Patient education: Early puberty (The Basics)

What is early puberty? — Puberty is a term for the changes in the body that happen as a child becomes an adult. Early puberty is when a child's body starts changing at a much younger age than normal.

Puberty usually starts between ages 9 to 12 in girls and ages 10 to 13 in boys. Puberty is early if it starts before age 8 in girls and age 9 in boys.

What causes early puberty? — Puberty is caused by hormones in the body. Normally, these hormones come from the brain as well as the ovaries (in girls) and testicles (in boys) (figure 1 and figure 2). Different things can cause puberty to start early.

Sometimes, when puberty starts early, it is because a child's body might just be ready to start puberty earlier than other children. This can be normal and not caused by a medical problem.

Other times, when puberty starts early, it is because of abnormally high levels of hormones in the body. This can be caused by:

●No reason – Many times, puberty starts early for no specific reason, especially in girls. Doctors call this "idiopathic" early puberty.

●A problem in the body, such as an abnormal growth in the brain, ovaries, or testicles

●Skin products for adults that have certain hormones in them – If a child touches these products, the hormones can rub off onto them.

What body changes happen in early puberty? — The body changes in early puberty are the same as those in normal puberty. They just happen at a much younger age.

The changes that happen during puberty in girls are:

●The breasts grow bigger. In many girls, this is the first sign of puberty. If your child has excess weight, her breasts might look like they are growing. That's because extra weight can cause the breasts to look big. This is different than starting puberty. Your doctor can help you tell if your child is starting puberty.

●Hair grows in the genital area (pubic hair), under the arms, and on the legs. In some girls, pubic hair is the first sign of puberty.

●They can have white or clear vaginal discharge. Vaginal discharge is the small amount of fluid that comes out of the vagina.

●They start having monthly periods. This usually happens a year or 2 after the first signs of puberty.

The changes that happen during puberty in boys are:

●The testicles get bigger. This is usually the first change that happens.

●The penis gets longer and wider.

●Hair grows in the genital area (pubic hair), on the face, and under the arms.

●The voice changes.

●They can ejaculate a small amount of sperm at night while they sleep. This is sometimes called a "wet dream."

●Their breasts can get slightly bigger. This usually goes away over time.

Will my child need tests? — Maybe. The doctor or nurse will want to know why your child started puberty early. They will talk with you and your child, and do an exam. They might also do:

●Blood tests

●X-rays of 1 of your child's hands and wrists – These X-rays can show how fast your child is growing.

Depending on these results, the doctor might do a CT scan, ultrasound, or other imaging test of your child's brain or belly. Imaging tests create pictures of the inside of the body.

The doctor or nurse will also do repeat exams over time to follow your child's growth and development.

How is early puberty treated? — Treatment depends on the cause of the early puberty, your child's age, and how fast their body is changing.

One main goal of treatment is to make sure that your child grows to a normal adult height. When children go through puberty earlier than normal, they are often shorter than normal as adults.

●For some children, doctors do not recommend treating early puberty. Children might not have treatment if they are going through puberty slowly, or if the puberty started but then stopped on its own. For example, some girls grow breasts very early, but then go through the rest of puberty at the normal time.

●For other children, doctors do recommend treatment. For many children, the doctor can stop puberty by giving a medicine. After a certain amount of time, your child will stop taking the medicine. Then, normal puberty can happen.

Other treatments help with the problem that is causing the early puberty. These treatments might include:

●Taking medicine to lower abnormally high amounts of hormones in the body

●Having surgery to remove an abnormal growth

What else can I do to help my child? — You can help your child feel good about themselves. Point out your child's strengths instead of focusing on their body changes. Some children who go through early puberty can have a hard time fitting in. They might be teased or treated differently, because their bodies look different than other children their age.

If your child is having problems at home or school, talk to the doctor or nurse about ways to get help.

More on this topic

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Patient education: Adolescent sexuality (Beyond the Basics)