Precocious Puberty in Boys
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Initial Management
The first sign of centrally driven puberty in boys is testicular enlargement over 4mls. This is considered abnormal when the onset is before the age of 9 years.
Assessment should include:
- Enquiry about maturation of the genitals and/or clinical examination.
- History of growth acceleration with plotting of height on growth chart, although be aware that the male growth spurt usually comes later in puberty.
- Ideally both parents’ height would be plotted and obtaining a family history of pubertal timing can also be helpful.
- If considering blood tests prior to referral then please include LH/FSH/testosterone and TFTs.
Who to Refer
The
Tayside precocious puberty/adrenarche pathway gives more detailed guidance on differentiating precocious puberty from the normal variant adrenarche:
Please refer
boys with onset of pubertal development before the age of 9 years to paediatric endocrinology via SCI gateway.
Who Not to Refer
Boys with pubertal onset after the age of 9 years with no other concerning features.
How to Refer
SCI Gateway
Useful Resources
The Scottish paediatric endocrine group website contains useful
SPEG parent information leaflets, including on GNRH testing and precocious puberty:
RCPCH Growth Charts.