Traditional Chinese Medicine Treatment for Pediatric Precocious Puberty

No matter the symptom, traditional Chinese medicine (TCM) often has a solution. Today, we’ll discuss the TCM diagnosis and treatment of pediatric precocious puberty.

Currently, the medication used in hospitals for treating precocious puberty is known as “gonadotropin-releasing hormone agonists.” Its primary function is to lower the secretion of pituitary gonadotropins by reducing regulation, allowing estrogen levels to return to pre-pubertal levels. This delays the onset of menstruation, delays bone age progression, and improves adult height. This is commonly referred to as “inhibitory therapy.”

Importantly, this medication has only been used for the treatment of precocious puberty for about two to three decades both domestically and internationally. Long-term side effect data is very limited, and regular follow-up monitoring is necessary. Therefore, parents must be cautious.

So, how does traditional Chinese medicine view this issue?

TCM emphasizes the harmony of Yin and Yang. Just as “all things carry Yin and hold Yang, they blend their vital breaths to achieve harmony,” the development of the body follows this principle. When there is disharmony between Yin and Yang, there may be an excess of one and a deficiency of the other. In such cases, we need to harmonize Yin and Yang, pacify the excess, and support the deficiency.

Among the five Zang organs, the Liver and Kidneys are responsible for reproductive development. If precocious puberty occurs, it is mainly related to Kidney deficiency and Liver dysfunction, leading to three common TCM patterns, which you can refer to:

1. Liver and Kidney Yin Deficiency Type

Symptoms: In girls, bilateral breast development occurs, with darkening of the areolas, the onset of menstruation, increased vaginal discharge. In boys, there might be erections, irritability, restlessness, sweating, thirst, redness of the face, a red tongue, and a rapid pulse.

This pattern is characterized by the rising of deficient Yang due to Kidney and Liver Yin deficiency. When Liver and Kidney Yin are insufficient, the Yin can’t restrain the Yang, resulting in signs of precocious puberty such as breast development and erections. If the Yin deficiency is more pronounced, symptoms like restlessness, sweating, and thirst can be observed.

Treatment Principles: Nourish Liver and Kidney Yin, clear Heat, and relieve Fire.

Prescription: Zhibai Dihuang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) with modifications.

For heavy vaginal discharge, add Baizhu and Qianshi to invigorate the Spleen and eliminate dampness; for bleeding from the vagina, add Han Liancao and Xianhecao to cool the blood and stop bleeding.

2. Damp-Heat in the Liver Meridian Type

Symptoms: In girls, bilateral breast development occurs, accompanied by a heavy, foul-smelling vaginal discharge. The labia minora darken. In boys, there might be erections, irritability, restlessness, a red tongue with a yellow, greasy coating, and a rapid pulse.

This pattern is related to dietary imbalances and the accumulation of Damp-Heat in the Liver meridian. The Liver meridian runs along the sides of the abdomen, passing around the genitals. When it becomes congested and overheated, it can lead to precocious puberty symptoms like breast development and erections. The Fire from the Liver often leads to irritability.

Treatment Principles: Clear Heat, resolve dampness, soothe the Liver, and drain Fire.

Prescription: Longdan Xiegan Wan (Gentiana Drain Liver Pill) with modifications. If there is irritability and restlessness, add Jiawei Xiaoyao Wan to soothe the Liver and invigorate the Spleen.

3. Phlegm-Damp Accumulation in the Spleen Type

Symptoms: Secondary sexual characteristics appear prematurely, accompanied by a tendency to be overweight, low activity levels, and laziness. There might be nausea, aversion to food, mental dullness, hard masses in the breasts in girls, and increased vaginal discharge. The tongue coating is greasy, and the pulse is slippery.

This pattern is due to Spleen deficiency, leading to the accumulation of Damp-Phlegm. The Spleen is responsible for postnatal development and transformation of food into Qi and blood. When it is weak, Damp-Phlegm accumulates, leading to excess body fat and developmental issues. The Phlegm-Dampness can descend and manifest as vaginal discharge.

Treatment Principles: Strengthen the Spleen, eliminate Dampness, and resolve Phlegm.

Prescription: Liujunzi Tang (Six Gentlemen Decoction).

If there are hard masses in the breasts, add Tianhuafen and Shengmuli to clear heat and resolve lumps.

There may be other patterns as well, as children’s constitutions, eating habits, and living environments can vary. Therefore, if precocious puberty occurs, parents should promptly seek TCM treatment, especially in the early stages, where there’s usually a better chance of success.

What TCM does is harmonize Yin and Yang; it doesn’t interfere with a child’s endocrine system. Even if the treatment doesn’t have a very pronounced effect, at the very least, it won’t leave any lasting side effects that could affect a child throughout their life.

No two people in the world are exactly the same, and children do not all have to experience their secondary sexual characteristics after the age of 13. Regardless of when it occurs, as long as a child’s condition is healthy, there’s no need to be overly concerned. If there’s any discomfort, symptoms can be managed, but it’s crucial not to be misled by so-called test results and resort to the misuse of hormones.

Please remember that TCM diagnoses and treatments should always be carried out by qualified TCM practitioners. It’s important for parents to consult a healthcare professional for proper guidance when dealing with issues like pediatric precocious puberty.