Could my child be
going
through puberty
too soon?

All photos are of models and not of persons with central precocious puberty.

When children show premature puberty (before age 8 in girls, age 9 in boys), it’s considered precocious. The most common type is known as central precocious puberty (CPP).1,2

Hear a doctor discuss when normal
puberty starts for girls and boys.

Karen Klein, MD, Pediatric Endocrinologist

What is the “normal” age for puberty?

Karen Klein, MD, Pediatric Endocrinologist

CPP is when puberty starts sooner than it should.1,2 Everyone goes through puberty. It’s a normal part of growing up. But when a child goes through puberty sooner than normal, it’s called early puberty or central precocious puberty (CPP).

CPP is triggered when the brain tells the pituitary gland (a pea-shaped gland located at the bottom of the brain) to release “puberty” hormones called gonadotropin-releasing hormone (GnRH) too soon. The result is that girls start producing estrogen, boys start producing testosterone, and sexual development begins.3

Hear a doctor discuss signs of early puberty.

Karen Klein, MD, Pediatric Endocrinologist

What are the signs & symptoms of CPP?

Karen Klein, MD, Pediatric Endocrinologist

Diagram shows both the pituitary and hypothalamus in the brain.
Normal puberty development in girls begins around age 10 (between 8 and 13 years old).
In girls, CPP is when puberty starts before age 8.2
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Age

Common signs of puberty in girls1,4-8

  • Breast development
  • Breast buds, a small lump under one or both nipples, begin to appear. The area may become tender and sore.
  • Menstrual periods
  • A few months before their first period, or menarche, some girls experience a clear or white vaginal discharge. The first period will likely be mild, with only a few drops of blood or spotting. However, the amount of blood and duration of periods varies from person to person.
  • Pubic or underarm hair
  • Light, straight hair appears in the pubic area but eventually turns darker, curlier, and coarser in texture. Approximately two years after pubic hair appears, hair appears on the underarms.
  • Oily skin/acne
  • At puberty, sebaceous glands underneath the skin become more active and may clog pores, leading to acne.
  • Adult body odor
  • This starts at puberty because of an increase in hormones. To regulate its temperature, your body sweats. When the sweat mixes with the bacteria on your skin, it causes body odor.
  • Sudden growth spurt
  • A dramatic growth spurt may make children going through puberty look gangly, but they will continue to fill out soon after.
Normal puberty development in boys begins around age 11 (between 9 and 14 years old).
In boys, CPP is when puberty starts before age 9.1
  • CPP Normal Puberty
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Age

Common signs of puberty in boys1,7,8,10,11

  • Testicle & penis enlargement
  • The testicles almost double in size at the beginning of puberty, followed by growth of the penis (first in length, then width).
  • Erections
  • During puberty, erections occur more frequently and for no apparent reason (and often at inconvenient times). Over time, they become less frequent.
  • Voice change
  • During a boy's growth period, his voice box, or larynx, also grows. While at first a boy's voice will crack, once the larynx stops growing the cracking will stop and the voice will deepen for good.
  • Facial hair
  • Hair starts growing first on the upper lip, then on the cheek, and finally the chin.
  • Muscle growth
  • During puberty boys fill out, so by the late teens their body composition is only 12% fat.
  • Pubic or underarm hair
  • Light, straight hair appears in the pubic area but eventually turns darker, curlier, and coarser in texture. Approximately two years after pubic hair appears, hair appears on the underarms.
  • Oily skin/acne
  • At puberty, sebaceous glands underneath the skin become more active and may clog pores, leading to acne.
  • Adult body odor
  • This starts at puberty because of an increase in hormones. To regulate its temperature, your body sweats. When the sweat mixes with the bacteria on your skin, it causes body odor.
  • Sudden growth spurt
  • A dramatic growth spurt may make children going through puberty look gangly, but they will continue to fill out soon after.

Remember, just because you’re seeing early signs of puberty doesn’t necessarily mean your child has CPP.

See What’s Normal

Compare the stages of puberty in normal development with the signs you see in your child. Use our Interactive Growth Tool now.


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Growth Chart for Girls
Growth Chart for Boys
Height

Adapted from CDC Growth Charts: United States; Developed by the National Center for Health Science in collaboration with the National Center for Chronic Disease Prevention and Health Promotion; (2000).

If your child is showing signs of puberty too soon, see your pediatrician to get a diagnosis as soon as possible.

CPP can be treated. But, left untreated, precocious puberty can cause long-term complications.9 Only a qualified healthcare provider can diagnose CPP and help find a treatment that is appropriate for your child. That’s why it’s important to see your pediatrician now. The sooner you know for sure, the sooner your child can get the treatment he or she needs.

References: 1. Muir A. Precocious puberty. Pediatr Rev. 2006;27:373-381. 2. Carel JC, Léger J. Clinical practice. Precocious puberty. N Engl J Med. 2008;358(22):2366-2377. 3. Saenger P. Novel treatments seem promising for central precocious puberty. http://www.healio.com/​endocrinology/​pediatric-endocrinology/​news/​print/​endocrine-today/​%7Bbe447e73-0aab-417e-​8ce4-4cb91d8f095d%7D/​novel-treatments-seem​-promising-for-central-​precocious-puberty. Accessed January 31, 2014. 4. Physical development in girls: what to expect. Healthychildren.org Web site. http://www.healthychildren.org/​English/​ages-stages/​gradeschool/​puberty/​Pages/​Physical-Development-Girls-​What-to-Expect.aspx. Accessed January 31, 2014. 5. Cleveland Clinic Website. How to Talk to Your Adolescent Girl About her Body. http://my.clevelandclinic.org/​childrens-hospital/​health-info/​ages-stages/​adolescence/​hic-How-to-Talk-to-​Your-Adolescent-Girl-​About-her-Body. Accessed June 16, 2015. 6. Menstruation: preparing your preteen for her period. Mayo Clinic Web site. http://www.mayoclinic.org/​health/​menstruation/​FL00040/​NSECTIONGROUP=2. Accessed January 31, 2014. 7. What causes acne? Healthychildren.org Web site. http://www.healthychildren.org/​English/​health-issues/​conditions/​skin/​Pages/​What-Causes-Acne.aspx. Accessed January 31, 2014. 8. Preventing body odor. WebMD Web site. http://www.webmd.com/​skin-problems-and-treatments/​preventing-body-odor. Accessed January 31, 2014. 9. Precocious Puberty: Complications. Mayo Clinic Website http://www.mayoclinic.org/​diseases-conditions/​precocious-puberty/​basics/​complications/​con-20029745. Accessed June 16,2015. 10. Physical development in boys: what to expect. Healthychildren.org Web site. http://www.healthychildren.org/​English/​ages-stages/​gradeschool/​puberty/​Pages/​Physical-Development-Boys-​What-to-Expect.aspx. Accessed January 31, 2014. 11. Physical development, ages 11 to 14 years—topic overview. WebMD Web site. http://children.webmd.com/​tc/​physical-development-​ages-11-to-14-years-​topic-overview. Accessed January 31, 2014.