Early puberty: the causes

There are two types of early puberty, the causes of which are different: central early puberty (or "true" PP), whose origin is hypothalamic-pituitary; and early peripheral pubertal (or pseudo-pubertal early), due to secretion of sex hormones independent of the hypothalamic-pituitary axis.

1- The causes of central early puberty.

Central early puberty is due to premature onset, lesional or not, of the hypothalamic-pituitary axis. They are eight times more common among girls than boys.

In girls, no cause is found in 80 to 95% of cases. In boys, a tumor is found almost every second time.

The causes of early puberty of central origin can be

  • tumor (tumor in the pituitary or hypothalamus),
  • neurological (hydrocephalus, cerebral irradiation, etc.) or
  • General (Recklinghausen's disease (neurofibromatosis type 1), tuberous sclerosis of Bourneville, etc.

These latter causes are nevertheless quite rare. In some cases, the cause of precocious puberty is not identified. This is called idiopathic central precocious puberty.

2- The causes of early peripheral puberty.

Early peripheral puberty results from the abnormal secretion of sex hormones by a gland or a tumor, localized or not at the level of the sexual glands.

The causes of early peripheral puberty may be tumoral (ovarian tumors for girls, leydigal adenomas and HCG tumors in boys), cystic (mostly benign ovarian cysts), medicated or genetic (testotoxicosis).

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