Puberty in girls of the 21st century

Abstract

Several studies have noted contemporary girls are undergoing pubertal maturation at younger ages. During this same time period many Western nations have experienced an obesity epidemic, prompting investigators and public health officials to consider the association of these 2 events, and if other exposures might impact this relationship. There are several potential mechanisms that could impact the relationship of pubertal timing in girls with greater body mass, including direct effects of obesity on pubertal timing as well underlying exposures that impact body mass as well as timing of pubertal maturation. These underlying conditions include chemical compounds that could impact synthesis or action of sex hormones, called endocrine disrupting chemicals (EDs). We examine the decline in the age of breast development and potential genetic and environmental influences, the obesity epidemic in the US and other nations, and potential mechanisms to explain the relationship between greater body mass index with earlier puberty in girls.

Figure 1

Figure 2. Proposed mechanism of contemporary factors impacting onset of pubertal changes in girls

Footnotes: EDs = Endocrine disrupting chemicals SHBG = sex hormone binding globulin Acknowledgment: Adopted from Ahmed ML, Ong KK, Dunger DB: Childhood obesity and the timing of puberty. Trends Endocrinol Metab 2009; 20(5):237–242.