Diagnosis and Treatment of Precocious Puberty

Created: 18.09.2026  ·  Last Updated: 18.09.2026  ·  Prepared by: Prof. Dr. Ayla Güven

What Is Precocious Puberty?

Puberty is a developmental period characterized by psychological changes, during which sexual maturation and growth are completed and reproductive ability is gained as a result. Precocious puberty is defined as the appearance of pubertal signs before the age of 8 in girls and before the age of 9 in boys.

Pubertal signs are defined as breast development in girls, enlargement of the testes and penis in boys, and hair growth in the genital area and underarms in both sexes.

How Is Precocious Puberty Diagnosed?

In the first stage, the child’s height and weight measurements should be taken, and a physical examination should be performed. Afterwards, laboratory tests such as hormone measurements are carried out, and a hand-wrist X-ray is taken to determine bone age. Then, ultrasonography is used to determine the size of the uterus and ovaries in girls. In boys, if there is asymmetric enlargement of the testes, scrotal ultrasonography should be performed. Brain and pituitary imaging is also performed in all boys diagnosed with central precocious puberty based on test results, and in girls younger than seven years of age.

How Is Precocious Puberty Treated?

In central precocious puberty, suppression treatment is applied for luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which cause puberty. For this purpose, leuprolide acetate or triptorelin acetate is administered by intramuscular injection every 28 days or every three months.

Frequently Asked Questions

Is every breast enlargement a sign of precocious puberty?
Causes of breast enlargement in girls may include taking medications containing estrogen; exposure to plants with estrogen-like effects such as soy, clove, lavender, henna, licorice, and similar substances, or exposure to endocrine-disrupting substances such as pesticides, dioxins, and similar agents. In some overweight or obese girls, fat accumulation may be seen in the breasts. In addition, estrogen-secreting cysts or malignant tumors, such as ovarian or adrenal tumors, may cause breast enlargement in both sexes. Low hormone secretion from the thyroid gland, known as hypothyroidism, may also cause breast enlargement and/or menstruation in girls. In boys, hypothyroidism may cause enlargement of the testes.
Is every genital hair growth a sign of precocious puberty?
Hair growth in the genital area may be seen after the age of eight in girls and after the age of nine in boys. However, genital hair growth may also be seen with the use of medications containing male hormones, known as androgens, such as tablets or creams; androgen-secreting tumors; congenital adrenal hyperplasia; Cushing syndrome; and similar diseases.

References

  1. Endocrine Society. Central Precocious Puberty: An Endocrine Society Clinical Practice Guideline, 2026
  2. Pediatric Endocrine Society. Central Precocious Puberty Clinical Practice Guideline
  3. MedlinePlus. Precocious Puberty
  4. American Academy of Pediatrics. Physical Changes During Puberty