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Roth, Christian

Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

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

Susanne M. Cabrera
  • Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
/ George M. Bright
  • San Mateo, CA, USA
/ James W. Frane
  • Vann-Frane Statistical Consulting, Santa Monica, CA, USA
/ Sandra L. Blethen
  • Belmont, CA, USA
/ 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
  • :
Published Online: 2013-08-17 | DOI: https://doi.org/10.1515/jpem-2013-0286


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.

Keywords: menarche; pubertal timing; puberty; thelarche

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:

Received: 2013-07-03

Accepted: 2013-07-22

Published Online: 2013-08-17

Published in Print: 2014-01-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism. Volume 27, Issue 1-2, Pages 47–51, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0286, August 2013

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