Premature adrenarche (PA) is the early onset of pubic hair, body odor, and/or axillary hair in girls less than 8 years of age and boys less than 9 years that is associated with increasing levels of adrenal androgens within the pubertal range. The aim of this guideline is to help providers in distinguishing those children who have PA or PP from those in whom there is a concern for a more serious and rare condition, such as late onset congenital adrenal hyperplasia (CAH) or virilizing tumors (adrenal or gonadal), which would require treatment.

Updated 10/2025


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These guidelines are intended solely for the use of healthcare professionals who are licensed to practice medicine. This material is not intended to replace professional medical judgment, prescribing information or consultation with a medical professional. Any health care provider using this material acknowledges full responsibility for the medical care and treatment of patients. All health care providers are solely responsible for confirming the accuracy, timeliness, completeness, appropriateness and helpfulness of this material and making all medical, diagnostic or prescription decisions.

For questions about the guidelines, CLASP [at] Connecticutchildrens.org (email the CLASP team).