​Precocious Puberty


Precocious puberty is a disorder in which your child starts entering puberty earlier than expected, which means they start developing into young men and women both physically and emotionally. In girls, puberty generally starts between eight to thirteen years of age, while boys reach puberty between nine and fourteen years of age. If your child reaches puberty before these age spans, doctors consider this as early puberty or precocious puberty. All signs of puberty – bone and muscle development, changes in body shape, physical developments, development of the body’s ability to reproduce – are noticed early in children with precocious puberty.

There are two kinds of precocious puberty:

  • Central precocious puberty: Precocious puberty caused when the pituitary gland – a small pea-sized gland at the base of the brain that produces hormones for growth and development – produces a hormone to stimulate ovaries and testicles earlier than expected. This is the more common type of precocious puberty

  • Peripheral precocious puberty: A rarer form of precocious puberty, in this disorder the brain and pituitary gland are not involved and a problem with the ovaries and testicles or the thyroid gland may cause early onset of puberty

Precocious puberty is not caused by any specific factor. Rarely, it may be linked to an infection, hormone disorder, tumours or brain injury. Girls are more at risk of precocious puberty, and so are children who are obese, who have been exposed to sex hormone through ointments or creams, or who have had radiation treatment for tumours, leukaemia or other conditions.

Besides the social and psychological pressure of being different from peers, children with precocious puberty may also suffer from complications such as insufficient growth in height as growth stops too early. Starting a treatment plan early is a good idea, and that’s why you must consult your child’s paediatrician working with the Children’s Hospital Service Line of The Aga Khan University Hospital when you identify any signs of precocious puberty in your child.

The signs of precocious puberty in girls and boys are the early appearance of physical features characteristic of developing to become a young man or woman.

In girls, the appearance of the following signs before seven to eight years of age is considered precocious puberty:

  • Breast development

  • Pubic or underarm hair development

  • Rapid height growth

  • Start of menstruation

  • Acne

  • Adult body odour

In boys, early appearance of the following signs and symptoms before nine years of age include:

  • Enlargement of the testicles or penis

  • Facial hair, pubic hair or underarm hair development

  • Rapid height growth

  • Deepening of the voice

  • Acne

  • Adult body odour

Some boys and girls may have ‘partial’ precocious puberty, which means they may exhibit some signs and symptoms, such as the early appearance of pubic or underarm hair, without other changes in sexual development. Your child’s doctor will be able to rule out if this is due to precocious puberty.

If you notice any of the above symptoms in your child, you must consult a paediatric Endocrinologist  to seek professional medical advice. Paediatric Endocrinologists working with the Children’s Hospital Service Line of The Aga Khan University Hospital are internationally trained and understand that customized treatment and care is required for your child for the treatment of their precocious puberty. Discuss all queries and concerns in detail with your child’s paediatrician to help the doctor make an accurate diagnosis and prescribe the most suitable treatment option.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

A medical history will help the doctor identify any specific symptoms you may have observed in your child. A physical examination will also be conducted to check for further signs of precocious puberty.

Tests that will be ordered to confirm the initial diagnosis of precocious puberty include:

  • Blood tests to check hormone levels

  • Imaging tests such as CT (Computerized Tomography) scan or MRI (Magnetic Resonance Imaging) to check the brain or abdomen for any tumours

  • X-rays of the wrists and hand to check the child’s bone age to see if the bones are growing too quickly

  • GnRH (Gonadotropin-releasing Hormone) stimulation test to check whether your child has central or peripheral precocious puberty

  • Thyroid function tests to see if other hormones are also affected

  • Ultrasound may be done in girls to check for cysts or tumours in the ovaries

Treatment for precocious puberty will depend on the cause diagnosed. For central precocious puberty, medications may be given to delay further development or stop the release of sexual hormones.

In case tumour is causing precocious puberty, the tumour can be surgically removed. You must talk to your child’s doctor and surgeon about all possible risks and complications associated with surgery before consenting to any procedure. 

Dealing with precocious puberty can be overwhelming for both parents and the child. Psychological counselling can be useful in helping your child cope with the challenges that accompany precocious puberty. Discuss the option of a qualified counsellor with your child’s paediatrician, who may refer you to a psychotherapist working with the Mind and Brain Service Line at The Aga Khan University Hospital for further support through your child’s treatment.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​