Central Precocious Puberty

When Puberty Occurs Earlier Than Expected

By Teri Brown

Stidham's pediatrician told her that puberty could indeed happen at that young of an age and she should continue to keep the lines of communication open with her daughter and not to worry, she wasn't in it alone.

Dr. Carol Wheeler, a board certified reproductive endocrinologist and director of the Pediatric and Adolescent Gynecology Clinic at Women & Infants Hospital in Providence, R.I., says central precocious puberty (CPP) is when the normal changes of puberty occur earlier than the expected time.

"For white girls, this would mean breast development prior to age 8," Dr. Wheeler says. "Since black girls tend to develop earlier, most would use prior to age 7. It is due to a problem where the brain triggers release of pituitary hormones (FSH, follicle stimulating hormone, and LH, luteinizing hormone), which then leads to the ovaries producing estrogen and progesterone. These ovarian hormones (estrogen and progesterone), then lead to breast development and ultimately can lead to menstrual bleeding."

According to Dr. Wheeler, there is no identifiable cause in 80 to 90 percent of the cases reported. A few possible causes are brain tumors, hydrocephalus (water on the brain) and prior x-ray treatment of the brain. Hypothyroidism (underactive thyroid) and high levels of male hormones may also lead to central precocious puberty. With overweight girls, puberty overall may be occurring slightly earlier, due to the fact that obese girls tend to start puberty earlier.

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