Central precocious puberty (CPP) is a condition that causes very early puberty in children. Puberty is the process during which children mature and develop into adults.

Girls typically reach puberty between the ages of 8 and 13. Boys typically start to go through puberty between ages 9 and 14.

Signs of puberty in both girls and boys include:

  • growth spurt
  • acne
  • body odor
  • growth of pubic and underarm hair

Other signs in girls include breast development and the start of menstruation. Other signs in boys include enlargement of the penis and testicles, facial hair growth, and deepening voice.

The signs of CPP are the same, but they start very early. For girls, that’s before age 8. For boys, it’s before age 9.

If you notice signs of early puberty in your child, speak with their doctor. In some cases, treatment can help slow or reverse CPP.

Here are answers to some common questions you may have about CPP.

Language matters

Sex and gender exist on spectrums. This article will use the terms “girl” and “boy” to refer to a person’s sex assigned at birth, but that may not align with the person’s gender identity.

If your child has CPP, they will start to mature sexually too early. CPP is not a life threatening condition, but it can cause a number of complications. These include:

  • shorter adult height
  • emotional and social problems
  • early sex drive

Not all children with CPP need treatment. But if your child starts puberty very early, they may be prescribed medication to help lower their levels of sex hormones. This can help slow or reverse puberty.

To understand what causes CPP, it helps to first understand the puberty process.

Puberty begins when a part of the brain called the hypothalamus releases gonadotropin-releasing hormone (GnRH). GnRH travels to the pituitary gland, which is located at the base of the brain. There, it triggers the production of two other hormones:

  • luteinizing hormone (LH)
  • follicle-stimulating hormone (FSH)

LH and FSH stimulate the ovaries to produce estrogen in girls and stimulate the testicles to produce testosterone in boys.

Estrogen and testosterone play important roles in the changes one goes through during puberty.

In children with CPP, the brain signals the hypothalamus to begin releasing GnRH earlier than it should. In most cases, the cause of CPP is unknown. But in some cases, it may be caused by factors that affect the brain. These may include:

  • brain tumor
  • brain infection
  • radiation to the brain, such as cancer treatment
  • brain trauma
  • other atypical brain development

A mutation in the MKRN3 gene may also lead to CPP. This gene plays a role in the onset of puberty.

CPP is more common in children who:

  • are genetically female
  • are African American
  • have a family history of CPP
  • have obesity

If CPP is not treated, your child will continue to go through the puberty process. This may result in several complications.

When early puberty starts, children may experience a rapid growth spurt and be taller than their peers. But their bone growth may stop at an earlier age. As a result, they may not reach their full adult height potential.

Children with CPP may be too young to understand the changes they’re experiencing. They may also feel different from their peers because they’re going through puberty at an earlier age. This can lead to a number of social and emotional challenges, including:

  • anxiety
  • depression
  • moodiness
  • aggression
  • self-esteem and body image issues

They may also develop an early sex drive. This may cause problems if children act on their impulses before they are mentally ready for sex.

Treatment for CPP depends on the age your child starts the puberty process. If it’s close to the age puberty typically starts, treatment may not be needed.

If your child starts puberty at a very young age, their doctor may prescribe medication to stop puberty and reverse changes as much as possible.

Medications called GnRH agonists stop the release of sex hormones to slow the progression of puberty.

These medications are typically given as injections once a month, or once every 3 to 6 months. Another option is a small implant placed under the skin of your child’s upper arm. This implant lasts for about a year.

Your child will continue to take medication until they are closer to the age puberty typically starts.

The goals of CPP treatment are to:

  • help the child reach normal adult height
  • slow physical growth and development
  • stop early menstruation
  • prevent problems with early sex drive
  • prevent social and emotional problems associated with CPP

If an underlying medical condition is causing your child’s CPP, it will need to be treated to help stop the progression of puberty.

CPP causes puberty to start in girls younger than age 8 and boys younger than age 9. Early puberty can lead to a number of complications, including shorter height and social and emotional problems.

Speak with your child’s doctor if you notice signs of early puberty. Medications are available to help slow or stop puberty until your child reaches an age closer to the typical onset of puberty.