I guess the main difference with premature adrenarche is that with most kids, puberty and adrenarche all come at the same time.  Like with my daughter, she first got little breasts and then pubic hair about 6 months later.  With my son, he has had body odor and a little pubic fuzz for 2 years, since he was 7 1/2, but nothing else has happened.  Also - a biggie - a growth spurt can signal true puberty but in CAH kids is also probably undersuppression.

Lupron (I think) is given either once every 3 weeks or once a month.  I don’t think every day.