Context: Precocious puberty currently affects 1 in 5,000 children and is 10 times more common in girls. Statistics indicate that girls in the United States are maturing at an earlier age than they did 30 years ago and the number of girls with diagnosed precocious puberty (the appearance of secondary sex characteristics before 8 years of age or the onset of menarche before age 9) is on the rise. A summary of the growing body of literature on this topic is necessary to inform nurses and other health care providers of the current trends and incidence of precocious puberty to better meet the physical and psychosocial needs of these girls and their families.
Methods: EBSCOhost Research Databases that included CINAHL Plus, Health Source: Nursing Edition, MEDLINE, PsycINFO, and Women's Studies International were searched for journal articles published in the past 10 years (1997-2006) that explicitly examined precocious puberty in females and proposed theories to describe the phenomenon. Search terms included precocious puberty, sexual maturation, menarche, and secondary sex characteristics. These terms were searched individually and in combination with proximate determinants such as endocrine disruptors, environmental toxins, phthalates, stress, skin care, genetics, age, ethnicity, obesity, and assisted reproduction. The search yielded 947 articles addressing this issue.
Results: Eighty-two studies or case reports met the criteria for inclusion in this literature review that captured six attributable causes of early sexual maturation in female children. These included genetic, ethnic, and pediatric obesity, as well as environmental toxins that disrupt endocrine function (chemicals, toxins, plasticizers, infant feeding methods, skin and hair products, assisted reproductive technologies), psychosocial stress, and early exposure to a sexualized society. The robustness of the reports varied and few of the studies were widely generalizable but did offer suggestions for assessment and nursing care.
Conclusions: Precocious puberty has health and social implications that are complex and influenced by multiple factors. Further research is needed to expand and elucidate theoretical relationships between the early development of secondary sex characteristics in young girls and the proposed causative factors.
Purper-Ouakil D, Didillon A. Purper-Ouakil D, et al. Encephale. 2016 Oct;42(5):453-457. doi: 10.1016/j.encep.2015.06.006. Epub 2016 May 16. Encephale. 2016. PMID: 27198075 Review. French.
Kaplowitz P. Kaplowitz P. J Clin Endocrinol Metab. 2004 Aug;89(8):3644-50. doi: 10.1210/jc.2003-031532. J Clin Endocrinol Metab. 2004. PMID: 15292280
Midyett LK, Moore WV, Jacobson JD. Midyett LK, et al. Pediatrics. 2003 Jan;111(1):47-51. doi: 10.1542/peds.111.1.47. Pediatrics. 2003. PMID: 12509553
Kaplowitz PB, Oberfield SE. Kaplowitz PB, et al. Pediatrics. 1999 Oct;104(4 Pt 1):936-41. doi: 10.1542/peds.104.4.936. Pediatrics. 1999. PMID: 10506238 Review.
Jarzabek-Bielecka G, Warchoł-Biedermann K, Sowińska E, Wachowiak-Ochmańska K. Jarzabek-Bielecka G, et al. Ginekol Pol. 2011 Apr;82(4):281-6. Ginekol Pol. 2011. PMID: 21735696 Review. Polish.
Tsai MM, Chen MH, Chien YH, Tung YC. Tsai MM, et al. Front Endocrinol (Lausanne). 2023 Aug 15;14:1150498. doi: 10.3389/fendo.2023.1150498. eCollection 2023. Front Endocrinol (Lausanne). 2023. PMID: 37654562 Free PMC article.
Song Y, Kong Y, Xie X, Wang Y, Wang N. Song Y, et al. Front Pediatr. 2023 Aug 11;11:1226933. doi: 10.3389/fped.2023.1226933. eCollection 2023. Front Pediatr. 2023. PMID: 37635793 Free PMC article. Review.
Park SJ, Nam HR, Choi EJ. Park SJ, et al. Child Health Nurs Res. 2023 Jul;29(3):195-206. doi: 10.4094/chnr.2023.29.3.195. Epub 2023 Jul 31. Child Health Nurs Res. 2023. PMID: 37554087 Free PMC article.
Shi L, Jiang Z, Zhang L. Shi L, et al. Front Endocrinol (Lausanne). 2022 Nov 18;13:1056871. doi: 10.3389/fendo.2022.1056871. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 36465655 Free PMC article. Review.
Calcaterra V, Rossi V, Massini G, Regalbuto C, Hruby C, Panelli S, Bandi C, Zuccotti G. Calcaterra V, et al. Front Endocrinol (Lausanne). 2022 Oct 21;13:1000919. doi: 10.3389/fendo.2022.1000919. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 36339428 Free PMC article. Review.