Avoid ordering luteinizing hormone- and follicle-stimulating hormone and either estradiol or testosterone for children with pubic hair and/or body odor but no other signs of puberty.

Rationale and Comments

Premature adrenarche is usually the diagnosis and does not involve activation of the pituitary-gonadal axis but is due to an early increase in adrenal androgens. DHEA-S levels are elevated for age but do not alter the management of this common and generally benign condition.

Sponsoring Organizations

American Academy of Pediatrics – Section on Endocrinology

Sources

American Academy of Pediatrics guidelines

Disciplines

Endocrinologic
Pediatric

References

Kaplowitz P, Bloch C, the SECTION ON ENDOCRINOLOGY. Evaluation and Referral of Children with Signs of Early Puberty. Pediatrics. 2016;137(1):e20153732.