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Doctors for Precocious Puberty 
What is Precocious puberty?
Precocious puberty is a medical condition wherein the signs of puberty can be seen in an individual at an age earlier than normal. Puberty is considered precocious if it occurs in girls younger than 8 years, and boys younger than 9 years of age.
What are its main signs and symptoms?
The earliest symptoms include the occurrence of changes that are associated with pubertal growth. Breast enlargement occurs in girls, which may be unilateral. Axillary hair appears at the same time. Clitoral enlargement may or may not be present. Menarche is a later phenomenon and occurs about 2-3 years after breast enlargement. Severe acne may occur in girls, before puberty. In boys, testicular enlargement occurs, followed by growth of the scrotum and penis. This may soon be followed by a growth spurt, acne, changes in voice, and other secondary sexual characters. The appearance of pubic hair is a common finding in both boys and girls.
What are the main causes?
Puberty is a normal phenomenon that is a part of growing up. The age of onset depends on various factors. This is genetically determined. Precocious puberty in a sibling or in a parent increases the likelihood of its occurrence in the second child. Alternatively, a tumour of the hypothalamus may be responsible for the surge of androgens. Precocious puberty includes early sexual development as a result of an early production of hormones like oestrogen, progesterone and testosterone in girls and boys, respectively.
How is it diagnosed and treated?
The appearance of physical changes is so subtle, it may go unnoticed initially. For confirmation, a biochemical investigation is required to know the levels of androgens in the body. X-rays and hormone stimulation tests might be performed to confirm the diagnosis. Elevated testosterone levels in boys and oestradiol levels in girls are good indicators of precocious puberty. Also, thyroid levels need to be assessed as well.
Treatment depends on the cause. Surgical intervention is needed in cases of tumours. Otherwise, hormonal balance is restored by giving antagonists of gonadotropin-releasing hormone. Borderline cases, that is, children who show signs of precocious puberty at the age of 8-9 years, may be left untreated and only require monitoring.
