How common is precocious puberty?

Updated: Nov 30, 2020
  • Author: Paul B Kaplowitz, MD, PhD; Chief Editor: Robert P Hoffman, MD  more...
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The frequency of findings suggestive of precocious puberty in girls and boys depends on whether one is looking at genital hair or breast development, as well as the age at which the condition is considered precocious. The prevalence also depends on whether one is doing population-based screening or assessing the number of patients who are referred to specialists for evaluation. One of the very few studies looking at the prevalence and incidence of precocious puberty based on a national patient register was a Danish report covering the period 1993-2001. The investigators estimated the prevalence at about 0.2% of girls (0.8% for girls ages 5-9 years) and less than 0.05% of boys. [3] This is far lower than indicated in the studies noted below, which are based on the examination of larger groups of children.

United States

In 1969, Marshall and Tanner published the results of their study of 192 White British girls, stating that the average age of thelarche was 11 years and defining precocious puberty in girls as commencing before age 8 years. [4] No studies that looked at the age of appearance of breast and pubic hair in normal children were performed in the United States during that time. However, many in the United States had the impression that girls had been maturing earlier than in the past.

No data were available to confirm this impression until 1997, when Herman-Giddens et al reported on the incidence of breast and pubic hair development by age and race in 17,000 US girls aged 3-12 years. [5]  They used the established definition that breast or pubic development in girls was precocious before age 8 years and estimated that approximately 8% of White and 25% of Black girls in the United States exhibited evidence of sexual precocity.

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