The most common cause of central precocious puberty

Central precocious puberty begins when the brain releases signals that activate the pituitary gland, which then stimulates the ovaries or testes to make sex hormones. This produces puberty-related changes earlier than expected, such as breast development, testicular enlargement, pubic hair, body odour, growth acceleration, or vaginal bleeding. In many children, no underlying problem is found. In others, the early signalling can be associated with a brain or spinal condition, previous injury, infection, or treatment affecting the central nervous system. The pattern and pace of change help guide evaluation.

Arrange an appointment with a paediatrician or paediatric endocrinologist when puberty changes appear unusually early or progress quickly. The clinician may review growth measurements, family timing of puberty, medicines, and neurological symptoms. Blood tests can assess hormone patterns, and a bone-age study may show how quickly bones are maturing. Some children need imaging or other tests based on the examination and hormone results. Keep a record of when changes began and whether growth, headaches, vision, or behaviour changed with them.

Seek prompt medical advice for rapidly progressing puberty changes, severe or persistent headaches, vision changes, seizures, unusual vomiting, weakness, or changes in balance. These symptoms do not establish a cause, but they may signal a need for timely assessment. Seek emergency help for a seizure, sudden weakness, severe headache with vomiting, or a child who is difficult to wake.

Ask whether the changes fit central puberty, which tests are needed, whether bone maturation is being assessed, and whether a specialist referral or brain imaging is appropriate. Ask how treatment decisions would relate to growth, development, and the cause found.