2013•Unpublished venueRequires access
Precocious Puberty
Paul B. Kaplowitz
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Abstract
Precocious puberty refers to the appearance of breast and/or pubic hair development before age 8 years. This chapter first discusses two common and benign normal variations, premature adrenarche (pubic hair and/or underarm odor only) and premature thelarche (isolated breast development starting before age 3 years) which are easy to diagnose without extensive hormonal or imaging studies. Central precocious puberty is becoming increasingly common as girls start breast development at an earlier age and in many cases does not require therapy with gonadotropin-releasing hormone analogs. Three less common but more worrisome scenarios, progressive breast development due to ovarian tumors or large ovarian cysts, as well as the puzzling entity of premature menarche, in which vaginal bleeding occurs in a girl with no breast development, are also discussed.