The puberty study, published in Pediatrics in April 1997, concluded that girls are maturing sexually at ages younger than the standards used in pediatric practices to determine normal development. That represents a shift from 30 years ago when puberty was considered premature if it took place in girls at age 10. Menstruation, however, doesn't appear to be occurring any sooner. The age at first period has hovered around 12 for decades, after falling at a rate of about six months every 50 years for about 150 years. It's not clear why girls seem to be maturing faster, although diet, obesity, genetics and environmental exposures, such as hormones in food and cosmetic products, are suspected factors.
Treatment is clearly advantageous in cases of true precocious puberty.
Children who experience premature development face the risk of an early growth spurt that can shut down too soon, causing them to be abnormally short. However, pubic hair growth without breast development is not considered a sign of early puberty and that condition does not respond to Lupron. Girls generally begin menstruation about two years after the start of breast development. A work-up could include testing of the pituitary gland and ovaries, and a determination of bone age. The gray area is whether to treat children between 6 and 8.