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The body of a child growing from childhood to adolescence is something that parents often pay close attention to and monitor closely, especially girls, where it can be said that almost every family tends to be particularly concerned about rapid growth, also known as
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“Precocious Puberty”. This may be because precocious puberty often results in changes in physical development, including hormones, and importantly, a reduction in adult height growth. Finally, it affects the child&#8217;s mental state, who may not be ready to cope with the changes occurring.
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<h2>What is “Precocious Puberty”?</h2>
It is a condition where girls begin to develop earlier than usual due to increased sex hormones in the body, causing clear physical changes such as breast development, being taller than peers, pubic hair before the age of 8, or menstruation before the age of 9.5 years.
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<h2>Causes of “Precocious Puberty”</h2>
<ul>
<li>Normal bodily changes</li>
<li>Stimulation of the anterior pituitary gland to secrete hormones (GnRH dependent) caused by congenital brain dysfunction 
Brain diseases occurring later such as radiation exposure, accidents, inflammation, tumors, or genetic causes, chromosomal abnormalities, obesity, or unknown causes</li>
<li>No stimulation of the anterior pituitary gland to secrete hormones (GnRH independent) caused by various reasons such as hypothyroidism, congenital adrenal hormone deficiency, adrenal tumors, external sex hormone intake, ovarian cysts or tumors, etc.</li>
</ul>
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<h2>How does “Precocious Puberty” affect?</h2>
<ol>
<li>“Advanced bone age” caused by female sex hormones or Estrogen, leading to rapid growth initially but causing early bone closure. 
This affects height by shortening the growth period compared to normal children, resulting in reduced adult height potential.</li>
<li>Psychological impact Rapid physical changes may affect the child&#8217;s mental health due to physical differences from peers and difficulty coping with changes when not yet ready to take care of themselves, such as starting menstruation or breast development.</li>
<li>Preparation for underlying disease causes that may occur, such as brain tumors, ovarian cysts or tumors, adrenal tumors, hypothyroidism, etc.</li>
</ol>
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<h2>How to diagnose “Precocious Puberty”</h2>
<ul>
<li>Medical history and physical examination by a specialist</li>
<li>Hormone tests or hormone stimulation tests</li>
<li>Bone X-ray to check bone age (X-RAY)</li>
<li>Magnetic resonance imaging of the brain and anterior pituitary gland (MRI)</li>
<li>Ultrasound of the abdomen or pelvis (Ultrasound)</li>
</ul>
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<h2>How to treat “Precocious Puberty”</h2>
Treatment of “Precocious Puberty” depends on the underlying cause, such as:
<ol>
<li>Close monitoring of growth every 3-6 months</li>
<li>Medication to inhibit hormone secretion for GnRH dependent cases. The medication helps revert growth to the pre-pubertal pattern to reduce advanced bone age and maintain adult height potential. Currently, medications are available as intramuscular injections, subcutaneous injections, or implants. In Thailand, intramuscular injections are used, administered every 1 month/3 months/6 months depending on the doctor&#8217;s discretion.</li>
<li>Treatment of underlying causes in GnRH independent cases, such as stopping external sex hormone intake, etc.</li>
</ol>
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Therefore, early diagnosis and identification of the cause are important to correct the cause, preserve adult height, and support the child&#8217;s mental health to enter adolescence when ready. Parents should pay attention and prepare with the guidance and close care of a specialist.
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Dr. Pitchaya Wathanasakphuban
Pediatric Endocrinologist and Metabolism Specialist

The body of a child growing from a child into an adolescent is something that parents often pay close attention to and monitor closely, especially girls, which can be said that almost every family tends to be particularly concerned about rapid growth, or also called

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