Precocious puberty

Abstract

Precocious puberty has become a hot topic in recent years because of concern that girls in the USA are starting puberty earlier now than in the past, and the uncertainty as to what might be causing this trend. Thus any discussion of this topic should begin with the problem of defining when puberty in girls should be considered precocious; this will involve a review of the data suggesting a trend towards earlier appearance of breast development and pubic hair, and the racial differences that have been reported. Distinctions will be made among two common normal variants, premature adrenarche and premature thelarche, central (‘true’) precocious puberty and the more serious but far less common peripheral precocious puberty, as well as the puzzling phenomenon of premature menarche. The most efficient and cost-effective laboratory evaluation based on the presenting signs of puberty will be discussed. Finally, there will be a brief discussion of the latest trends in the treatment of central and peripheral precocious puberty.