Snapshot A 8-year-old Caucasian girl presents to her pediatrician due to breast enlargement, axillary odor, and menarche. Breast examination is suggestive of Tanner stage 3 with axillary hair growth. Pubic hair appears to be Tanner stage 3. After relevant testing, the patient's findings are consistent with central precocious puberty and is started on a gonadotropin-releasing hormon analog. Introduction Mechanism of action a gonadotropin-releasing hormon (GnRH) analog that acts on GnRH receptor resulting in agonism when used in a pulsatile fashion antagonism when used in a continuous fashion Clinical use central precocious puberty endometriosis uterine leiomyomata (fibroids) advanced prostate cancer used as palliative treatment Toxicity edema headache antiandrogen side-effects