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New research · Endocrinology
The Journal of clinical endocrinology and metabolism · 2d
GuidelineThe Journal of clinical endocrinology and metabolism · 2026

Central precocious puberty: an Endocrine Society clinical practice guideline.

Ana Claudia Latronico, Stephanie A Roberts, Morgan Alonzo … Christopher R McCartney
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EndocrinologyGuideline

Watchful waiting is suggested for girls with early puberty between ages 7 and 8 years.

Central precocious puberty: an Endocrine Society clinical practice guideline.

Ana Claudia Latronico et al. · The Journal of clinical endocrinology and metabolism · 2026
Background

Central precocious puberty (CPP), which is traditionally defined as the development of secondary sexual characteristics before age 8 years in girls and age 9 years in boys, results from the premature activation of the hypothalamic-pituitary-gonadal (HPG) axis.

Purpose

Develop evidence-based recommendations related to the diagnosis and treatment of CPP.

Methods

A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to address 10 clinical questions related to the diagnosis and treatment of CPP.

Results
girls with early breast development for whom doctors suggest observation, not immediate tests
More results

These recommendations are largely based on evidence that girls with slowly progressive puberty attain a normal adult height without treatment.

More results

The GDP suggests against routine genetic testing for patients with CPP, although they judged that genetic testing (eg, MKRN3 sequencing) should be considered for patients with familial CPP through a shared decision-making process.

“
Conclusion · 1 of 3

These clinical recommendations were developed to address important uncertainties in the diagnosis and treatment of children with CPP.

Conclusion · 2 of 3

They are based on the best available scientific evidence regarding clinical outcomes judged to be most important to patients and families.

Conclusion · 3 of 3

The GDP's overarching goal was to suggest diagnostic and therapeutic strategies that will most likely provide net clinical benefits while simultaneously considering important contextual factors such as cost and feasibility.

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