Clinical features:
(1) breast enlargement
(2) development of axillary and pubic hair
(3) enlargement of internal and external secondary sex organs, often with palpable ovaries
(4) irregular uterine bleeding (breakthrough)
(5) a whitish vaginal discharge
Becoming pregnant would indicate true precocious puberty and exclude pseudoprecocious puberty.
Laboratory features:
(1) evidence of elevated levels of estrogens (in serum or plasma, hyperestrogenic effects on the Pap smear, endometrial biopsy, other)
(3) no cyclic increase in progesterone
(2) no signs of ovulation
(3) urinary FSH is usually decreased, associated with inhibition by high estrogen levels
(4) urinary levels of 17-ketosteroids and 17-hydroxyketosteroids are normal
(5) pregnanediol is absent
