If the findings are abnormal or medication is being considered, you'll be referred to an endocrinologist — a doctor who specializes in the body's hormone-secreting glands.
Treatment, if given, will depend on what the doctor finds. An endocrinologist can help parents decide what to do based on their child's individual situation and test results (her age, her rate of maturation, her height and estimated future height, and the absence of underlying disorders, for example).
It's possible to delay puberty temporarily with hormones, but this is not something that's lightly or commonly done. It's usually accomplished with a drug called an LHRH analog, which the endocrinologist will inject either daily or every three to four weeks.
Children may show further signs of puberty during the first six weeks or so of treatment — mood changes, acne, even a period — but gradually these will stop. Side effects are minimal, and puberty starts again as soon as the child stops the drug. In the meantime, it's important to see a doctor regularly to monitor growth and hormone levels.
For most children, being different is painful, and physical differences can be particularly embarrassing for girls. It will be up to you to reassure, comfort, and support your daughter through her daily difficulties, but don't hesitate to get emotional help for your child or for yourself if you need it.
Here are a few tips from the experts:
You'll also probably want to help your daughter adjust to her new body by taking her shopping for bras, deodorant, and skin-care products as they become necessary. And try not to worry too much. Early or late, puberty is something that we all eventually manage to survive.
A debate has been raging for years over whether girls are now reaching puberty earlier than ever before. The debate escalated in 1997, when the journal Pediatrics published a study that suggested that European American girls were developing breasts and growing pubic hair a year earlier than previously thought, and that African American girls were beginning two years earlier.
The study sparked heated discussion. Some researchers and doctors felt that the study was flawed and that it would be irresponsible to lower the average age of puberty. If children as young as 6 who showed signs of puberty were considered to be within the range of normal, then they might not be evaluated, and serious conditions might go untreated.
But everyone — including the authors of the study — noted that while girls might be getting curvy earlier, the age that menstruation begins has not changed for at least 50 years. The average European American girl still gets her period at 12.8 years, and the average African American girl at 12.1.
"There's no question that girls are developing breasts and pubic hair sooner, but kids are still ending up the same height, and they're certainly not ready to reproduce any earlier," says Kaufman. "I don't think this trend means that our children are being harmed by something terrible in the environment. In general, puberty is a sign of wellness."
At this point, the general understanding is that much more research needs to be done before we can draw any new conclusions about the timing of puberty. Meanwhile, follow the safest guideline: Regardless of when your daughter shows signs of puberty, take her in for a checkup.