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Precocious puberty

Neely, E. Kirk; Crossen, Stephanie S.

Current Opinion in Obstetrics & Gynecology: October 2014 - Volume 26 - Issue 5 - p 332–338
doi: 10.1097/GCO.0000000000000099
ADOLESCENT AND PEDIATRIC GYNECOLOGY: Edited by Paula J. Adams Hillard

Purpose of review: Precocious puberty continues to elicit great interest and concern among medical practitioners, as well as the public.

Recent findings: Studies have elucidated neural regulation of puberty by kisspeptin, neurokinin B, and other factors. Cohort studies from the North America and Europe suggest that the age of thelarche may be earlier than determined 2 decades ago, and menarche may be slightly earlier, but the causes are unclear. Long-term outcomes of gonadotropin-releasing hormone analog therapy demonstrate increases in final height in the youngest treated patients, with no apparent adverse bone or reproductive consequences.

Summary: Although the appropriate threshold age of onset of central puberty remains uncertain, gonadotropin-releasing hormone analog therapy is well tolerated and effective in suppressing luteinizing hormone pulses and ovarian activity.

Division of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, California, USA

Correspondence to E. Kirk Neely, MD, Division of Pediatric Endocrinology and Diabetes, Rm G-313, Stanford University Medical Center, Stanford, CA 94305-5208, USA. Tel: +1 650 723 5791; fax: +1 650 725 8375; e-mail: neely@stanford.edu

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