I just want to clarify what I have been told by endocrinologists.  Body odor, acne and pubic hair are adrenarche.  They come from hormones from the adrenal glands.  Since all CAH kids can have excess androgens from their adrenal glands this shouldn’t surprise or panic any of us.  It would be a symptom of undersuppression and should be checked out by a doctor but it isn’t early puberty.

For girls, breasts are the first sign of puberty, and this would indicate that the central axis (I don’t really know what that means exactly!) has been activated and I guess hormones are coming from the gonads.  I’m really more clear on this with boys, because I’m dealing with my son now, who’s 9 and has had premature adrenarche but not puberty since 7.  With boys, the first sign of true puberty is when the testes start to grow, and then the penis.  My son’s doctor is always checking for this with my son.

My daughter started true puberty at 8, with breasts, soon followed by pubic hair.  It wasn’t terrible, but in retrospect, I would have stopped it with Lupron because I think she lost height because of it.  She’s 5’2" and "should" have been 5’6".  But aside from breifly being a giant and getting the little breasts early, she really didn’t suffer any traumas.  If you want to talk to me send me an email.