When people find out that they may have a disease, they usually have two doubts: Why do they have the disease? Can this disease be cured? So what is the current situation regarding the treatment of precocious puberty in children? There is a guideline that may be able to solve some of our doubts. The emergence of a diagnosis and treatment guide In order to do the diagnosis and treatment of precocious puberty in a scientific and standardized way and promote the healthy growth of children, the Ministry of Health formulated and released the “Diagnosis and Treatment Guide for Precocious Puberty (Trial)” in 2010. Although the target audience of this guideline is professionals in medical institutions, not the general public, the guideline still provides a window for the general public to understand the diagnosis and treatment of precocious puberty in children. About the clinical manifestations and diagnostic basis of precocious puberty in children The guideline classifies precocious puberty in children into two types: central and peripheral. The following are the corresponding clinical manifestations and diagnostic bases, which readers can refer to. (A) Central precocious puberty 1. Early appearance of secondary sexual characteristics (age in accordance with the definition) and progress according to the normal developmental procedure. Girls: breast development, sudden increase in height growth rate, pubic hair development, usually presented at menarche 2 years after the beginning of breast development. Boys: testicular and penile enlargement, sudden increase in height growth rate, pubic hair development, generally 2 years after the testicular enlargement begins to present the change of voice and spermatorrhea. 2, there is a basis for gonadal development, girls are judged by ultrasound images, boys have testicular volume ≥ 4 ml. 3, the development process presents a sudden increase in height growth. 4.Gonadotropins are elevated to puberty level. 5. There may be advancement of bone age, but there is no diagnostic specificity. The most common type of incomplete central precocious puberty is simple precocious breast development, which is characterized by early breast development without other secondary sexual characteristics, no coloration of the areola, and a non-progressive self-limiting course. (B) Peripheral precocious puberty 1. Early appearance of secondary sexual characteristics (age according to the definition). 2. The development of sexual characteristics does not progress according to the normal developmental procedure. 3.Gonadal size is at prepubertal level. 4. The gonadotropins are at prepubertal levels. Diagnosis and examination of precocious puberty in children The guideline states that to determine precocious puberty in children, in addition to the initial judgment by clinical features, four auxiliary examinations such as basal sex hormone measurement, gonadotropin-releasing hormone (GnRH) stimulation test, uterine ovarian ultrasound, and bone age determination are required. In addition, brain CT or MRI examination is required after the diagnosis of central precocious puberty is confirmed. Patients with peripheral precocious puberty undergo further endocrine examination according to specific clinical features and after the initial screening of endocrine hormones, and imaging examination of gonads, adrenal glands or other related organs is done as needed. Treatment of precocious puberty in children The goals of treatment for precocious puberty are to suppress premature or rapid sexual development, to improve adult height loss due to early bone age, and to prevent or alleviate social or psychological problems associated with precocious puberty in the child or parents. With early detection and timely treatment, most cases of precocious puberty can be cured. Patients with precocious puberty can also achieve a normal psychological status and desired adult height. In terms of treatment, central and peripheral precocious puberty are also different. (i) Central precocious puberty Currently, GnRH analogs such as treprostinil and leuprolide extended-release (GnRHa) are the main treatment of choice. The guidelines highlight several issues in treatment: patients may experience vaginal bleeding after the first injection, or bleeding again if they have already had their first menstrual period; the duration of treatment for the purpose of improving adult height should be at least 2 years, and the specific duration of treatment should be individualized; it is generally recommended to discontinue the drug at age 11.0 years, or at 12.0 years of bone age, when maximum adult height can be expected to be reached, with more significant improvement in adult height in those who start treatment earlier (<6 years). In addition, the guidelines specifically state that patients with central precocious puberty with central organic lesions should be treated for the appropriate etiology according to the nature of the lesion. (ii) Peripheral precocious puberty For this type of precocious puberty, the guidelines suggest that it should be treated separately according to different etiologies, such as surgical treatment of various tumors and cortisol replacement therapy for congenital adrenocortical hyperplasia.