Precocious Puberty

Studies in Sweden, Belgium, Italy and France have documented that children adopted internationally are at risk for early puberty and short final height. Thirteen percent of Indian girls adopted to Sweden reached menarche before the age of ten years. Girls who had the most growth impairment on arrival and who had the highest rate of catch-up growth were at highest risk. However, precocious puberty in male adoptees appears to be rare. International adoptees who exhibit signs of early puberty should be referred to a pediatric endocrinologist. Treatment with gonadotropin-releasing hormone (GnRH) analogues can delay puberty and prolong the growth period. This will allow more time for psychological maturation as well. The addition of growth hormone (to GnRH analogue) improved final height by an average of 2.7 cm in these children.