Puberty may be a trying time for many kids and parents. But for some, the early arrival of this development milestone brings additional physical and emotional concerns.

Central precocious puberty (CPP) is a condition that causes puberty to start at an early age. It occurs when the brain signals the hypothalamus to begin releasing gonadotropin-releasing hormone (GnRH) earlier than usual.

CPP is more common in girls than boys. According to the American Academy of Family Physicians (AAFP), puberty symptoms in a boy younger than 9 years old or a girl younger than 8 years old may indicate CPP.

These symptoms include:

  • breast development and the start of menstruation in girls
  • enlargement of the testicles or penis in boys
  • rapid growth
  • pubic or underarm hair
  • acne

Language matters

Sex and gender exist on spectrums for adults and children. This article will use the terms “girl” and “boy” to refer to a person’s sex assigned at birth. Your child’s gender identity may not align with how CPP affects their body.

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Although the exact cause of CPP is unknown, it may stem from health factors that occur in the brain, such as a brain tumor, trauma, infections, radiation, or other brain defects, according to the AAFP.

If your child experiences early puberty symptoms, you may want to speak with your child’s pediatrician about treatment.

Read on to learn about CPP treatment options, who should receive treatment, and the risks involved.

Puberty typically begins between ages 8 and 13 in girls and 9 and 14 in boys. When premature development happens earlier, a doctor may diagnose a child with CPP and recommend treatment if needed.

CPP can affect a child’s emotional and physical health.

For example, they may experience psychological and social concerns related to early puberty. They might also fail to reach their full height because growth halts too soon, according to the National Institute of Child Health and Human Development.

Not all children with CPP will require medical intervention. When recommended, however, the goals of CPP treatment often include the following, according to a 2018 research review:

  • delaying further sexual maturity or development
  • stopping rapid growth and bone maturation
  • minimizing emotional and psychological impacts
  • preserving height potential

Treatment should also address the underlying cause of CPP, if it is known.

A pediatrician can treat CPP, though they may refer you to a pediatric endocrinologist. This is a doctor who specializes in growth and hormonal disorders in children.

According to a 2019 review, the top treatment for CPP is long-acting GnRH agonists, also called GnRHa. This may include medications like leuprolide acetate (brand name Lupron Depot) or triptorelin (brand name Triptodur Kit).

Early on, healthcare professionals administered these treatments monthly for CPP. But in 2011, the Food and Drug Administration (FDA) approved a form of depot leuprolide that’s administered every 3 months for CPP. In 2017, the FDA approved a form of depot triptorelin that’s administered every 6 months.

These new treatments give families more options and the ability to extend the time between treatments.

Another treatment option for CPP is a histrelin implant (brand name Supprelin LA), which is inserted in the upper arm. Like other treatments for CPP, the histrelin implant is a GnRHa.

The main benefit of a histrelin implant is that its effectiveness lasts up to 12 months. However, placement in the upper arm requires minor surgery. A healthcare professional can discuss the pros and cons of surgical intervention with you and your child.

If a doctor determines that an underlying medical condition is causing CPP, they will recommend treatment for that condition to stop the early progress of puberty.

Treatment for CPP is not always recommended in children who develop early signs of puberty, especially if they are above a certain age at the time of diagnosis.

According to a 2019 review of scientific literature, some researchers recommend a 6-month observation period after initial signs of puberty unless the puberty is already at an advanced stage. That said, other researchers suggest that early intervention might be better for slowing down height growth.

Another reason to seek treatment includes the desire to avoid or reduce the negative psychological consequences related to early puberty. However, researchers caution against this being the sole reason for treatment and say that more studies are needed on the psychological effects of CPP.

Speak with your child’s doctor to determine the best course of action, including which treatment is right for your child and when they should begin treatment.

GnRHa treatments are generally safe. The most common side effect is a mild reaction at the site of the injection. While rare, in some children a sterile abscess (a pus-filled lump) may form if their body does not fully absorb the injection.

A small 2006 study suggests that GnRHa treatment can cause growth velocity to decline, especially if a child has advanced bone age. Growth velocity refers to the child’s changes in height and weight and how they develop over time.

Because of this, the doctor may recommend supplementary treatment of growth hormones or oxandrolone.

CPP is not a life threatening condition, but it can cause certain concerns in children, such as:

  • early sexual maturation
  • emotional and social difficulties
  • a shorter adult height

If you notice early signs of puberty in a girl younger than age 8 or a boy younger than age 9, make an appointment with a healthcare professional. They can do a thorough physical exam and discuss treatment options that may help delay puberty until the right age if necessary.