Should be considered when secondary sexual characteristics appear before 8 years of age in girls and 9 years in boys.
Results in accelerated skeletal development with an impaired final height, and may have a psychosocial impact.
Two forms exist: gonadotrophin-dependent (GDPP; due to premature activation of the hypothalamo-pituitary-gonadal axis) and gonadotrophin-independent (GIPP; due to autonomous secretion of sex steroids).
History should be directed dependent on whether puberty is consonant or disconsonant (i.e., whether the pattern of endocrine change is the same as in normal puberty or not).
Treatment of GDPP is usually straightforward with gonadotrophin-releasing hormone agonists.
GIPP is more difficult to treat; may require ketoconazole, or aromatase inhibitors and anti-androgens.
Treatment should be stopped once an acceptable age of puberty is reached.
Puberty is an interval characterised by the acquisition of the secondary sexual characteristics, accelerated linear growth, increase in the secretion of sex hormones, maturation of gonads (testes in boys; ovaries in girls), and the potential for reproduction. It is typically complete within 2 to 5 years. Precocious puberty (PP) should be considered when secondary sexual characteristics appear before 8 years in girls and 9 years in boys.   It also results in accelerated skeletal development with an impaired final height.
AM is an author of several articles cited within this monograph.
Professor of Paediatric Endocrinology
University College London
PH is an author of several articles cited within this monograph.
Senior Lecturer in Child Health
Department of Child Health
Royal Hospital for Sick Children
MD has received lecture fees and financial support from pharmaceutical companies (Pfizer, Novo Nordisk, Serono) who manufacture growth hormone and whose brands of growth hormone MD recommends. MD is also an author of a few articles cited within this monograph.
Assistant Professor of Pediatrics
University of Chicago
DD declares that she has no competing interests.
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