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Puberty: when it comes too soon guidelines for the evaluation of sexual precocity.

Sexual precocity, evidence of secondary sexual characteristics before the age of 9 years in boys and 8 years in girls, can be distressing for families and challenging for primary care physicians. In this article, I discuss the most common causes of early sexual development and provide an algorithm for the initial evaluation of such children. The information presented here is not intended to be a complete guide to the diagnosis of disorders resulting in sexual precocity, but rather is designed to aid in the initial evaluation and facilitate the identification of those children who would benefit from referral to a pediatric endocrinologist.