A 9 year girl presents with menarche. History reveals thelarche at the age of 8 years the most common cause of this condition in girls is

Precocious pubey:The term is reserved for girls who exhibit any secondary sexual charecters before the age of 8 or menstruate before the age of 10 Causes GnRH Dependent: 80% Constitutional : Activation of HPO axis Juvenile Primary Hypothyroidism Intracranial Lesions GnRH Independent Ovary Adrenal Liver Iatrogenic Granulosa cell tumour Theca cell tumor Leydig cell tumor Androblastoma McCune Albright syndrome Hyperplasia Tumor Hepatoblastoma Exogenous Estrogen or Androgen intake Ref: D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY; 6th edition; Pg no:51