By MultiCare Health System

Puberty. We all go through it, and most of us probably have some uncomfortable memories from that time in our lives. Just imagine what it would’ve been like if you’d gone through puberty when you were only 7 or 8 years old.

It does happen to some children, but fortunately treatment is available.

We sat down with Gad Kletter, MD, a pediatric endocrinologist new to Mary Bridge Children’s Hospital in Tacoma, to learn more about precocious, or early, puberty. Kletter specializes in diagnosing and treating the endocrine system and hormone disorders in infants, children and adolescents.

Q: What is central precocious puberty?

Kletter: Central precocious puberty (CPP), also known as early puberty, is a condition in which puberty starts too soon in children. For girls, this would be under the age of 8; for boys, under the age of 9. Puberty normally begins in girls between the ages of 8 and 13 and for boys ages 9 to 14.

Most children don’t go through early puberty. It occurs in one out of every 5,000 to 10,000 children.

Q: What causes early puberty?

In most cases, there is no special reason early puberty occurs, and it’s not known to be genetic. Girls are more at risk than boys, but it’s unknown as to why.

Q: Are there complications?

Bone maturation is quicker than normal in children with CPP, which could cause them to stop growing earlier than usual. This could affect their adult height if left untreated.

Early puberty could also lead to social and emotional difficulties, such as estrangement from peers who haven’t entered puberty yet. Studies on this are difficult to reproduce, so it’s hard to say for certain — but hormones do cause behavioral changes, so it’s not hard to believe.

Q: What are the signs and symptoms?

The signs of CPP are the same typical signs of puberty, just at a younger than normal age: Girls begin producing extra estrogen in the ovaries and boys begin producing more testosterone in the testicles. These hormones produce the physical and emotional changes associated with puberty, such as pubic hair and rapid growth.

Your child does not need to be showing all signs of puberty to be considered to be in early puberty.

Q: How is it diagnosed?

Your child’s primary care provider will give your child a physical exam and a series of tests and labs, then may refer you to a pediatric endocrinologist. An X-ray may be done to help determine bone maturation, as well as a blood test to see the level of hormones in a child’s bloodstream. An ultrasound may be used to determine the development of sex organs and an MRI or CAT scan may be done to examine any abnormalities in the pituitary gland in the brain.

Q: What treatment is available?

There are two major options for treatment: injections or a small implant. The implant is inserted into the forearm of the non-dominant hand. The treatments work by suppressing puberty hormones and start working within a few weeks.

How long treatment is needed depends on your child’s individual progression, which is determined based on height, bone growth rate and other factors.

Q: What should I do if I think my child needs treatment?

Talk to your child’s doctor to find out if treatment is necessary. It’s best to have an evaluation if you think your child is going through early puberty — the earlier it’s detected, the more effective treatment will be.

Mary Bridge Children’s Hospital was founded in 1955 and is southwest Washington’s only pediatric hospital. Located in Tacoma, Washington, the hospital offers a wide range of pediatric care and services, and is recognized for medical excellence and child-friendly care.