Q: I'm worried that my daughter is starting puberty early. What should I do?
A: This is a tough question to answer without more details about your daughter's symptoms, but she could be experiencing central precocious puberty (CPP). CPP, in which a child shows signs of puberty much earlier than normal (before 8 years for girls and 9 for boys), affects one in every 5,000 to 10,000 kids. Symptoms include growing taller, growing pubic hair, developing breasts, having monthly periods, having oily skin and acne, and demonstrating aggressive or moody behavior. If you notice any of these signs, you should talk to your child's pediatrician as soon as possible. Although the cause of CPP often remains a mystery, your doctor will probably do several tests to confirm the diagnosis, including:
• X-rays of your daughter's hand and wrist to see if her "bone age" corresponds to her true age• Blood tests to check for hormone levels• Pelvic ultrasound to check for abnormalities in the ovaries• MRI or CAT scan to check for abnormalities in the pituitary gland
If it turns out that your daughter has CPP, treatment usually involves taking medication to halt the onset of puberty by stopping the production of certain hormones. Although it can be tempting to forgo medication and simply let your daughter grow into her body over the next few years, studies have found that the rapid bone growth associated with CPP can cause a child's final adult height to actually be shorter than it could have been without treatment, so the drugs are almost always recommended.