Precocious
Puberty
By: Rein Jezter S. De los Reyes
Judelyn Bornales
Precocious Puberty
Precocious puberty is when a child's body begins changing into that of an adult (puberty) too
soon. When puberty begins before age 8 in girls and before age 9 in boys, it is considered
precocious puberty.
Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of
the body's ability to reproduce.
The cause of precocious puberty often can't be found. Rarely, certain conditions, such as infections,
hormone disorders, tumors, brain abnormalities or injuries, may cause precocious puberty. Treatment for
precocious puberty typically includes medication to delay further development.
Symptoms
Precocious puberty signs and symptoms include
development of the following before age 8 in girls
and before age 9 in boys.
● Breast growth and first period in girls
● Enlarged testicles and penis, facial hair and
deepening voice in boys
● Pubic or underarm hair
● Rapid growth
● Acne
● Adult body odor
Images of Precocious Puberty
Girls and Boys
it
Precocious Puberty: Cause
• Central Precocious Puberty • Peripheral Precocious Puberty
Idiopathic, with or without hypothalamic
hamartoma - familial male-limited precocious
puberty
• Secondary - Albright syndrome
- congenital anomalies - gonadal or extragonadal tumors
- post inflammatory: Encephalitis, meningitis, - Adrenal
abscess, granulomatous disease Congenital adrenal hyperplasia
- radiotherapy Adenoma, carcinoma Glucocorticoid
- trauma resistance
- neoplasms - Exogenous sex hormones
- Primary hypothyroidism
• Incomplete Precocious Puberty
-premature thelarche
-premature menarche
-premature pubarche or adrenarche
Classification of Precocious puberty
Precocious puberty can be divided into 2 types:
• Gonadotropin-releasing hormone (GnRH)–dependent (central precocious
puberty)
• GnRH-independent (peripheral sex hormone effects)
GnRH-dependent precocious puberty is GnRH-independent precocious
more common overall and 5 to 10 times puberty is much less common.
more frequent in girls. In GnRH- Secondary sexual characteristics
dependent precocious puberty, the result from high circulating levels of
hypothalamic-pituitary axis is activated, estrogens or androgens, without
resulting in enlargement and maturation activation of the hypothalamic-
of the gonads, development of secondary pituitary axis.
sexual characteristics, and oogenesis or
spermatogenesis.
Incomplete or unstained pubertal development is common,
most often as isolated premature thelarche or adrenarche.
Girls with premature thelarche typically display breast
development during the first 2 years of life, but this change is
not accompanied by pubertal hormone levels, menarche,
advanced bone age on x-ray, androgen effects, or growth
acceleration. Isolated premature adrenarche is likewise not
associated with progressive pubertal development.
Prevention
Some of the risk factors for precocious puberty, such as sex and race,
can't be avoided. But, there are things you can do to reduce your
child's chances of developing precocious puberty, including:
• Keeping your child away from external sources of estrogen and
testosterone — such as prescription medications for adults in the
house or dietary supplements containing estrogen or testosterone
• Encouraging your child to maintain a healthy weight
Precocious puberty: Treatment
The primary goal of treatment is to enable your child to grow
to a normal adult height.
Treatment for precocious puberty depends on the cause.
However, in some cases, there is no identifiable cause for
precocious puberty. In this instance, your child may not need
treatment depending on his or her age and how rapidly
puberty is progressing. Your child's doctor may want to
monitor your child for several months to see how he or she is
developing.
Treating Central Precocious Puberty
Most children with central precocious puberty, in which there's no underlying medical
condition, can be effectively treated with medication. This treatment, called GnRH
analogue therapy, usually includes a monthly injection of a medication, such as leuprolide
acetate (Lupron Depot), or triptorelin (Trelstar, Triptodur Kit), which delays further
development. Some newer formulations can be given at longer intervals.
Treating an underlying medical condition
If another medical condition is causing your child's precocious puberty, treatment of that
condition is necessary to stop the progress of puberty. For example, if a child has a tumor
that's producing hormones and causing precocious puberty, puberty usually will stop
when the tumor is surgically removed.
Precocious Puberty: Therapeutic
Management
● CPP is managed with monthly injections of a synthetic analog of
the luteinizing hormone-releasing hormone
● Treatment is discontinued at a chronologically appropriate time,
allowing pubertal changes to resume
Precocious puberty: Nursing Care
Management
● Both parents and the affected child should be taught the injection
procedure
● Dress and activities for the physically precocious child should be
appropriate to the chronologic age.
Thank you!
CREDITS: This presentation template was created by Slidesgo, and
includes icons by Flaticon, and infographics & images by Freepik
Resources
https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc
-20351811
https://www.msdmanuals.com/professional/pediatrics/endocrine-disorders-in-
children/precocious-puberty#v29302086
