Signs of sexual precocity

Signs of sexual precocity

In girls

In girls, breast development is often the first event of sexual precocity. However, an alternative initial manifestation may be growth of pubic hair or menarche.[1]

Girls begin to perspire and develop body odor. Additionally, secretions from sebaceous glands may result in oily skin and hair and sometimes acne as a result of apocrine gland activity. Growth velocity increases, skeletal maturation is accelerated, and bone density increases as a result of the secretion of estrogen.[1]

In addition:

  • Some emotional lability and cyclic mood swings may occur in these younger girls
  • Body shape and composition also change
  • The percentage of body fat composition can increase and a female body contour can develop.[1]

One other important feature is the premature fusion of the epiphyseal growth plates in long bones, resulting in significantly shorter stature as an adult.[1]

In boys

In boys, the first sign of precocious puberty may be growth of pubic hair. An increase in genital size, which may or may not include the testes, depending on the underlying cause, is also associated with sexual precocity. Testicular volume of greater than 2 cm3 (Tanner stage 2) indicates pubertal development. The testes progressively increase in volume through puberty.

Boys begin to perspire and develop body odor. Additionally, secretions from sebaceous glands may result in oily skin and hair and sometimes acne as a result of apocrine gland activity. Growth velocity increases, skeletal maturation is accelerated, and bone density increases as a result of the secretion of androgen.[1]

Other clinical indications of the development of early puberty in boys that are associated with production of androgens include:

  • an increase in muscle bulk and strength
  • deepening of the voice
  • facial hair growth (eventually)
  • premature fusion of the epiphyseal growth plates in long bones, resulting in significantly shorter stature as an adult

In addition:

  • boys also may experience more frequent erections, penile emissions, and changes in behavior, including increased libido and possibly even aggressive behavior.[1]

One other important feature is the premature fusion of the epiphyseal growth plates in long bones, resulting in significantly shorter stature as an adult.[1]

References
  1. Haqq D, Boston B, LaFranchi S. Precocious puberty. Vol 5. In: Sciarra JJ, ed. Gynecology and Obstetrics. Philadelphia: Lippincott Williams & Wilkins; 2004.

IMPORTANT SAFETY INFORMATION

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FENSOLVI (leuprolide acetate) for injectable suspension is a gonadotropin releasing hormone (GnRH) agonist used to treat patients 2 years of age and older with central precocious puberty (CPP). CPP may be diagnosed when signs of sexual maturity begin to develop in girls under the age of 8 or in boys under the age of 9.

FENSOLVI is contraindicated in individuals with hypersensitivity to any drug that is in the same class as FENSOLVI, in individuals who are allergic to any of the ingredients in FENSOLVI, or in individuals who are pregnant. FENSOLVI may cause fetal harm when administered to a pregnant patient.

During the first few weeks of treatment, increases in gonadotropins and sex steroids above baseline may result in an increase in signs and symptoms of puberty including vaginal bleeding in girls.

Psychiatric events have been reported in patients taking GnRH agonists. Events include emotional lability, such as crying, irritability, impatience, anger, and aggression. Patients should be monitored for development or worsening of psychiatric symptoms.

Convulsions have been observed in patients treated with GnRH agonists with or without a history of seizures, epilepsy, cerebrovascular disorders, central nervous system anomalies or tumors, and in patients on concomitant medications that have been associated with convulsions such as bupropion and SSRIs.

Pseudotumor Cerebri (Idiopathic Intracranial Hypertension) has been reported in pediatric patients treated with GnRH agonists.  Patients should be monitored for headache, papilledema and blurred vision.

The most common adverse events seen with FENSOLVI were: injection site pain, nasopharyngitis, pyrexia, headache, cough, abdominal pain, injection site erythema, nausea, constipation, vomiting, upper respiratory tract infection, bronchospasm, productive cough and hot flush. 

Please see Full Prescribing Information for FENSOLVI for additional important safety information. 

To report suspected adverse reactions contact Tolmar at 1-844-4TOLMAR (486-5627) or the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.