What is the prognosis of precocious puberty without treatment?

Updated: Nov 30, 2020
  • Author: Paul B Kaplowitz, MD, PhD; Chief Editor: Robert P Hoffman, MD  more...
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Most girls who are aged 6-8 years at the onset of puberty achieve an adult height within the normal range or appropriate for their genetic potential. [19, 20] This is because most such girls are significantly taller than average at the time of diagnosis, and thus early cessation of growth typically brings their height into, but not below, the normal range.

Consider therapy following initial evaluation for girls who have predicted heights of less than 4 ft 11 in or who are well below their target height (ie, average of parents' heights, less 2.5 in), when the patient also has very advanced bone age, a height below the 25th percentile, or both.

Controversy surrounds the significance of several studies (mostly with small numbers of patients and no control group) that appear to indicate that girls with CPP are at increased risk for significant behavior problems, such as poor self-esteem and higher anxiety, irritability, or withdrawal. Other studies, however, have no shown such problems. A review of this topic by Walvoord and Mazur concluded that CPP may become a risk factor for psychosocial problems, mainly in the setting of other risk factors, but they cautioned against medical therapy as a means of avoiding presumed negative psychological consequences of precocious puberty. [21]

In a study of 36 girls with signs of early puberty, including 15 patients with CPP, eight with premature adrenarche, and 13 with early normal puberty, GnRH agonist treatment was administered to all girls with CPP. Normal findings were seen, on average, for baseline psychological assessments of cognitive competence, peer acceptance, physical competence, and maternal acceptance. At 1-year follow-up, results were “largely reassuring regarding concerns of adverse psychological consequences of early puberty in girls.” [22]

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