What are the psychosocial complications of precocious puberty?

Updated: Nov 30, 2020
  • Author: Paul B Kaplowitz, MD, PhD; Chief Editor: Robert P Hoffman, MD  more...
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Isolated sexual precocity of unknown etiology carries no increased risk of mortality; however, distinguishing between children with idiopathic CPP and the rare patient with a CNS, an adrenal, or an ovarian tumor is important because the latter group may be at risk for tumor-related complications. Moreover, some studies have found an association between early puberty in girls and a higher risk of breast cancer. [15]

Children with precocious puberty may be stressed because of physical and hormonal changes that they are too young to understand and may be teased by peers because of their physical difference. Girls who reach menarche before age 9-10 years may become withdrawn and may have difficulty adjusting to wearing and changing pads. Both sexes, but more so boys than girls, may have increases in libido leading to increased masturbation or inappropriate sexual behaviors at a young age. In girls with a history of early puberty, initiation of sexual activity may occur at a slightly earlier age than usual.

Some studies have found that children with precocious puberty more frequently exhibit behavioral problems and are less socially competent than age-matched peers. Some, but not all, studies find evidence of emotional problems persisting into adulthood. The distress associated with early menses can be decreased if parents are encouraged to prepare their daughters for this event when they reach stage III-IV of breast development.

Early puberty accelerates growth, with the result being that children with this condition may initially be considerably taller than their peers. Because bone maturation is also accelerated, however, growth may be completed at an unusually early age, resulting in short stature. Short stature is more likely if puberty starts very early (ie, before age 6 y) than if it begins moderately early (ie, ages 6-8 y). Several studies show that most untreated girls with idiopathic CPP reach an adult height within the reference range. Determination of bone age can be used to predict adult height and to select patients with high risk for short stature if left untreated.

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