A new Endocrine Society Clinical Practice Guideline released on June 14 recommends that some subgroups of children with precocious puberty, such as older girls with slowly progressing puberty, may not require the same level of testing or treatment as others.
Central precocious puberty occurs when a child's brain activates puberty-related hormones earlier than usual—before age 8 in girls and before age 9 in boys. This early hormone signaling leads to physical changes including breast development in girls, testicular enlargement in boys, rapid growth, and sometimes early menstruation. Early onset of puberty can impact adult height and is linked to long-term physical and emotional health risks such as psychosocial stress, heart disease, and certain cancers later in life.
The guideline authors say that medication designed to pause the brain signals initiating puberty can be an effective treatment. This approach has the potential to increase adult height and improve both psychosocial and long-term health outcomes for children experiencing early puberty.
"Some subgroups of children may not need the same level of testing or treatment. For example, older girls with slowly progressing precocious puberty often have normal adult height without intervention," said Stephanie Roberts, M.D., co-chair of the guideline writing group from Boston Children's Hospital. "We give clinicians suggestions that avoid unnecessary or invasive testing and treatment, such as sometimes initially using a period of observation by their health care provider, using simpler testing methods and individualizing treatment when indicated."
The guideline was developed by a committee including members from medical institutions across North America, South America, Europe, and Australia. The document titled "Central Precocious Puberty: An Endocrine Society Clinical Practice Guideline" was published online and presented at ENDO 2026—the annual meeting of the Endocrine Society—and will appear in the September print issue of The Journal of Clinical Endocrinology & Metabolism.
