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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

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Volume 27, Issue 1-2


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 / Peter A. Lee
  • Corresponding author
  • 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
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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


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About the article

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.

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