FEMALE PUBERTY: ONSET, DEVELOPMENT AND NEED FOR DIAGNOSTIC WORKUP

Key words: Female puberty, Telarche, Precocious puberty, Diagnosis

Over the last century there has been a trend to earlier onset of female puberty and a great variability of the age of onset has been observed. A tendency towards a slower pubertal development, particularly in cases at earlier onset, has also been observed, and it has been shown that the final growth deficit consequent to early onset puberty may be ultimately compensated. As a consequence, the age limits for defining when puberty is precocious and for starting a diagnostic workup have been reexamined. Precocious puberty is now defined as initial appearance of secondary sexual characters before 7 years of age. Between 7 and 8 years a diagnostic workup is recommended when the speed of pubertal development appears abnornal. Treatment with LHRH analogues is in principle indicated only in cases with idiopathic central precocius puberty with onset before 6 years of age.