What to do if your child has precocious puberty

Precocious puberty in children is a problem that troubles many parents. The appearance of symptoms that shouldn't occur at such an early age not only worries parents but also causes some distress to children. Therefore, many parents believe that their children’s early precocious puberty is a sign of physical problems, so many parents choose to take their children to the hospital for relevant examinations. So what should we do if our children experience precocious puberty?

1. Etiological treatment: For intracranial, gonadal, and adrenal tumors, surgical resection or radiotherapy can be adopted. For patients with congenital adrenal hyperplasia and hypothyroidism, appropriate hormone replacement therapy is used.

2. The application of sex hormone antagonists and inhibitors.

1. Luteinizing hormone-releasing hormone analogue (GnRHa): GnRHa is the first choice drug for the treatment of central precocious puberty and is not used to treat pseudo-precocious puberty. The goals of treatment are to improve adult height, delay the progression and speed of maturation of secondary sexual characteristics, prevent premature menarche, and prevent the emergence of psychosocial problems. GnRHa changes the structure of natural GnRH, making it have a stronger affinity with the GnRH receptor, while also having a long half-life and being less susceptible to degradation. Currently, the treatment mostly uses sustained-release preparations of LHRH, the main preparations of which are triptorelin and leuprorelin (enaptoplastin). Non-sustained-release preparations and nasal inhalation preparations used in the 1980s are almost no longer recommended.

2. Danazol: It is a synthetic steroidal heterocyclic compound and a derivative of 17α-ethynyltestosterone. It inhibits estrogen synthesis and ovarian follicle development, can bind to progesterone receptors, accelerate the clearance of progesterone, has strong anti-gonadotropin and weak androgenic effects, and directly inhibits the secretion of GnRH and GH. The dosage is 100-200 mg orally once a night. Adverse reactions include skin allergies, weight gain, elevated transaminase, hematuria, and headache. Liver function and urine routine tests should be reviewed regularly. Some authors have used low-dose danazol to treat idiopathic central precocious puberty and found that danazol can accelerate the growth rate of height. An 8-year follow-up showed that 72.4% of the subjects' final adult height reached or exceeded the genetic target height without obvious androgenic side effects.

3. Cyproterone acetate (androcur, cyprostat, cyproterone acetate): It is a derivative of 17-hydroxyprogesterone. It has a strong anti-androgenic effect and progestin activity. It can inhibit the secretion of gonadotropin. It was widely used in Europe to treat precocious puberty. The dosage is 100 mg/m2, taken orally in 2 to 3 times. It can inhibit the secretion of LH stimulated by GnRH, thereby reducing the level of sex hormones and causing breast shrinkage, but its effectiveness in causing the final growth toward height in adulthood remains to be determined.

3. Others Medroxyprogesterone (progesterone acetate) is no longer used to treat precocious puberty. Intracranial gray tubercle hamartoma in boys is the most common cause of true precocious puberty. Because the tumor is very small, it can be treated with GnRHa instead of surgery. Other tumors require surgery, radiation therapy, and/or chemotherapy.

When parents find that their children are experiencing precocious puberty, they must not scold them with overly provocative words, because children may not be very clear about the cause of their condition. Therefore, parents should pay more attention to changes in their children's daily behavior and try their best to avoid precocious puberty in their children.