Recent trends in pubertal timing and current management of precocious puberty in girls

Precocious puberty is defined as development of pubertal signs at a younger age than the accepted lower limits for the onset of puberty. Precocious puberty can be classified as gonadotropin dependent (central or true) and gonadotropin independent (peripheral or pseudo). Commonest etiology in girls is idiopathic gonadotropin dependent precocious puberty. Recently, timing of onset of puberty in girls has gained considerable interest among the professionals and general public. Recent data suggests a decrease in the age of onset of puberty in girls over the past 2–3 decades which may be attributable to increased incidence of obesity, improved nutrition and other environmental factors.Precocious puberty in girls warrants prompt evaluation and early initiation of treatment to optimize adult height potential and to minimize psychosocial stress to the child. Treatment is directed at the primary cause. Gonadotropin releasing hormone analog (GnRHa) is the treatment of choice for gonadotropin dependent precocious puberty. GnRHa are effective in preventing pubertal progression clinically as well as biochemically. A variety of GnRHa preparations are available and the details are mentioned in the text.