Editing Precocious puberty (section)

== Diagnosis ==
Studies indicate that breast development in girls and the appearance of pubic hair in both girls and boys are starting earlier than in previous generations.<ref name=ncbi/><ref name="adc.bmj.com">{{Cite journal | last1 = Zukauskaite | first1 = S. | last2 = Lasiene | first2 = D. | last3 = Lasas | first3 = L. | last4 = Urbonaite | first4 = B. | last5 = Hindmarsh | first5 = P. | title = Onset of breast and pubic hair development in 1231 preadolescent Lithuanian schoolgirls | doi = 10.1136/adc.2004.057612 | journal = Archives of Disease in Childhood | volume = 90 | issue = 9 | pages = 932–936 | year = 2005 | pmid =  15855182| pmc =1720558 }}</ref><ref name="news.bbc.co.uk">{{cite news |first=Michelle |last=Roberts |title=Why puberty now begins at seven|work=BBC News|date=2005-05-15|access-date=2010-05-22|url=http://news.bbc.co.uk/2/hi/health/4530743.stm}}</ref> As a result, "early puberty" in children as young as 8 and 9 is no longer considered abnormal, particularly with girls. Although it is not considered as abnormal, it may be upsetting to parents<ref name=www.msnbc.msn.com/><ref name="www.suntimes.com">{{cite news|first=Jim|last=Ritter|title=Parents worried by girls' earlier start of puberty|newspaper=[[Chicago Sun-Times]]|date=2000-08-02}}</ref> and can be harmful to children who mature physically at a time when they are immature mentally.<ref name="www.center4research.org">{{cite web |url=http://www.center4research.org/early-puberty-girls/|title=Early Puberty in Girls|author=Diana Zuckerman |publisher=Cornell University Program on Breast Cancer and Environmental Risk Factors |year=2001 |work=The Ribbon |access-date=18 February 2018 }}</ref>

No age reliably separates normal from abnormal processes in children, but the following age thresholds for evaluation are thought to minimize the risk of missing a significant medical problem:
* Breast development in boys before appearance of pubic hair or [[testicle|testicular]] enlargement
* [[Pubic hair]] or genital enlargement ([[gonadarche]]) in boys with onset before 9 years
* Pubic hair ([[pubarche]]) before 8 or breast development ([[thelarche]]) in girls with onset before 7 years
* [[Menstruation]] ([[menarche]]) in girls before 10 years

Medical evaluation is sometimes necessary to recognize the few children with serious conditions from the majority who have entered puberty early but are still medically normal. Early sexual development warrants evaluation because it may:
* induce early [[bone maturation]] and reduce eventual adult height
* indicate the presence of a tumour or other serious problem
* cause the child, particularly a girl, to become an object of adult sexual interest.<ref name=newscientist.com/><ref name="Stattin & Magnussion">(Stattin & Magnussion, 1990)</ref><ref name="Mendle">{{cite journal |vauthors=Mendle J, Leve L, Van Ryzin M, Natsuaki M | title = Linking Childhood Maltreatment With Girls' Internalizing Symptoms: Early Puberty as a Tipping Point | journal = Journal of Research on Adolescence | volume = 24 | issue = 3 | pages = 626–30 |date=August 2013 |doi=10.1111/jora.12075| pmid = 25419091 |pmc=4236856 }}</ref>