body
odor

Adult-like body odor in a young child may be caused by central precocious puberty (CPP).

HOW CPP AFFECTS THE BODY
pubic
hair

Signs of central precocious puberty (CPP) are the signs of normal puberty—they just happen earlier.

CHECK FOR SIGNS OF CPP
breast
growth

If a girl shows signs of breast development before age 8, it may be caused by central precocious puberty (CPP).

WHAT IS CPP?
mood
swings

Girls and boys going through central precocious puberty (CPP) may display signs of moodiness typically associated with "teen attitude."

EMOTIONAL CONCERNS OF CPP
acne/oily
skin

Acne and oily skin are common in teenagers going through puberty. Does your young child have acne or oily skin?

HOW EARLY IS TOO EARLY
body
hair

Appearance of facial hair or underarm hair may be caused by central precocious puberty (CPP).

OTHER SIGNS OF CPP
growth
spurt

A sudden growth spurt caused by central precocious puberty (CPP) may lead to reduced adult height.

CPP and HEIGHT
testicle
growth

When a boy shows signs of enlarged testicles, it may be caused by central precocious puberty (CPP).

WHAT IS CPP

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How CPP Affects Adult Height

Learn how a sudden growth spurt
can lead to reduced adult height.

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What is Central
Precocious Puberty (CPP)?
CPP is puberty that
starts too early.
Puberty is the process of becoming sexually mature. It's the time when a child starts to become a young adult. Everyone goes through it. But central precocious puberty, or CPP, is not regular puberty. A simple way to describe it is that it's the right process happening at the wrong time. CPP is when a child's body begins changing into an adult body too soon.
How early is too early?
CPP is a type of early puberty. When puberty begins before age 8 for girls, and before age 9 for boys, it is considered CPP. CPP occurs in 1 out of every 5,000 to 10,000 children. And it's more common in girls.
The changes that puberty brings are challenging, even when they come at a normal time. They may be overwhelming when they happen to a child too early. That's why it's important to know the difference between signs of regular puberty and the onset of CPP, which is driven by early hormone secretion. For this, there are treatments available. In certain rare cases, these signs may also indicate the presence of an underlying condition. So, it's important to see your child's pediatrician if he or she shows signs of CPP.
Signs and Symptoms
of Central Precocious
Puberty (CPP)
CPP starts in the brain
In normal child growth development, a tiny part of the brain, called the hypothalamus, releases a gonadotropin-releasing hormone (GnRH) in the endocrine system. The GnRH signals the body's puberty alarm clock, saying it's time to wake certain processes that prepare a young person's body for the start of adulthood.
Not every child reaches puberty at the same time. It typically begins between age 8 and 13 in girls, and between 9 and 14 in boys. But if the alarm clock goes off too early, puberty begins to happen sooner than expected.
Signs that your child's body is "waking" too early:
Girl
Boy
click on the symptoms to read more
Could your child possibly have CPP?
mood swings
Girls and boys going through central precocious puberty (CPP) may display signs of moodiness typically associated with "teen attitude."
acne/oily skin
Acne and oily skin are common in teenagers going through puberty. Does your young child have acne or oily skin?
FACIAL HAIR
The appearance of facial hair—usually growing first on the upper lip—could be a sign of Central Precocious Puberty (CPP).
deepening of voice
Typically occurring at mid-puberty, a boy's deepening voice may be a symptom of Central Precocious Puberty (CPP).
body odor
Adult-like body odor in a young child may be caused by central precocious puberty (CPP).
underarm hair
Underarm hair may be caused by central precocious puberty (CPP).
testicle growth
When a boy shows signs of enlarged testicles, it may be caused by central precocious puberty (CPP).
pubic hair
Signs of central precocious puberty (CPP) are the signs of normal puberty—they just happen earlier.
growth spurt
A sudden growth spurt caused by central precocious puberty (CPP) may lead to reduced adult height.
mood swings
Girls and boys going through central precocious puberty (CPP) may display signs of moodiness typically associated with "teen attitude."
acne/oily skin
Acne and oily skin are common in teenagers going through puberty. Does your young child have acne or oily skin?
body odor
Adult-like body odor in a young child may be caused by central precocious puberty (CPP).
underarm hair
Underarm hair may be caused by central precocious puberty (CPP).
breast growth
If a girl shows signs of breast development before age 8, it may be caused by central precocious puberty (CPP).
pubic hair
Signs of central precocious puberty (CPP) are the signs of normal puberty—they just happen earlier.
growth spurt
A sudden growth spurt caused by central precocious puberty (CPP) may lead to reduced adult height.
What Causes
Central Precocious Puberty (CPP)?
CPP is when puberty
begins too early
The process of puberty itself is completely normal. What makes CPP abnormal is timing. In CPP, the puberty process and sexual maturing of a child begin too soon. For the majority of children with CPP, there's no underlying medical problem. Doctors call it idiopathic, which is a medical word for unknown cause.
Some children are
at higher risk
Even though CPP affects 1 out of every 5,000 to 10,000 children, it's more common in girls, specifically African American girls. The risk is also higher for children with medical conditions such as McCune-Albright Syndrome or congenital adrenal hyperplasia. In rare cases, CPP can also be caused by a serious underlying condition, such as a tumor. If your child is experiencing signs of CPP, it's important to make an appointment with your child's pediatrician.
Why Treat Central
Precocious Puberty (CPP)?
Treatment can help stop
the progression of CPP
CPP has important consequences that may impact a child both physically and psychologically. Once your child's body begins to release sex and growth hormones, CPP may not be able to be reversed, but treatment can stop the progression of puberty.
See your child's
pediatrician
There are two reasons to see a pediatrician. The first reason is that if your child has CPP, the longer you wait, the more your child's body will develop. So it is important to diagnose if, in fact, your child has CPP. The second reason is that treatment can halt the progress of early puberty development.
Talk to your child's pediatrician about CPP and treatment options.
2
Central Precocious
Puberty (CPP) May Result in
reduced Adult Height
Children with CPP may be taller
than their classmates now, but...
If CPP is not treated, your child may have one or more early growth spurts. But the end result is that your child is likely to end up shorter as an adult than he or she might otherwise have been. The reason is that with CPP, growth hormones prematurely stimulate bone growth and shorten the normal amount of time for a child's height to increase. Once bones have reached a certain limit and growth plates have fused, no further growth is possible.
CPP treatment may help
a child reach their adult
height potential
Treatment has been shown to effectively "halt" the progress of early puberty development that occurs when a child has CPP. Because of the suppressive effect of medicines used to treat CPP, hormones can return to pre-puberty levels, and slow the fusion of bone plates. This can help children with CPP reach their adult height potential.
What You Can Do
Don't let signs of central
precocious puberty (CPP)
go unchecked
No one knows your child better than you, so trust your instincts. If you feel something isn't normal, or that your child is going through puberty too early, talk to your child's pediatrician. If the pediatrician suspects that your child has CPP, you may be referred immediately to a pediatric endocrinologist. This is a doctor who specializes in the treatment of hormone-related conditions in children.
If your child's pediatrician does not mention a pediatric endocrinologist to you, and you still suspect your child has CPP, you can ask for a referral.
Why the pediatric
endocrinologist is important
A pediatric endocrinologist is a specialist who is trained to diagnose and treat CPP. CPP is not a common condition; it occurs in 1 out of every 5,000 to 10,000 children. It is more common in girls than boys. Not every child who is diagnosed with CPP needs treatment. However, if your child is diagnosed with CPP and it is determined that your child needs treatment, there are safe and effective medicines that may help. You should have an open conversation with your pediatric endocrinologist about the benefits and possible side effects that your child may experience when they receive treatment for their CPP.
How Central Precocious Puberty (CPP)

Treatments Work
Puberty is triggered by a release of growth hormones at an appropriate age. If the release starts too early, there's a need to call a time-out. The objective of any treatment for CPP is to suppress the release of hormones and delay puberty until a more appropriate age.
Puberty begins in the brain
The brain sends a chemical signal called gonadotropin-releasing hormone (GnRH) to the pituitary gland. When the signal is received, the pituitary gland releases hormones that start the puberty process. Treatments for CPP tell the pituitary to ignore the signal. In other words, without an active GnRH signal, puberty can then be delayed.
CPP treatment options
The FDA has approved treatments for CPP. They all use a medicine called a GnRH-agonist to stop hormones being sent from the pituitary gland to the ovaries or testes. By stopping the release of these hormones, puberty is delayed until the treatment ends, and then puberty can proceed as normal.
Dosing regimens vary including: daily, monthly, quarterly, or yearly. You and your doctor should discuss the right treatment for your child.
To learn more about a treatment option, click here >>
An important part of taking any medicine is taking it regularly and on time. Be sure to understand the benefits and risks of any medicine that you consider.
Talking to your child's Doctor
The Doctor Discussion Guide Can Help
Finding out that your child may have central precocious puberty (CPP) may be upsetting, confusing, and even overwhelming. As such, it's important to stay focused when you talk to your child's doctor about CPP and treatment options. Our Doctor Discussion Guide can help guide you through your conversation.
This valuable tool includes:
A checklist of symptoms, so you won't forget to tell your doctor everything your child is experiencing.
Some suggested questions to ask your child's doctor, so you can be well prepared at every stage of diagnosis and treatment.
Talking to Your Child

Help them understand what's happening
You can help at a time of confusion by talking to your child, and also by listening. Explain the condition to them in easy-to-understand language. And encouraging your child to speak openly is equally important. Listening can help them express their worries and confusion.
CPP means changes are happening in your child's body, perhaps sooner than they are for their friends. This could lead to embarrassment, behavioral disturbances, or even depression. Encouraging your child to be open about his or her feelings can help make this time much easier to cope with.
Remember, you are your child's most trusted source of comfort and guidance. It may help to offer reassurance that they're still your little child and that there are treatment options that may help slow down their body from growing up too fast.
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