Everything Parents Need To Know About Precocious Puberty

It started with a joke from either my husband or I about pubic hair, which made my then 7-year-old son, who still finds farts, boogers, and testicles hilarious, fall into a fit of giggles. Then came the sardonic comments I couldn't help but make about raising a teenager, even though my son was several years away from that age. Then others started mistaking my son for a few years older than he was—and suddenly the jokes weren't so funny anymore.

My son's growth was undeniable. And even though I told myself that some kids just grow faster than others, I wanted real answers that came from somewhere other than Dr. Google. Finally, we brought it up at his eight-year well-child visit with his pediatrician.

The immediate suspicion was precocious puberty. I had read about it before the appointment and probably scared myself more than I should have with all of the varying stories from other parents. Unfortunately, we didn't get an official diagnosis just yet, but we were on the track to figuring out why my son, who is now 9, has pubic hair, high emotions, and is growing faster than I expected.

What Is Precocious Puberty?

Precocious puberty is when puberty begins early in children. That's typically "before age 8 in girls and before age 9 in boys," according to Mayo Clinic. The condition only affects up to 1% of children.

"Early puberty is caused when a brain hormone controlling reproduction is released too early in life," says William L. Dees, Ph.D., senior professor of veterinary integrative biosciences at the Texas A&M School of Veterinary Medicine & Biomedical Sciences, who has published research on precocious puberty.

What does that mean exactly? The brain starts the process of puberty by producing the gonadotropin-releasing hormone (GnRH). This hormone then travels to a small bean-shaped gland at the base of the brain called the pituitary gland and causes the production of estrogen in the ovaries and testosterone in the testicles. This process is started earlier than expected in children with precocious puberty.

Precocious Puberty Causes

Often, the cause of precocious puberty is unknown. But experts say it can be a result of hormone disorders or brain abnormalities. Other experts point to endocrine-disrupting chemicals found in food packaging, plastics, can linings, and other consumer products. And some believe early onset obesity might be a reason.

Genetics can also play a role. "The ages of pubertal development in family members often trend together," says Lisa Swartz Topor, M.D., MMSc, fellowship program director of pediatric endocrinology at Hasbro Children's Hospital and associate professor of pediatrics and teaching scholar at the Warren Alpert Medical School of Brown University.

Precocious Puberty Symptoms

There are some telltale signs of precocious puberty in children, says Dr. Swartz Topor, though every case is different and the signs or symptoms can vary. But some common ones include acne, body odor, and pubic hair, according to the Cleveland Clinic.

Precocious Puberty Diagnosis

The first step in diagnosing precocious puberty involves a physical exam. After that, various tests can begin. "Testing often includes blood tests to check hormone levels, along with an x-ray of the left hand, which is used to determine the bone age," says Dr. Swartz Topor. "As pubertal hormones can cause maturation of the skeleton, the bone age may be older than the child's chronological age. Further testing may be indicated based upon results of initial tests."

After my son's bone age x-ray, we learned his bone age was that of an 11- or 12-year-old. My son then underwent blood testing of his hormones to determine what may be causing his precocious puberty. They checked his levels of 17-hydroxyprogesterone, a hormone made by the adrenal glands, and his testosterone levels. Both were in the normal range.

From there, we were told to schedule an appointment with an endocrinologist, who took more blood to again examine 17-hydroxyprogesterone. But in this case, a synthetic hormone was given to my son so his body could stimulate the glands and determine if his levels would then be extremely high. Again, his results returned as normal. This particular test was used to see if my son has congenital adrenal hyperplasia (CAH), a genetic condition that can cause early puberty. Because my son's results were in the normal range, this was ruled out as a reason.

Precocious Puberty Treatment

We are still in the process of deciding the next steps for my son. Families in our position may decide not to treat at all or opt for hormone blockers. This medication is given to children to temporarily prevent puberty from happening. It's either given as a shot every one, three, or six months, or as an implant that is usually replaced annually. Hormone blockers are generally considered safe and puberty starts again after a person stops taking them.

Precocious puberty can cause a short stature because of the quicker than usual bone maturity. Starting puberty earlier than peers may also lead to social and emotional issues, including depression, that's why it's always important to speak with professionals about treatment.

Each case is, of course, different. "The management of each child requires input from the family, child, and medical team," says Dr. Swartz Topor. "Many factors play a role in the decision to treat or not to treat, and how to treat."

Support Can Help

It can be emotionally difficult for both you and your child when they are dealing with precocious puberty. In our case, my son's first appointment with the endocrinologist came three months after the initial appointment with his pediatrician. For me, that meant three months of crying, fearing the worst, and reading about something I had absolutely no experience in. I reached out to friends in the medical field and one suggested I find a support group on Facebook.

My first foray into looking for help on social media made things worse. I reached out to a local parents' group, only to find that the one parent who had experience in precocious puberty also dealt with extenuating circumstances of her child having a brain tumor that only scared me into thinking my son may have an underlying health issue.

Luckily, I later was able to find helpful support groups for parents on social media. Through those groups, I was able to connect with parents whose children were dealing with serious body changes even earlier than my son and others with similar growth. Learning of other parents' experiences and what their kids were going through, with varying cases, helped me better understand my own son's journey. And we felt a lot less alone in learning about what we might face.

My son has been through a lot and he has yet to fully understand what it means to possibly be in the throes of puberty earlier than his peers. He continues to deal with offhand comments from other kids about how much older he looks, how tall he is, and how he "should" be better at football with a team of kids who are mostly shorter and look younger than him. I'm grateful to say my son seems to be able to easily move on from these comments and focus on being a kid. It's a bit tougher for me. But what I can say is that knowing my son is healthy and that he will be OK is what keeps me going as a mom.