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Licensed Unlicensed Requires Authentication Published by De Gruyter August 17, 2013

Age of thelarche and menarche in contemporary US females: a cross-sectional analysis

  • Susanne M. Cabrera , George M. Bright , James W. Frane , Sandra L. Blethen and Peter A. Lee EMAIL logo


Aim: A recent secular trend towards earlier thelarche has been suggested. The aim of this study is to examine normative ages of thelarche and menarche in contemporary US females.

Methods: Trained physicians documented Tanner breast stage by observation in a cross-sectional cohort. Age of menarche was self-reported. The subjects were healthy female children and adolescents. The mean age of thelarche was determined by probit analysis and the mean age of menarche was determined by using a normal time-to-event model.

Results: Mean age of thelarche was 9.7 years among 610 females aged 3.0–17.9 years (70% non-Hispanic Caucasian (NHC), 14% African-Americans, 7% Hispanic, 9% “other”). The mean age of menarche was 12.8 years for NHC, with African-Americans having menarche 0.6 years earlier.

Conclusions: Thelarche occurred earlier than recently reported, while age of menarche remained unchanged, this supported a persistent secular trend towards earlier thelarche but stable age of menarche. This suggests that the observed thelarche is gonadotropin-independent or the tempo of pubertal advancement has slowed.

Corresponding author: Peter A. Lee, Department of Pediatrics, Pennsylvania State University College of Medicine, The Milton S. Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033, USA, Fax +1-717-531-6139, E-mail:

The interpretation of the data, manuscript preparation, and decision to submit the paper were performed independently of the funding source for the study.

Conflict of interest statement: GMB has been an employee of Ipsen Biopharmaceuticals. GMB participated in data analyses. JF consults for Genentech, Inc. and Ipsen Biopharmaceuticals. SLB is a former employee of Ipsen Biopharmaceuticals. PAL has research support from Ipsen Biopharmaceuticals, NovoNordisk, Pfizer, and Abbott Laboratories and consults for NovoNordisk and Abbott Laboratories. Funding for the study, including design, collection, analysis, and interpretation was provided by Ipsen Biopharmaceuticals.


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Received: 2013-7-3
Accepted: 2013-7-22
Published Online: 2013-08-17
Published in Print: 2014-01-01

©2014 by Walter de Gruyter Berlin Boston

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