Early Puberty

Many children with WS go through puberty a little earlier than normal. This is usually not a problem unless your child is not emotionally ready for puberty.

Doctors can diagnose early puberty through a physical exam and blood tests. In some cases, a bone age test (an X-ray of your child’s left wrist) is also helpful. The bone age test helps doctor see how mature your child’s bones have grown. People with early puberty often will have an “advanced bone age.” This means the bones look more mature than the age of the person.


The first sign of puberty in girls is breast development. The first sign of puberty in boys is the testes getting larger.


If your child starts puberty at a very young age, the care team might do tests to make sure puberty is not starting for other medical reasons.

In children with Williams syndrome, early puberty does not usually need treatment unless your child is not emotionally ready for puberty. If this happens, your child might be able to take medications called GnRH agonists. These medications are given as either a shot or an implant (small plastic rod about the size of a matchstick) in the arm. They stop puberty temporarily.

Are there any recommendations specifically for people with WS?

Like all children, children with WS should have annual exams with their primary care doctor. If the doctor notices the early development of puberty, a pediatric endocrinologist can help recommend further evaluation and discuss options.

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Rev. 8/2019. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.