Sexual precocity and its treatment

DeAnna B Brown, Lindsey A Loomba-Albrecht, Andrew A Bremer

Nashville, TN, USA

Author Affiliations: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA (Brown DB, Bremer AA); Department of Pediatrics, University of California Davis School of Medicine, Sacramento, California 95817, USA (Loomba-Albrecht LA); Department of Pediatrics, Division of Endocrinology, Vanderbilt University, 2200 Children's Way, 11134-A DOT-9170, Nashville, TN  37232-9170, USA (Bremer AA)

Corresponding Author: Andrew A Bremer, MD, PhD, Department of Pediatrics, Division of Endocrinology, Vanderbilt University, 2200 Children's Way, 11134-A DOT-9170, Nashville, TN 37232-9170, USA (Email: andrew.a.bremer@vanderbilt.edu)

doi: 10.1007/s12519-013-0411-7

Background: Puberty is a complex and dynamic period in development during which individuals transition from the juvenile to adult state. Regulated by multiple genetic and endocrine controls, it is characterized by somatic growth and sexual maturation. Sexual precocity is defined as the appearance of secondary sexual characteristics before the lower limit of the normal age for pubertal onset.

Data sources: Based on recent publications and the experience with the disease of our group, we reviewed the normal timing and order of puberty, the definition of sexual precocity, the classification of sexual precocity, the differential diagnosis of sexual precocity, variations in pubertal development, the diagnosis of sexual precocity, and the treatment of sexual precocity.

Results: Sexual precocity can be classified as either gonadotropin-releasing hormone (GnRH)-dependent or GnRH-independent. Regardless of the etiology, sexual precocity causes increased height velocity, somatic development, and skeletal maturation, which may have profound physical and psychological implications.

Conclusions: The treatment of sexual precocity is focused on its cause and must address both its psychosocial and clinical implications. For GnRH-dependent precocious puberty, GnRH agonists are the main pharmacological agents used. Alternatively, the treatment of disorders causing GnRH-independent sexual precocity is directed toward the underlying abnormality.

Key words: puberty; sex precocity