Precocious Puberty: Incidence, Causes, and Treatment

    October 2006 in “ Pediatrics in review ”
    Andrew Muir
    TLDR Early puberty is more common in girls and African-American children, possibly due to nutrition, obesity, stress, and environmental factors, and is treated with hormone therapy.
    The document from 2006 provides an in-depth look at precocious puberty, noting its higher incidence in females and African-American children, with a range from 0.01% to 0.05% per year in the United States. It discusses the potential roles of nutrition, obesity, stress, and environmental chemicals in the early onset of puberty, particularly in girls. The article outlines the hypothalamic-pituitary-gonadal axis's involvement in puberty and explores both central dysregulation and genetic factors as causes of precocious puberty. Diagnostic approaches, including hormone tests and bone age assessment, are detailed, with GnRH stimulation testing being used to diagnose central precocious puberty. Treatment with GnRH agonist therapy is highlighted as effective, potentially increasing final height by 8 to 12 cm. The document underscores the importance of pediatricians recognizing precocious puberty and knowing when to refer to specialists. No cause for central precocious puberty is found in most affected girls, while boys are more likely to have an identifiable cause.
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