your child has been developing
Blood tests check levels of hormones.
X-rays help find out if your child's bones are maturing too early.
Magnetic resonance imaging (MRI) or CT scans can rule out a tumor. These tests scan and make pictures of the inside of the body and brain.
For an older child, early development might be normal. Some kids start puberty as young as age 7.
Questions for Your Doctor
- What caused my child's symptoms?
- Is there a way to slow down their development?
- Could treating it cause other problems?
- What happens after treatment stops?
- What happens if we don't do anything?
- What's the best way to explain CPP to my child?
- Will my child be OK?
Treatment
If your doctor can find a specific cause, such as a tumor, he'll treat that.
For other causes, doctors can use a drug to block the sex hormones and prevent further development. A man-made version of the hormone GnRH stops the pituitary gland from sending out gonadotropins. The doctor can give your child a shot once a month or every 3 months, or your doctor could put a small implant under the skin of your child's upper arm, which works for a year. Where they get the shot or implant may hurt a bit, or their skin might get irritated around that spot, but there aren't any long-term side effects.
You'll probably want to keep up the treatment to hold back their hormones until your child gets old enough to let puberty continue -- around age 11 for girls and 12 for boys.
Most doctors always treat a child younger than 7 years old. When you're thinking about whether to treat CPP in an older child, you'll want to think about:
- Your child's age
- Their rate of development
- How your child has been reacting
- The chance of early menstruation
- Concerns about their height as an adult
Before you make any decisions, talk these things over with your child's doctor.
Taking Care of Your Child
Most kids want to fit in with their peers. Developing early could make your child feel self-conscious. Other people may expect more maturity because they think your child is older than he or she is.
These challenges plus the emotional changes from extra hormones can be a lot for them to deal with -- when they just want to feel "normal." Check in with the teachers and counselors at school, and keep an eye on your child's grades. Pay attention to their interest in doing things and being around friends and classmates.
How can you help? Explain what's happening in simple terms. Keep the lines of communication open.
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- Encourage your child to talk freely about his or her feelings.
- Treat your child appropriately for his or her age.
- Watch out for teasing.
- Do what you can to boost self-esteem. Try to focus your praise on achievements, rather than appearance.
What to Expect
An early growth spurt can make your child taller than their classmates and friends at first, but their bones may stop growing earlier, too. Without treatment, your child may end up shorter than they could have been.
With treatment, they're more likely to reach their full adult height. Within a year, their growth should slow to a normal rate. Their sexual development will stall and might even reverse. For example, a girl's breasts and a boy's penis and testicles could get smaller. Your child should start acting like other kids their age, too.
Studies show that children who are treated with GnRH have normal bone density. The treatment shouldn't cause problems for them having kids of their own later.
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