The goal of the treatment is to synchronize the physical and psychological development with the chronological age and avoid short stature by early closing of the growth plates.
The type of treatment depends on the cause of the precocious puberty:
- Central precocious puberty
In most cases, the origin is a central precocious puberty with the hypothalamus producing high peaks of LHRH. For this form, medication (LHRH analogues) can block the LHRH from interacting with the pituitary gland. The currently available LHRH analogues need to be injected in the muscle or subcutaneously, and different forms with different duration of action exist. Some formulas only work for a few hours, but fortunately the pharmaceutical industry succeeded in binding these molecules to a gel permitting very slow release of the active substance during 1, 3 or even 6 months.
Usually, the treatment is very effective. The breast development stops, and a small reduction of the breast volume is often obtained. The emotional fluctuations and ‘puberty behaviour’ also decrease. The closure of the growth plates is delayed, with a positive effect on adult height, especially in girls with puberty onset before the age of 6 years. In older girls, the effect on adult height is variable.
The most common adverse events of the treatment are pain, redness and swelling at the injection site, exceptionally, an allergic reaction to the medication can occur. After the first injection, 5-10% of the girls experience a vaginal bleeding that does not reoccur with continuation of the treatment. After stopping the treatment, puberty development continues and most girls have menstruations within 2 years
During the treatment, the bone density may decrease, but this will restore after stopping the treatment.
- Peripheral precocious puberty
The peripheral precocious puberty can be treated with medication reducing the production of female hormones in the ovaries or in some tumours and/or blocking the effect of female hormones. If a tumour causes the production of female hormones, this can be surgically removed.