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Tests and diagnosis
By Mayo Clinic staffIf your child's doctor suspects precocious puberty, he or she may refer you to a doctor who specializes in the treatment of hormone-related conditions in children (pediatric endocrinologist).
To diagnose precocious puberty, the doctor will:
- Review your child's and your family's medical history
- Do a physical exam
- Run blood tests to measure hormone levels
X-rays of your child's hand and wrist also are important for diagnosing precocious puberty. These X-rays can help the doctor determine your child's bone age, which shows if the bones are growing too quickly.
Determining the type of precocious puberty
Once an initial diagnosis has been made, the doctor will need to find out which type of precocious puberty your child has. To do so, he or she will perform a test that involves injecting your child with Gn-RH hormone and then taking a blood sample. In children with central precocious puberty, a Gn-RH injection causes LH and FSH hormone levels to rise. In children with peripheral precocious puberty, LH and FSH hormone levels stay the same.
Additional testing for central precocious puberty
- Magnetic resonance imaging (MRI). A brain MRI is usually done for children who have central precocious puberty to see if any brain abnormalities are causing the early start of puberty.
- Thyroid testing. The doctor may also test your child's thyroid if he or she shows any signs of hypothyroidism, such as fatigue, sluggishness, increased sensitivity to cold, constipation, a drop in school performance or pale, dry skin.
Additional testing for peripheral precocious puberty
Other tests also are necessary for children with peripheral precocious puberty to find the cause of their condition. For example, the doctor may run additional blood tests to further examine hormone levels or, in girls, he or she may do a pelvic ultrasound to check for an ovarian cyst or tumor.
- Biro F. Normal puberty. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2008.
- Pralong FP. Diagnosis and treatment of delayed puberty. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2008.
- Saenger P. Overview of precocious puberty. http://www.uptodate.com/home/index.html. Accessed Oct. 13, 2008.
- Carel JC, et al. Precocious puberty. New England Journal of Medicine. 2008;358:2366.
- Muir A. Precocious puberty. Pediatrics in Review. 2006;27:373.
- Precocious puberty. The Hormone Foundation. http://www.hormone.org/Resources/Growth/upload/bilingual_precocious_puberty.pdf. Accessed Nov. 24, 2008.
- Styne D. Precocious puberty (sexual precocity). In: Gardner DG, et al. Greenspan's Basic & Clinical Endocrinology. 8th edition. New York, N.Y.: McGraw-Hill; 2007. http://www.accessmedicine.com/content.aspx?aID=2631040&searchStr=precocious+puberty. Accessed Nov. 11, 2008.
