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Early puberty
Early development of secondary sexual characteristics
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What is Precocious Puberty?
Precocious puberty is when puberty starts earlier than usual (before age 8 for girls and before age 9 for boys), causing early development of puberty signs. The cause is unknown but could be due to hormonal imbalances, genetic conditions, central nervous system problems, or a positive family history.
Typical Symptoms of Precocious Puberty
- Being taller than peers until about age 10
- Vaginal bleeding or discolored discharge outside of your period
- Early puberty
- Hoarse or husky voice
Diagnostic Questions for Precocious Puberty
Your doctor may ask these questions to check for this disease:
- Were you taller than others until age 10?
- Have you experienced any vaginal bleeding or unusual discharge outside of your period?
- Did you start puberty earlier than others?
- Do you have a hoarse or husky voice?
Treatment of Precocious Puberty
Treatment depends on the cause of precocious puberty. If there's an underlying medical condition, it should be treated. Medication is available to delay further development until the child reaches the normal age of puberty.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Hidetaka Hamasaki, MD (Endocrinology)
Dr. Hamasaki graduated from the Hiroshima University School of Medicine and the Graduate School of Medicine, Jichi Medical University. He completed his residency at the Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Hospital and the Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine. He has served in the National Center for Global Health and Medicine Hospital and Kohnodai Hospital and joined Hamasaki Clinic in April 2017. Dr. Hamasaki specializes in diabetes and treats a wide range of internal medicine and endocrine disorders.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Bleeding between periods
- Hoarse voice
- Bloody vaginal discharge
- Bleeding after menopause
- Sore throat
- Experienced puberty earlier than my friends
- Implantation bleeding
- Scratchy throat
- Brown spotting between periods
- Precocious puberty
- Bleeding after period ends
- Throat pain
- Bleeding 2 weeks after period
- Throat hurts to swallow
- Itchy throat cough
See full list
Symptoms Related to Precocious Puberty
Diseases Related to Precocious Puberty
FAQs
Q.
Worried about growth? Why achondroplasia occurs and your medical next steps
A.
Achondroplasia is a short-limb growth condition caused by a change in the FGFR3 gene, most often a new mutation, leading to shorter arms and legs with an average-sized trunk and typically normal intelligence. Next steps include seeing your pediatrician for evaluation with achondroplasia-specific growth charts, confirming the diagnosis with genetic testing, arranging specialist monitoring for issues like ear infections, sleep apnea, spinal stenosis or hydrocephalus, and discussing newer FDA-approved therapies that may improve growth; there are several factors to consider, so please see the complete guidance below.
References:
* Yang Z, Yang H, Chen H, et al. Achondroplasia: a systematic review of the clinical features, molecular pathophysiology, and current and emerging therapeutic approaches. Orphanet J Rare Dis. 2022 Dec 27;17(1):475.
* Savarirayan R, Ireland P, Irving M, et al. International consensus statement on achondroplasia: An update. Nat Rev Endocrinol. 2023 Feb;19(2):107-117.
* Doria MJ, Murray M. Achondroplasia: New Perspectives and Management Beyond Skeletal Dysplasia. Am Fam Physician. 2022 Jun;105(6):627-635.
* Hoover-Fong J, Alade AY. Achondroplasia: An Update on Pathophysiology, Diagnosis, and Management. Curr Osteoporos Rep. 2021 Jun;19(3):328-336.
* Alkhayyat A, Gencpinar P, Alkhayyat M, Almarzouki B, Hamad M. Molecular, Clinical, and Management Aspects of Achondroplasia. Genes (Basel). 2023 May 23;14(5):1127.
Q.
Is it FAS? Why early signs require clinical action and your next steps.
A.
Fetal Alcohol Syndrome is caused by prenatal alcohol exposure and can appear early as distinct facial features, growth delays, and brain-based developmental and behavioral differences, so early clinical evaluation matters because timely therapies, school accommodations, and family supports can significantly improve long-term outcomes. Speak with your child's doctor now to request a comprehensive developmental assessment and begin early intervention, and seek urgent care for severe sudden issues like seizures or regression; there are several factors to consider, and you can find important details below.
References:
* Flannigan KM, O'Connor M, McLaughlin J, Chhina H, Nguyen A, Nguyen R, Noga M, Akbari A, Pei J, Do MT. Fetal Alcohol Spectrum Disorders: An Overview of Current Concepts on Diagnosis, Prevention, and Treatment. Children (Basel). 2020 Jul 29;7(8):83. doi: 10.3390/children7080083. PMID: 32731380; PMCID: PMC7399432.
* Rudowicz K, Loock C, Barden S, Frosch J, Lussier AA, Popova S. Fetal Alcohol Spectrum Disorders: A Scoping Review of Canadian Diagnostic and Clinical Guidelines. Int J Environ Res Public Health. 2022 Mar 22;19(6):3745. doi: 10.3390/ijerph19063745. PMID: 35329324; PMCID: PMC8956961.
* Rangmar J, Hellström A, Ekblad M. Fetal Alcohol Spectrum Disorders: Clinical Features, Diagnosis, and Management. J Clin Med. 2019 Jul 29;8(8):1122. doi: 10.3390/jcm8081122. PMID: 31362423; PMCID: PMC6682772.
* Popova S, Lange S, Burd L, Rehm J. Early Identification of Fetal Alcohol Spectrum Disorders for Intervention: A Review of the Literature. Alcohol Alcohol. 2018 May 1;53(3):287-293. doi: 10.1093/alcalc/agx122. PMID: 29369986.
* Peadon E, Latimer J, de Graaff B, Mutch RC, Bower C, Payne JM. Management of Fetal Alcohol Spectrum Disorders (FASD) in Children and Adolescents. J Clin Med. 2020 Sep 17;9(9):2989. doi: 10.3390/jcm9092989. PMID: 32959639; PMCID: PMC7565814.
Q.
Am I Normal? Average Height for Women & Medically Approved Next Steps
A.
In the U.S., the average height for women is about 5 feet 4 inches (162 to 163 cm), and globally it’s roughly 5 feet 2 inches to 5 feet 5 inches; being a few inches shorter or taller is usually normal unless growth patterns, puberty timing, or other symptoms raise concern. If you’re worried, review family height patterns, track growth in kids, and talk with a clinician about possible thyroid or hormone issues; adults cannot naturally increase height, but posture and treating underlying conditions can help. There are several factors to consider. See below for red flags, urgent symptoms, and step by step next steps, including when to check for early puberty.
References:
* NCD Risk Factor Collaboration (NCD-RisC). Trends in adult height from 1953 to 2010 in 200 countries: a systematic review and pooled analysis of 1472 population-based studies with 18.6 million participants. Elife. 2016 Jul 26;5:e13410. doi: 10.7554/eLife.13410. PMID: 27461247; PMCID: PMC4958930.
* Wehkalampi K, Lichtenstein P, Johansson L, Hallberg L, Forsman H, Nilsson S, Gatz M, Hämäläinen E, Hulting AL. Genetic and environmental factors contributing to the variation in human height. Scand J Public Health. 2008 Apr;36(2):193-200. doi: 10.1177/1403494807085779. PMID: 18456637.
* Vlachopapadopoulou E, Voutetakis A, Chrousos GP. Etiology and management of short stature. Hormones (Athens). 2019 Jun;18(2):141-152. doi: 10.1007/s42000-019-00109-1. PMID: 31222718.
* Wit JM, Ranke MB, Kelnar CJ. Tall stature: aetiology and management. Best Pract Res Clin Endocrinol Metab. 2010 Apr;24(2):207-23. doi: 10.1016/j.beem.2009.09.006. PMID: 20409623.
* Cohen P, Rogol AD, Howard CP, Bright GM, Kappelgaard AM, Rosenfeld RG; American Association of Clinical Endocrinologists. Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, Lawson Wilkins Pediatric Endocrine Society, and European Society for Paediatric Endocrinology Workshop. J Clin Endocrinol Metab. 2008 Nov;93(11):4210-7. doi: 10.1210/jc.2008-0533. PMID: 18765955.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Latronico AC, Brito VN, Carel JC. Causes, diagnosis, and treatment of central precocious puberty. Lancet Diabetes Endocrinol. 2016 Mar;4(3):265-274. doi: 10.1016/S2213-8587(15)00380-0. Epub 2016 Feb 4. PMID: 26852255.
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00380-0/fulltextBradley SH, Lawrence N, Steele C, Mohamed Z. Precocious puberty. BMJ. 2020 Jan 13;368:l6597. doi: 10.1136/bmj.l6597. PMID: 31932347.
https://www.bmj.com/content/368/bmj.l6597Gangat M, Radovick S. Precocious puberty. Minerva Pediatr. 2020 Dec;72(6):491-500. doi: 10.23736/S0026-4946.20.05970-8. Epub 2020 Aug 4. PMID: 32748611.
https://www.minervamedica.it/en/journals/minerva-pediatrics/article.php?cod=R15Y2020N06A0491Schoelwer M, Eugster EA. Treatment of Peripheral Precocious Puberty. Endocr Dev. 2016;29:230-9. doi: 10.1159/000438895. Epub 2015 Dec 17. PMID: 26680582; PMCID: PMC5345994.
https://www.karger.com/Article/Abstract/438895Aguirre RS, Eugster EA. Central precocious puberty: From genetics to treatment. Best Pract Res Clin Endocrinol Metab. 2018 Aug;32(4):343-354. doi: 10.1016/j.beem.2018.05.008. Epub 2018 May 26. PMID: 30086862.
https://www.sciencedirect.com/science/article/abs/pii/S1521690X18300769?via%3DihubPrecocious Puberty - Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811#:~:text=Precocious%20puberty%20is%20when%20children's,might%20naturally%20reach%20puberty%20earlier.