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

Susanne M. Cabrera 1 , George M. Bright 2 , James W. Frane 3 , Sandra L. Blethen 4 , and Peter A. Lee 5
  • 1 Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
  • 2 San Mateo, CA, USA
  • 3 Vann-Frane Statistical Consulting, Santa Monica, CA, USA
  • 4 Belmont, CA, USA
  • 5 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
Susanne M. Cabrera, George M. Bright, James W. Frane, Sandra L. Blethen and Peter A. Lee

Abstract

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.

  • 1.

    Terasawa E, Fernandez DL. Neurobiological mechanisms of the onset of puberty in primates. Endocr Rev 2001;22:111–51.

    • Crossref
    • PubMed
  • 2.

    Tanner JM. Growth at adolescence, 2nd ed. Oxford: Blackwell, 1962.

  • 3.

    Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303.

    • Crossref
    • PubMed
  • 4.

    Sun SS, Schubert CM, Chumlea WC, Roche AF, Kulin HE, et al. National estimates of the timing of sexual maturation and racial differences among US children. Pediatrics 2002;110:911–9.

    • Crossref
  • 5.

    Euling SY, Herman-Giddens ME, Lee PA, Selevan SG, Juul A, et al. Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics 2008;121(Suppl 3):S172–91.

    • Crossref
  • 6.

    Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV, et al. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. Pediatrics 1997;99:505–12.

    • Crossref
  • 7.

    Biro FM, Galvez MP, Greenspan LC, Succop PA, Vangeepuram N, et al. Pubertal assessment method and baseline characteristics in a mixed longitudinal study of girls. Pediatrics 2010;126:e583–90.

    • Crossref
  • 8.

    Aksglaede L, Sørensen K, Petersen JH, Skakkebaek NE, Juul A. Recent decline in age at breast development: the Copenhagen Puberty Study. Pediatrics 2009;123:e932–9.

    • Crossref
  • 9.

    Chumlea WC, Schubert CM, Roche AF, Kulin HE, Lee PA, et al. Age at menarche and racial comparisons in US girls. Pediatrics 2003;111:110–3.

    • Crossref
  • 10.

    Wu T, Mendola P, Buck GM. Ethnic differences in the presence of secondary sex characteristics and menarche among US girls: the Third National Health and Nutrition Examination Survey, 1988–1994. Pediatrics 2002;110:752–7.

    • Crossref
  • 11.

    MacMahon B. Age at menarche, United States, 1973. Rockville: National Center for Health Statistics, 1974.

  • 12.

    Tanner JM, Davies PS. Clinical longitudinal standards for height and height velocity for North American children. J Pediatr 1985;107:317–29.

    • Crossref
  • 13.

    Frane J, Bright GM, Lee PA. A method to determine the likelihood of transition to puberty in a heterogeneous prepubertal age group. J Pediatr Endocrinol Metab 2012;25:843–6.

    • Crossref
  • 14.

    Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, et al. 2000 CDC growth charts for the United States: methods and development. National Center for Health Statistics. Vital Health Stat 2002;11. http://www.cdc.gov/growthcharts/2000growthchart-us.pdf. Accessed 8 August 2013.

  • 15.

    US Census Bureau. 2010 Census Data. http://www.census.gov/2010census/data/. Accessed 8 August 2013.

  • 16.

    Huang B, Biro FM, Dorn LD. Determination of relative timing of pubertal maturation through ordinal logistic modeling: evaluation of growth and timing parameters. J Adolesc Health 2009;45:383–8.

  • 17.

    Damon A, Bayema CJ. Age at menarche of recall after 39 years. Human Biol 1974;46:381–4.

  • 18.

    Koprowski C, Coates RJ, Bernstein L. Ability of young women to recall past body size and age at menarche. Obesity Res 2001;9:478–85.

    • Crossref
  • 19.

    Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, et al. Relation of age at menarche to race, time period, and anthropometric dimensions: the Bogalusa Heart Study. Pediatrics 2002;110:e43.

    • Crossref
Purchase article
Get instant unlimited access to the article.
$42.00
Log in
Already have access? Please log in.


or
Log in with your institution

Journal + Issues

Search