Precocious Puberty: Signs of Early Puberty Every Parent Should Know

Puberty is a rite of passage for teens. If you have a child at home, you may be wondering when they will start puberty. Research shows that children are going through puberty earlier than in past generations. Right now, the earliest age for starting puberty is 8 years old in female children and 9 years old in male children. 

But some children develop signs of puberty before those ages. Children with early puberty, or precocious puberty, are at risk for long-term health consequences if they don’t receive treatment. Here are signs of early puberty every parent and caregiver should know. 

What are the signs of precocious puberty?

The signs of precocious puberty are exactly the same as regular puberty. The only difference is these symptoms develop earlier than they should.

Some of these symptoms are easier to see than others. As children get older, they should have more privacy and become self-sufficient. That can make it harder to spot these changes. That’s why it’s important to keep an open dialogue with your child about their body and puberty. You want them to come to you if they notice any changes. 

1. Breast development 

Breast development is the first sign of puberty in female children. The earliest children should begin to develop breasts is at 8 years old. 

Some studies suggest that breast development can begin slightly earlier, between 7 and 8 years old. But experts still agree that these children should receive a full evaluation for precocious puberty. 

2. Penis and testicular enlargement

The first sign of puberty in male children is penis and testicle growth. If you notice any changes in the size of your child’s penis or testicles before they are 9 years old, they could have early puberty. 

3. Body odor

It’s normal for children to sweat (even a lot), but your child’s sweat should be more or less odorless. When people go through puberty, they develop the apocrine sweat gland in their armpits and genital area. Apocrine sweat glands create sweat that has a distinct smell. 

If your child is younger than 8 years old and you think they could benefit from deodorant to help with body odor (not sweat), they might have early puberty.

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4. Pimples and acne

Breakouts are a common burden of puberty and early adulthood (and sometimes beyond). But children younger than 9 years old shouldn’t develop any kind of acne. That includes regular pimples like whiteheads and blackheads. If you notice skin blemishes, that’s a sign your child may be going through puberty.

5. Underarm and pubic hair

Your child is going through puberty if they have hair in their armpits or in their pubic area. Underarm and pubic hair can be light and less coarse at the start of puberty, regardless of your child’s hair color or skin tone. That can make it hard to spot, so you may need to peer a little more closely if your child points out new hair. 

Hair growth from puberty is an all-or-nothing event. Even if you only spot a few strands, it’s a sign of possible puberty.

6. Voice changes

If you notice that your male child’s voice is deepening or cracking, they’re going through puberty.  Make sure to ask them about other signs of puberty, too. Voice changes happen during the middle part of puberty, so they may have other symptoms, like hair growth and penis or testicle growth. 

7. Growth spurt

The pubertal growth spurt lets children achieve their adult height. The growth spurt happens toward the end of puberty. Ideally, you want to spot puberty before your child hits this growth spurt. But, many times, this is the first sign adults notice because it’s so easy to spot. 

Female children hit their growth spurt 2 years after they start puberty. So, if your female child is younger than 10 and hitting a growth spurt, that could be a sign of early puberty. 

Male children hit their growth spurt between 12 and 15 years old. So, if your male child is younger than 12 and having a growth spurt, they may be in early puberty.

8. Periods

Female children get their period at the end of puberty. Still, this might be the first sign you and your child pick up on. If your child is younger than 10 years old and has started to menstruate, it might be a sign of precocious puberty. 

Should you see a healthcare provider if your child has signs of precocious puberty?

Yes. If you or your child notice any of the symptoms of early puberty, see your child’s healthcare provider as soon as possible. 

Precocious puberty happens for a reason. It’s important to figure out what’s causing your child’s early puberty because some causes need immediate attention. 

Plus, if you spot early signs of puberty, your child can start treatment sooner. And this will prevent the long-term consequences of untreated precocious puberty. 

What causes precocious puberty?

Several things can lead to early puberty, including:

• Tumors: Brain tumors can cause early puberty, and sometimes children don’t have any other symptoms. Male children are more likely than female children to have brain tumors when they have early puberty. In some studies, up to 74% of male children with early puberty had brain tumors. Tumors in the ovaries and testicles can also lead to early puberty.

• Genetics: Some children are more likely to develop early puberty because of their genetics. Usually other family members also went through puberty early. 

• Medical conditions: Children with certain medical conditions, including cerebral palsy, neurofibromatosis, tuberous sclerosis, as well as Struge-Weber or McCune-Albright syndromes are more likely to go through early puberty. 

• Brain injury: Children with a history of brain injury or radiation treatment that targeted the brain or head are more likely to develop precocious puberty. 

• Chemical exposures: Children who were exposed to certain chemicals, including medications that contain testosterone or estrogen, are more likely to develop early puberty. 

Sometimes, it’s not clear why a child develops precocious puberty. Studies show that a cause for early puberty is found about 20% of the time in female children and 40% to 80% of the time in male children.

What are the long-term complications of precocious puberty?

Without treatment, there are two main complications of precocious puberty:

• Loss of adult height: Children who go through puberty early don’t achieve their expected adult height. They end up much shorter than they should be. 

• Mental health stress: There is some data that children who go through early puberty face greater mental health stressors. They may feel anxious or embarrassed about the fact that they look different than their peers. This can lead to feelings of isolation and depression.  

There may also be long-term health complications from the underlying cause of a child’s early puberty. 

How do you diagnose precocious puberty?

Your child’s healthcare provider can diagnose precocious puberty with these tools:

• A physical exam: This can find which signs of puberty your child has.

• Blood tests: These can check your child’s hormone levels.

• A bone-age wrist X-ray: This can show whether your child has finished growing.

Your child may also need imaging studies to look for conditions that can lead to precocious puberty. This may include a brain MRI or an ultrasound of their testicles or ovaries. 

How do you treat precocious puberty?

Not every child with precocious puberty needs treatment. If your child has already finished (or has almost finished) going through puberty, then there’s no reason to start treatment. 

But if your child is still early in puberty, they may be able to start treatment with puberty-blocking medications. 

Puberty blockers will stop your child’s puberty and keep open their growth plates. This lets them reach their maximum adult height. There’s even some evidence that children who get treatment report feeling less stressed about their early puberty.  

Leuprolide acetate is the most commonly used medication to treat precocious puberty. It’s given as an injection every 3 months. Some children need additional medications to stop their body from making estrogen or testosterone. Some commonly prescribed medications include:

• Anastrozole 

• Letrozole 

• Spironolactone 

Keep in mind that these treatments only help slow down puberty. If your child has early puberty because of an underlying medical condition, they will need separate treatment for that condition. 

Why trust our experts?

Written by:

Jennifer Sample, MD

After a fellowship, Dr. Sample worked as the medical director at the University of Kansas Hospital Poison Center (The University Of Kansas Health System Poison Control Center), which served the state of Kansas for poison exposures. In 2007, she returned to Children’s Mercy Hospital in Kansas City, Missouri, as a consultant in clinical pharmacology and medical toxicology.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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