Investigating precocious puberty in boys

Pubertal changes in boys typically occur between the ages of 9 and 14 years. True precocious puberty in boys is rare and can be easy to miss. Puberty is considered precocious in boys when it occurs before the age of 9 years, representing more than two standard deviations below the mean age of 11.5 years. Although precocious puberty in girls (before the age of 8 years) is usually benign, early puberty in boys is much less common and much more worrying. Signs of puberty, including testicular enlargement, presence of pubic hair, adult body odour and voice changes, in boys younger than 9 years should be investigated promptly, because precocious puberty in a boy is frequently a sign of serious underlying pathology.