Condition
Early-Onset Puberty
Early-onset puberty is when puberty starts before age 8 in girls or before age 9 in boys, often because the brain signals sex hormones too early. The strongest evidence is for two prescription medicines, histrelin and nafarelin: trials found histrelin kept luteinizing hormone suppressed for years, and nafarelin brought sex hormones down to prepubertal levels and slowed growth. Vitamin D, omega-3s, probiotics and fiber have only limited evidence.
Sources: PMID 25803268; PMID 2138079
- Supplements studied
- 0
- Medicines and peptides
- 2
- Graded outcomes
- 3
No supplement studies yetWe haven’t found supplement studies for Early-Onset Puberty. The medicines and peptides studied for it are listed below.
Prescription medicines and peptides studied, for context
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Puberty Suppression Suppresses LH and sex steroids to prepubertal levels. Arrests secondary sexual development and slows linear growth. | Changes; see studies | Large effect | 16 studies | |||
Studies that measured puberty suppression
| ||||||
Key findings
- Puberty SuppressionChanges; see studies
- LH Suppression (CPP)Improves (the measure goes down)
- Predicted Adult HeightImproves (the measure goes up)
The Early-Onset Puberty Supportive Care protocol
1 primary supplement · 3 supporting supplements
- Vitamin DAge-appropriate: 600–1,000 IU daily for children (per pediatrician)
Studies cited
66 studies from PubMed
- Periovulatory anticoagulant therapy enhances embryo recovery rates in superovulated mares.
- Adverse event profile differences among long-acting gonadotropin-releasing hormone analogs: A real-world, pharmacovigilance study.
- Review of drug-drug interactions in patients with prostate cancer.
- Long-term experience with the use of a single histrelin implant beyond one year in patients with central precocious puberty
- Fertility preservation in transfeminine adolescents using TESE at the time of Histrelin Acetate subcutaneous implant placement: A Case Series.
- Case Report: Ovulation Induction in Greater One-Horned Rhinoceros (Rhinoceros unicornis).
- Effects of GnRH agonists on testosterone and testosterone-stimulated parameters for contraception and aggression reduction in male lion-tailed Macaques (Macaca silenus).
- Comparative Efficacy of Histrelin Acetate and hCG for Inducing Ovulation in Brazilian Northeastern Jennies (Equus africanus asinus).
- Histrelin acetate-induced ovulation in Brazilian Northeastern jennies (Equus asinus) with different follicle diameters.
- Association of Surgical Risk With Exogenous Hormone Use in Transgender Patients: A Systematic Review.
- Elagolix (Orilissa)--an oral GnRH antagonist for endometriosis pain.
- Prolonged injectable formulation of Nafarelin using in situ gel combination delivery system.
- Long-term efficacy and tolerability of abdominal once-yearly histrelin acetate subcutaneous implants in patients with advanced prostate cancer
- Long-Term Continuous Suppression With Once-Yearly Histrelin Subcutaneous Implants for the Treatment of Central Precocious Puberty: A Final Report of a Phase 3 Multicenter Trial
- A single histrelin implant is effective for 2 years for treatment of central precocious puberty
- Long-term efficacy and tolerability of once-yearly histrelin acetate subcutaneous implant in patients with advanced prostate cancer
- Histrelin: in advanced prostate cancer
- Relationships between FSH, inhibin B, anti-Mullerian hormone, and testosterone during long-term treatment with the GnRH-agonist histrelin in patients with prostate cancer.
- Analysis of testosterone suppression in men receiving histrelin, a novel GnRH agonist for the treatment of prostate cancer.
- A review of the pharmacokinetic and pharmacological properties of a once-yearly administered histrelin acetate implant in the treatment of prostate cancer.
- A review of the use of histrelin acetate in the treatment of prostate cancer.
- Increased risk of metabolic syndrome, diabetes mellitus, and cardiovascular disease in men receiving androgen deprivation therapy for prostate cancer.
- Efficacy and safety of histrelin subdermal implant in children with central precocious puberty: a multicenter trial
- Efficacy and safety of histrelin subdermal implant in patients with advanced prostate cancer
- The histrelin implant: a novel treatment for central precocious puberty
- Reversibility of androgen deprivation therapy in patients with prostate cancer.
- An evaluation of the pharmacokinetics and pharmacodynamics of the histrelin implant for the palliative treatment of prostate cancer.
- Comparison of single-agent androgen suppression for advanced prostate cancer.
- A randomized, parallel, comparative study of the efficacy and safety of nafarelin versus danazol in the treatment of endometriosis in Taiwan.
- Delivery and stability of LHRH and Nafarelin in human skin: the effect of constant/pulsed iontophoresis.
- The case of the elusive androgen.
- Effective long-term androgen suppression in men with prostate cancer using a hydrogel implant with the GnRH agonist histrelin
- Efficacy of nafarelin in assisted reproductive technology: a meta-analysis.
- An implant releasing the gonadotropin hormone-releasing hormone agonist histrelin maintains medical castration for up to 30 months in metastatic prostate cancer
- Treatment of endometriosis with a decreasing dosage of a gonadotropin-releasing hormone agonist (nafarelin): a pilot study with low-dose agonist therapy ("draw-back" therapy)
- Treatment with nafarelin for endometriosis in young women. Efficacy, safety and lipid metabolism. Niigata Nafarelin Study Group.
- [Conservative treatment of interstitial ectopic pregnancy and endometriosis with laparoscopic methotrexate and potassium chloride and complementary management with nasal nafarelin. Report of a case and review of the literature].
- Clinical use of nafarelin in the treatment of leiomyomas. A review of the literature.
- Use of nafarelin versus placebo after reductive laparoscopic surgery for endometriosis
- Retreatment with nafarelin for recurrent endometriosis symptoms: efficacy, safety, and bone mineral density.
- Nafarelin vs. leuprolide acetate depot for endometriosis. Changes in bone mineral density and vasomotor symptoms. Nafarelin Study Group.
- Therapeutic efficacy and bone mineral density response during and following a three-month re-treatment of endometriosis with nafarelin (Synarel).
- Intranasal nafarelin versus buserelin (short protocol) for controlled ovarian hyperstimulation before in vitro fertilization: a prospective clinical trial.
- A review of drug-induced Leydig cell hyperplasia and neoplasia in the rat and some comparisons with man.
- Prospective randomized double-blind trial of 3 versus 6 months of nafarelin therapy for endometriosis associated pelvic pain
- Nafarelin therapy in endometriosis: long-term effects on bone mineral density.
- Histrelin. A review of its pharmacological properties and therapeutic role in central precocious puberty
- Gonadotropin-releasing hormone agonist as a probe for the pathogenesis and diagnosis of ovarian hyperandrogenism.
- Nafarelin for endometriosis: a large-scale, danazol-controlled trial of efficacy and safety, with 1-year follow-up. The Nafarelin European Endometriosis Trial Group (NEET).
- Nafarelin versus leuprolide in ovulation induction for in vitro fertilization: a randomized clinical trial.
- Hyperandrogenism--what is normal?
- Medical treatment of endometriosis: a comparison of the suppressive effects of danazol and nafarelin on reproductive hormones.
- Efficacy and safety of nafarelin in the treatment of endometriosis
- Nafarelin acetate: a gonadotropin-releasing hormone agonist for the treatment of endometriosis
- Treatment of children with central precocious puberty by a slow-release gonadotropin-releasing hormone agonist
- Nafarelin in the treatment of infertility caused by endometriosis.
- Nafarelin in the treatment of pelvic pain caused by endometriosis.
- Effects of nafarelin versus danazol on lipids and calcium metabolism.
- Nafarelin. A review of its pharmacodynamic and pharmacokinetic properties, and clinical potential in sex hormone-related conditions.
- Role of nafarelin in the management of endometriosis
- A new test of combined pituitary-testicular function using the gonadotropin-releasing hormone agonist nafarelin in the differentiation of gonadotropin deficiency from delayed puberty
- Clinical experience treating endometriosis with nafarelin
- Administration of nasal nafarelin as compared with oral danazol for endometriosis. A multicenter double-blind comparative clinical trial
- Lack of correlation between fertility and sperm numbers in male rats treated with histrelin, a potent LHRH agonist.
- Treatment of endometriosis with a potent agonist of gonadotropin-releasing hormone (nafarelin)
- Ovulation inhibition with nafarelin acetate nasal administration for six months.