Central Precocious Puberty in Girls: Diagnosis, Management and Outcome

Abstract

Puberty is a normal physiological process of during which children develop secondary sex characteristics, experience growth acceleration, and achieve bone maturation and reproductive competence. The onset of puberty is initiated by the activation of the hypothalamic-pituitary-gonadal (HPG) axis. Precocious puberty is defined as the appearance of secondary sex characteristic at an age younger than 8 years in girls and 9 years in boys, or the beginning of menstruation before 9 years in girls. The most common etiology of central precocious puberty (CPP) is idiopathic (>90.0% in girls and 25.0-60.0% in boys), in which at present the etiologies of idiopathic CPP in some patients can be identified to be from a mutation of KISS1 or MKRN3 genes. The standard treatment for CPP is a gonadotropin-releasing hormone analog (GnRHa). The aims of treatment are to halt and regress the pubertal status of the patient to the prepubertal state that is appropriate for their age, prevent early onset of menses and attenuate the loss of height potential consequence upon advanced skeletal maturation. A study of long-term follow-ups of former CPP women at the age of mid-20s to 50 years found that most of the participants had regular menstrual cycles. The marital status and the pregnancy rate were the same as in controlled group and were not different between the GnRHa-treated and untreated CPP women.