Hello Angi & CAH friends,

I hope to answer your questions without confusing anyone.

Precocious Puberty
Your Hypothalamus (it's like a thermometer) regulates the Pituitary Gland
(the master gland, which regulates the release of adrenal, sex, thyroid and
growth hormones). The hypothalamus tells the pituitary to release more sex
hormones.
When this happens puberty begins for girls by way of their ovaries and boys
by their testicles.

Your endocrinologist can see that if the CAH is regulated (by testing) and if
the testosterone levels are going through the roof, than there is another
problem. They do more extensive blood tests to find which gland is producing
the excess.

In Charlie's case they found CPP and he is in tanner stage 3 of puberty.
This means that he is in the middle of puberty (which is not good for a 4.5
year old, June 1998).

While not all CAH children start precocious puberty they seem to have a
better chance at getting it and you need to be aware of the signs and know
the normal levels for a child your age so when they call with results you can
see if there may be a problem that the doctor missed.

The signs are that of a normal teen going through puberty.
Charlie's are:
height and weight-much larger than peers
bone age advanced
levels still high even though CAH is suppressed
moody, aggressive
sleeping a lot
penis size much, much too large
constant erections and masturbation
pimples, blackheads
pubic, underarm, facial hair
deepening voice (Charlie did not have this but it does occur for boys in
puberty)

If not treated the psychological aspects are very hard! I know that now at
5.3 years the questions are coming and they are hard to answer because there
is nothing to help explain erections to your child as they are crying and
asking why this is happening to them. Teachers, strangers, family members
and sometimes I even find myself expecting more out of him because he doesn't
look 5.
Also boys that go untreated usually don't reach 5'2" and girls rarely above
5'.
I am worried more about the psychological damage than height right now
(Although I know that as an adult it would also be hard for a man or woman
that is shorter than most).
I also worry about the Lupron that they have these children on. There is no
long term testing that has been done on children. Adult men use it for
prostate cancer and adult woman for endometriosis (sp?). But you are stuck!
You can't have a preschooler going through puberty yet you worry about the
long term affects this may have in life. I just pray that everything works
out for Charlie and others.

I hope I helped and didn't confuse anyone more. My typing is much to be
desired so if you would like to talk, please e-mail me with your phone number
and I will gladly answer any questions.
Thanks for the warm welcome, your concerns and wanting to know more about
CPP. I think all parents of CAH children should be made aware of CPP and
that is a strong possibility.

Diane