There are many causes of precocious puberty, which can be divided into central (true) and peripheral (pseudo) according to whether the hypothalamus-pituitary-gonadal axis function is activated in advance.
I. Central precocious puberty (CPP)
Also known as true precocious puberty, due to the premature activation of hypothalamic-pituitary-gonadal axis function and GnRH pulse secretion, the affected children have the development of ovaries or testes in addition to the development of secondary sexual characteristics. The process of sexual development follows the same sequence as normal pubertal development. Only the age is advanced. It mainly includes organic lesions secondary to the central nervous system and idiopathic precocious puberty.
1.Idiopathic precocious puberty
Also known as somatic precocious puberty, it is caused by the hypothalamus’ decreased sensitivity to the negative feedback of sex hormones, resulting in premature secretion of gonadotropin-releasing hormone, which is more common in females and accounts for more than 80% of girls’ CPP, while only about 40% of boys.
2.Secondary precocious puberty
It is mostly seen in central nervous system abnormalities, including: tumor or occupational lesion: hypothalamic malformation tumor, cyst, granuloma, central nervous system infection, acquired injury: trauma, post-operative radiotherapy or chemotherapy, developmental abnormalities: hydrocephalus, optic septal hypoplasia, etc.
3.Other diseases
Primary hypothyroidism.
Peripheral precocious puberty
Also called pseudoprecocious puberty. It is the precocious sexual maturity caused by non-controlled hypothalamic-pituitary and gonadal functions, with the development of secondary sexual characteristics and elevated level of sex hormones, but immature hypothalamic-pituitary-gonadal axis and no development of gonads.
1. Gonadal tumors
Ovarian granulosa-vesicular membrane cell tumor, luteinoma, testicular mesenchymal cell tumor, teratoma, etc.
2.Adrenal gland diseases
Adrenal tumors, congenital adrenal cortical hyperplasia, etc.
3.Exogenous
Such as estrogen-containing drugs, food, cosmetics, etc.
4.Other
McCune-Albright syndrome.
III. Partial precocious puberty
Simple premature breast development, simple premature pubic hair development, simple early menarche. Some precocious puberty is due to the appearance of tumors in the body, which can secrete substances similar to sex hormones. Sometimes, when the tumor is still small, the amount of sex hormones it secretes is already large enough to cause sexual development, so children with precocious puberty must see a doctor in time for early diagnosis and treatment.