Premature thelarche related to fennel tea consumption?

Deniz Okdemir 1 , Nihal Hatipoglu 1 , Selim Kurtoglu 1 , Leyla Akın 1 , and Mustafa Kendirci 1
  • 1 Faculty of Medicine, Department of Pediatric Endocrinology, Erciyes University, Kayseri, Turkey
Deniz Okdemir, Nihal Hatipoglu, Selim Kurtoglu, Leyla Akın and Mustafa Kendirci


Background: Isolated premature thelarche is the breast development in the absence of other secondary sex characteristics in prepubertal girls. Fennel is a plant which contains a phytoestrogen called anethole as an active ingredient.

Case: Here, we report a case of a 12-month-old girl who showed breast development that became apparent in the last 3 months. Her medical history revealed that she was given two to three teaspoons of fennel tea by her mother every day for restlessness for the last 6 months. Isolated premature thelarche was diagnosed based on physical and laboratory findings. On follow-up, after cessation of fennel consumption, the breast development of the patient regressed gradually and became normal by the end of 1 year.

Conclusion: Reporting this case, we want to emphasize the importance of awareness of fennel tea, a commonly used plant in babies, as a preventable cause of premature thelarche.

  • 1.

    Greydanus DE, Matytsina L, Grains M. Breast disorders in children and adolescents. Prim Care 2006;33:455–502.

    • Crossref
  • 2.

    Traggiai C, Stanhope R. Disorders of pubertal development. Best Pract Res Clin Obstet Gynaecol 2003;17:41–56.

    • Crossref
  • 3.

    Stanhope R, Brook CG. Thelarche variant: a new condition of sexual maturation? Acta Endocrinol (Copenh) 1990;123:481–6.

    • Crossref
  • 4.

    Stanhope R. Premature thelarche: clinical follow-up and indication of treatment. J Pediatr Endocrinol Metab 2000;13:827–30.

    • Crossref
    • PubMed
  • 5.

    Wemeau-Jacquemont C. Precocious puberty and ovarian follicular cysts. Pediatrie 1988;43:355–60.

  • 6.

    Javidnia K, Dastgheib L, Mohammadi Samani S, Nasiri A. Antihirsutism activity of fennel extract. A doubleblind placebo controlled study. Phytomedicine 2003;10:455–8.

  • 7.

    Malini T, Vanithakumari G, Megala N, Anusya S, Devi K, et al. Effect of Foeniculum vulgare Mill. seed extract on the genital organs of male and female rats. İndian J Physiol Pharmacol 1985;29:21–6.

  • 8.

    Brito VN, Latronico AC, Arnhold IJ, Mendonça BB. Update on the etiology, diagnosis and therapeutic management of sexual precocity. Arq Bras Endocrinol Metabol 2008;52:576.

    • Crossref
  • 9.

    Chiabotto P, Costante L, de Sanctis C. Premature thelarche and environmental pollutants. Minerva Med 2006;97: 277–85.

    • PubMed
  • 10.

    Pattishall AE, Spector ND. Endocrine disruptors, travel-associated illness, and media violence: important health considerations for children and adolescents. Curr Opin Pediatr 2010;22:814–21.

    • Crossref
  • 11.

    Davis SR, Dalais FS, Simpson ER, Murkies AL. Phytoestrogens in health and disease. Recent Prog Horm Res 1999;54:185–210.

  • 12.

    Massart F, Saggese G. Oestrogenic mycotoxin exposures and precocious pubertal development. Int J Androl 2010;33:369–76.

    • Crossref
    • PubMed
  • 13.

    Reinli K, Block G. Phytoestrogen content of foods – a compendium of literature values. Nutr Cancer 1996;26:123–48.

    • Crossref
  • 14.

    Cassidy A, Hanley B, Raventos R. Isoflavones, lignans and stilbenes – origins, metabolism and potential importance to human health. J Sci Food Agric 2000;80:1044–62.

    • Crossref
  • 15.

    Fitzpatrick LA. Selective estrogen receptor modulators and phytoesterogens: new therapies for the postmenopausal women. Mayo Clin Proc 1999;74:601–7.

    • Crossref
    • PubMed
  • 16.

    Brandi ML. Natural and synthetic isoflavones in the prevention and treatment of chronic disease. Calcif Tissue Int 1997;61:S5–8.

    • Crossref
  • 17.

    Namavar Jahromi B, Tartifizazadeh A, Khabnadideh S. Comparison of fennel and mefenamic acid for the treatment of primary dysmenorrhea. Int J Gynaecol Obstet 2003;80:153–7.

    • Crossref
  • 18.

    Tognolini M, Ballabeni V, Bertoni S, Bruni R, Impicciatore M, et al. Protective effect of Foeniculum vulgare essential oil and anethole in an experimental model of thrombosis. Pharmacol Res 2007;56:254–60.

    • Crossref
  • 19.

    Dhar SK, Anti-fertility activity and hormonal profile of trans-anethole in rats. İndian J Physiol Pharmacol 1995;39:63–7.

  • 20.

    Zeller A, Horst K, Rychlik M. Study of the metabolism of estragole in humans consuming fennel tea. Chem Res Toxicol 2009;22:1929–37.

    • Crossref
  • 21.

    Türkyilmaz Z, Karabulut R, Sönmez K, Can Başaklar AC. A striking and frequent cause of premature thelarche in children: Foeniculum vulgare. J Pediatr Surg 2008;43:2109–11.

    • Crossref
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