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Early Puberty

Children who start puberty before age 11 usually end up short, no matter how tall they are in comparison to their classmates when they enter puberty (1). Girls who start puberty before age 11 are at increased risk for breast cancer (2). Bones grow from special growth centers near their ends. Puberty closes these growth centers and prevents further vertical growth forever. Sex hormones that children start to produce in large amounts as they enter puberty cause bones to grow rapidly and then close off. So children who are tall in the sixth grade who start puberty early often are short as adults because they stop growing sooner than their peers.

Early puberty is associated with increased risk for breast cancer and can be started by a high fat, high-calorie diet which increases the body's production of insulin like growth factor-1 that may cause breast cancer. Therefore children with signs of early puberty, such as hair growth under the arms and around the genitals should check with their doctors. They may be able to delay puberty with a regular exercise program, but some may need to be treated with a drug regimens (3) to stop puberty and give them several more years to grow taller.

A study from the National Institutes of Health showed that drugs can delay puberty in children who start puberty before age ten (4). Doctors at the National Institutes of Health successfully delayed puberty in these children by giving them drugs called LHRH agonists, and they ended up much taller than they would have if they had not been treated.

A study from Spain shows that girls who weighed less than six pounds at birth usually start puberty early and because of this, end up shorter than girls who are heavier at birth (5). Women who give birth to small babies usually do not gain the recommended 20 pounds during pregnancy, and lack of calories during pregnancy causes the baby to gain more weight during early childhood. Eating extra calories and being heavy during the early years brings on the start of menstruation, which stops growth and prevents a girl from continuing to grow.

A study from France showed that polycystic ovary syndrome, a condition that affects seven percent of women in North American, is associated with starting to menstruate at an early age (6).

1) WF Paterson, E Mcneill, S Reid, AS Hollman, MDC Donaldson. Efficacy of Zoladex LA (goserelin) in the treatment of girls with central precocious or early puberty. Archives of Disease in Childhood 79: 4 (OCT 1998):323-327. Zoladex LA was effective in controlling precocious puberty in girls when given at intervals of 9-12 weeks.

2) BA Stoll. Western diet, early puberty, and breast cancer risk. Breast Cancer Research and Treatment 49: 3 (JUN 1998):187-193. increase in bioactive levels of insulin-like growth factor-I may synergise with oestrogen in stimulating proliferative activity in mammary epithelium. Dietary modification and exercise regimens are proposed in families at high risk to breast cancer. The measures have been shown to reduce insulin levels in both children and adults.

3) EW Leschek, J Jones, KM Barnes, SC Hill, GB Cutler. Six-year results of spironolactone and testolactone treatment of familial male-limited precocious puberty with addition of deslorelin after central puberty onset. Journal of Clinical Endocrinology and Metabolism 84: 1(JAN 1999):175-178. EW Leschek, NICHHD, Dev Endocrinol Branch, NIH, Bldg 10, Room 10N262, 10 Ctr Dr, MSC 1862, Bethesda, MD 20892 (spironolactone (5.7 mg/ kg day) and testolactone (40 mg/kg day) for at least 6 yr. Deslorelin (4 mu g/ treatment was initiated 2.6 +/- 1.3 yr after beginning spironolactone and testolactone treatment.)

4) Increased final height in precocious puberty after long-term treatment with LHRH agonists: The National Institutes of Health Experience. Journal of Clinical Endocrinology and Metabolism, 2001, Vol 86, Iss 10, pp 4711-4716. KO Klein, KM Barnes, JV Jones, PP Feuillan, GB Cutler.

5) Ibanez, A Ferrer, MV Marcos, FR Hierro, F deZegher. Early puberty: Rapid progression and reduced final height in girls with low birth weight. Pediatrics, 2000, Vol 106, Iss 5, Part 1, pp U73-U75 Address Ibanez L, Univ Barcelona, Hosp Sant Joan de Deu, Endocrinol Unit, Passeig Sant Joan de Deu 2, Barcelona 08950, SPAIN

6) Endocrine consequences of premature pubarche in post-pubertal Caucasian girls. Clinical Endocrinology, 2002, Vol 57, Iss 1, pp 101-106. T Meas, D Chevenne, E Thibaud, J Leger, S Cabrol, P Czernichow, C LevyMarchal. Levy-Marchal C, Hop Robert Debre, INSERM, U457, 48 Blvd Serurier, F-75019 Paris, FRANCE

Checked 2/21/12

May 30th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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