precocious puberty (true)

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True precocious puberty is where the puberty is early but the pattern is normal.

It would be expected that the lesion is one of early adrenarche, and a central cause is usually suspected. It is gonadotrophin dependent.

  • is gonadotropin-dependent and involves the premature activation of the hypothalamic-pituitary-gonadal (HPG) axis

Precocious puberty is commonly defined as puberty that starts before age 8 in girls and 9 in boys (1)

  • thelarche and increased growth velocity before age 8 in girls and genital development in boys before age 9 suggests precocious puberty

  • precocious puberty in boys represents a substantial risk of underlying pathology
    • this scenario requires urgent referral to a paediatric endocrinologist

  • many cases of precocious puberty in girls over 6 have benign causes, but precocious puberty can indicate serious pathology in some cases

  • " idiopathic" precocious puberty is the commonest cause of gonadotrophin releasing hormone (GnRH) (gonadotrophin dependent precocious puberty or GDPP)
    • GDPP and is more commonly seen in girls than boys


  • Muir A.Precocious puberty. Pediatr Rev 2006;27:373-81.
  • Bradley S et al. Precocious puberty. BMJ 2020; 368:16597

Last edited 01/2020 and last reviewed 01/2020