A short introduction to precocious puberty by Dr. Om J Lakhani

1. PRIMER TO PRECOCIOUS
PUBERTY
DR. OM J LAKHANI
CONSULTANT ENDOCRINOLOGIST
www.dromlakhani.com

2. • Q. What is definition of precocious puberty ?

3. • Age of onset of puberty 2 -2.5 SD earlier than
normal
• Ie Onset of puberty before 8 years on girls and
before 9 year in boys

4. • Q. What is the mean age of pubertal onset in
girls and boys and what is 1 SD of both ?

5. • Mean in girls- 10.5 years
• Mean in boys- 11.5 years
• 1 SD – around 1 year
• Hence 2.5 SD would be 8 and 9 respectively

6. • Q. What is sequence of pubertal development
in girls ?

7. 1. Thelarche (11-11.5 years)
2. Pubarche
3. Menarche

8. • Q. And boys ?

9. 1. Increase testicular size
2. Increase penile size
3. Pubic hair

10. Pearl
• Precocious puberty is more common in girls
• Delayed puberty- more common in boys

11. Pearl
• With trend for earlier puberty – the cutoffs for
evaluation of precocious puberty are changing
• Hence the patient must be evaluated seeing
the racial and clinical context rather than age
alone

12. CLASSIFICATION AND CAUSES

13. • Q. Classify precocious puberty ?

14. 1. Benign / Non progressive variants
2. Central precocious puberty
3. Peripheral precocious puberty

15. • Q. Which are the benign variants ?

16. 1. Premature thelarche
2. Premature adrenarche (? Pubarche)
3. Isolated premature menarche (controversial)
4. Non progressive Precocious puberty or
Intermittently progressive precocious
puberty

17. Q. What is isosexual precocity and contrasexual
precocity ?

18. • Isosexual – early development sexual features
characteristic of the same sex
• Contrasexual – early development sexual
features characteristic of the opposite sex