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Sex Roles (2006) 54:315–322

DOI 10.1007/s11199-006-9003-5


Early Menarche: A Review of Research on Trends in Timing,
Racial Differences, Etiology and Psychosocial Consequences
Rachel Blumstein Posner

Published online: 12 October 2006 
C Springer Science+Business Media, Inc. 2006

Abstract This paper elucidates varying definitions of “early serves as a common container for societal anxiety about fe-
menarche” and reviews evidence in four well-documented male sexuality. Indeed, menstrual taboos are the most endur-
areas: (a) A potential trend toward earlier maturation, (b) ing and stringent across cultures, underscoring male fear of
racial differences in menarcheal timing, (c) etiology of early female sexual power (Bettleheim, 1962; Delaney, Lupton, &
puberty, and (d) consequences of early puberty. While teach- Toth, 1988). Unlike other gradual pubertal changes, menar-
ers and physicians perceive menarche as occurring earlier che dramatically signals the transition from girl to woman.
than in the past, mean menarcheal age has remained rela- Most contemporary American girls view menarche as a “hy-
tively constant over the past 50 years. Conflicting results gienic crisis” rather than a maturation process (Brumberg,
concerning racial differences in timing highlight the need 1997); however, menarche signals reproductive fertility and
for further research to unravel the effects of race and so- the advent of adult sexuality (Koff & Rierdan, 1991).
cial economic status (SES). Evidence regarding the relative Although menarche occurs relatively late in the process of
etiological contributions of nutrition, environmental stress, puberty, it has long been used as a marker of puberty because
and genetics is evaluated. Maturing earlier than one’s peers it occurs suddenly and is memorable, making it feasible
has negative consequences for girls, especially when com- to measure by self-report. In recent years, research on the
bined with simultaneous stressors. However, the negative psychological and social consequences of early puberty has
psychosocial consequences of early puberty may not last burgeoned (Caspi & Moffitt, 1993; Dick, Rose, Viken, &
into later adolescence or adulthood. Few studies have in- Kaprio, 2000; Ge, Conger, & Elder, 1996; Graber, Brooks-
vestigated early-maturing adolescents’ subjective experience Gunn, & Warren, 1995; Stice, Presnell, & Bearman, 2001)
with menarche, particularly those from non-white and non- and fears about early puberty, exacerbated by the media, have
middle-class backgrounds. seized popular imagination (Belkin, 2000; Lemonick, 2000).
Most research into early pubertal maturation has focused on
Keywords Pubertal timing . Menarche . Menstruation females; there has been little interest in male development.
Additionally, this line of research has been preoccupied with
Women bleed; some consider this the primary point of dif- early, rather than late, timing of pubertal development.
ference between the genders (Lupton, 1993). Menstruation The media barrage decrying early puberty has somewhat
obscured the different questions that researchers are ask-
ing. This review will focus on four research questions that
This article is based on a paper presented at the 2003 Society for
Menstrual Cycle Research Conference in Pittsburgh, PA. have been actively pursued in the medical and psycholog-
ical literature in the past decade, including: (a) Is there a
R. B. Posner ()
national trend towards girls maturing earlier? (b) Are there
Department of Applied Psychology, New York University,
239 Greene Street, New York, NY 10003, USA racial/ethnic differences in timing? (c) What is the etiology of
e-mail: early puberty? (d) What are the psychosocial consequences
of early puberty? This review aims to survey our current
Present address: 2711 Henry Hudson Parkway, #7G, Bronx,
understanding of this phenomenon, and illuminate areas for
New York 10463
future research.


Early puberty has been variously described as (a) a national trend in the mean age of maturation. These disorders. including concerns about The sexuality of African-American and Latina females the attainment of full height. particularly girls. loss of educational opportunities. However. 2002. Lerner. Moran. popular media. through sex education classes to view sex as a dangerous tion is measured relative to the development of other peers game in which men are aggressors and women are vic- in the same community (Simmons & Blyth. endocrinologists have focused their investigation cent sexuality has remained “a social problem” (Irvine. searing The most recent norms for the United States define “pre. now considered between ages 10 and 14 (Lerner. 1992). social programs) has served to make adolescent females. Stanhope. ality. the media has 1994). and for the legacy of psychologists. including “true” or “central” precocious particularly those who are poor and/or Black and Latina. and “normal puberty” as nancy. who are poor and live in urban areas has been particularly chological as well as medical risks. There pregnancy (evident in research agendas. etal anxiety about adolescent female sexuality has inhibited ation (has) been put on hormonal fast-forward” (Lemonick. sociologists. 2003). Stanley Hall coined the term “adolescence” to & Finkelstein. 1994. depending on the purpose of the dialogue Research into pubertal timing must be understood within and the professional orientation of the discussant. The “myth” of an “epidemic” of teenage pregnancy confounded these separate issues. In our present-day culture. and (c) a socially defined category rel- ative to peers. sequences of teenage pregnancy have mixed support (Irvine. in the minds of young people the fears associated with it: cocious puberty” as onset before the age of 6 or 7. The diagnosis and treat. The need to control adolescent sexual than previously thought. 6). have been associated with psy. has noted that “the unstated assumption that certain girls— (See Dorn and Rotenstein. Oostdijk. Soci- cases are occurring “everywhere you turn” and that “a gener. The developmental period of mal range” for onset of menarche in the United States is adolescence was a “modern invention” (Irvine. and are several different endocrine disorders involving early pu. for a discussion of the poor girls. but a particular) has represented a gateway to adolescent sexu- means for categorizing individuals in order to grasp the psy. p. “early puberty” is not a disorder akin to CPP. endocrine disorders. G. The significance of menarche has been entwined with chosocial implications of maturing earlier. two clinical cases of precocious puberty (diagnosed active fear of “children having children” has driven public by endocrinologists) are followed by an assertion that such policy over the past several decades (Nathanson. and teenage preg- puberty” as between ages 7 and 9. “early STDs. 2000). in a Time Magazine has not borne out in sociological research. and expectations age norms vary from population to population. 1994). over the past 50 years (Adams Hillard. schools have socialized children cially defined sense of timing. young women’s abilities to healthfully and positively con- 2000). 1994). Dorn and Rotenstein (2004) noted that the public’s solidate their sexuality into their identities. The media barrage of sexualized teens has sold sex as fun Psychological studies of early puberty often use a “so. This “socially de. However. all decline in the mean age of pubertal onset. problematized in research agendas and in the media. Pubertal the framework of societal beliefs. & Drop. on girls who deviate from the norm within their population. Tolman ment of these disorders are beyond the scope of this article. pubertal research must be evaluated with an eye toward Springer . The “nor. Conceptual framework docrine disorder. (b) an uncommon en. Our culture has decried adolescent sexuality. or thelarche is earlier the turn of the century. about adolescent sexuality. 2004. However. puberty (CPP).” That is. Controversy exists over whether the describe the youth culture emerging in the United States at mean age of onset breast budding. re- article. and important.) the intensive study and surveillance to which these girls are Although the diagnosis and treatment of disorders such as subjected” (Tolman. bertal maturation. Thus. Puberty in general (and menarche in sense. pre. The “escalating cultural panic” surrounding teenage beginning after age 9 (Mul. timing of matura. and premature menarche (Traggiai & (Irvine. 2002). the negative con- CPP should be distinguished from questions about the over. 2000). 2001). nevertheless. “the source of public anxiety and the target of social control” mature adrenarche. girls of color. urban girls—are more sexual and physiological and psychological consequences of premature thus are at higher risk of negative outcomes is reproduced by adrenarche. premature thelarche (breast budding). there is ample evidence urges was the organizing principle behind the act of defining to show that the mean age of menarche has remained stable adolescence for Hall. physicians.316 Sex Roles (2006) 54:315–322 The definition of early puberty view of the etiology and psychosocial consequences of early menarche. fears. 2002). perception that early maturation has become the norm might Adolescents. In this tims (Fine. have received conflicting inhibit parents and doctors from identifying and treating true cultural messages regarding their sexuality and their selves. cultural beliefs regarding adolescent female sexuality and fined” sense of timing will be considered in the following re. 1987). adoles- over time. and politicians concerned with While many social scientists investigate population trends managing adolescents.

conceptualized as an to distinguish (Obeidallah. White females.6% of the sample) matured earlier than White girls. Thus. because Herman-Giddens across races. the age at which girls attain cus of research and media attention. recent studies have the past half century (Adams Hillard. Nevertheless. Recent research (Obeidallah et al. biasing the results toward early maturers (Chumlea other ethnic minorities. a statistically insignificant vestigation into the role that SES plays in potential timing change (Chumlea et al. environmental stressor.. have collapsed et al. of puberty may be decreasing. Chumlea et al. the researchers fit partic.. Herman-Giddens and her col- leagues captured the attention of researchers as well as the In Herman-Giddens et al. teachers and physi. cians have perceived menarche as occurring earlier (Finlay. and have highlighted the need for further in- has decreased by about 4 months. in con- (Obeidallah et al.’s study (2000). discussed further later) has offered trast with Obeidallah et al. However. Finally. more work must be et al. 2003).000 girls.’s study.. In Obeidallah et al. Research diatric texts and previous research studies (Herman-Giddens on pubertal timing has predominantly focused on middle- et al. It appears that while the age of onset The age of pubertal onset has increasingly become a fo. 2002). Those who have examined differences criticized on several fronts. Comparing data provided conflicting results on racial and ethnic differences over a 30-year period.” Other between Latinas and Whites disappeared and the differences ethnic categories were not included. In 1997. American girls reached menarche significantly earlier than Though it is clear that the age of menarche has decreased non-Hispanic White and Mexican American girls. self-report or parental report). the confounding effects of SES and sider in relation with other variables that influence timing nutrition were not investigated in this study. girls ethnic differences into categories of “African-American” and who reached menarche later than 12 were not included in the “White. aged 3–12 years. reviewing 12 studies using data Pubertal Timing: A National Trend Towards from 1948–present (Coleman & Coleman. probably due to improvements in nutrition Ethnic/Racial Differences in Pubertal Timing and living conditions. differences. 2000. 1991). the clinic ble? Obeidallah et al.’s research has been class. age of participants.. these re- in the past century. A second criticism done to “disentangle the effects of SES from those attributed of Herman-Giddens et al. ing conclusions based on meta-analyses of research findings is difficult. researchers found that menarcheal age in the timing.. psychosocial consequences. and methods for assessing three most common hypotheses regarding the etiology of Springer . found that African- results that contradict Herman-Giddens et al.’s work include concerns about their African-American peers. 2000). Notably. Brennan. The reasons the offices of 225 pediatricians. 2004. such as Herman-Giddens et al. tionship between pubertal timing and ethnicity/race difficult The researchers concluded that SES. Menarcheal age for girls in in- dustrialized Western societies decreased in the past 150 years (Tanner. draw- sexuality. methods used to determine pubertal development (see Dorn Are the results of Herman-Giddens et al. 2004). Herman-Giddens et al. Latina adolescents whole (Dorn & Rotenstein. Brooks-Gunn. The researchers found girls for earlier onset of puberty in African-American girls remain developing at younger ages than suggested in standard pe. (2000) found that African-American population treated in the offices of pediatricians who partic.. between Latinas and African-Americans were diminished.e. (9. First. but may be related to genetics or nutrition. 2002) concluded Earlier Maturation? that there is scant evidence to suggest a continued decline in menarcheal age. the significance in differences ipants into ethnic categories of “Black” and “White.Sex Roles (2006) 54:315–322 317 the entangled relationship of menarche and adolescent age at menarche (i.’s study replica- and Rotenstein. though research findings on re- cent changes in the timing of menarche mostly indicated The Etiology of Early Puberty: Three Hypotheses that menarcheal age has remained constant. and White females did not significantly differ on menarcheal ipated in the study may not represent the US population as a age. Because stud- ies assessing menarcheal timing vary significantly in sample Why do some girls mature earlier than their peers? The size. 1997)).’s findings. which renders the rela.. (2000). Dorn & Rotenstein. Additionally. Kindlon. 2002). Additional criticisms of reached menarche significantly earlier than their White and Herman-Giddens et al.’s sample included only girls from ages 3 to 12. 2000).” (Obeidallah et al. is an important component to con- & Earls. factors were controlled for. for further critique). or study. at velopment of over 17. when social economic handling of ethnic factors. (2003).’s study concerns the imprecise to racial/ethnic differences. Asians. 2003. Jones. the trend has probably not continued in searchers did not control for SES. unclear. setting. & Coleman. 2000). Namely. Thirdly.. who visited every age and for each characteristic assessed. as a debate has ensued reproductive capability has remained relatively constant in over the possibility of puberty occurring earlier and related past 50 years. 2004).” obscuring the measurement of Latinas. African-American girls media when they revealed their findings on the pubertal de.

in African. early puberty. other the. while presence of unrelated males speeds repro- vestigated whether the relationship between maturation and ductive maturation (Izard. Susman.. Researchers relations. no relationship between father absence and pubertal timing. 2002). tors. Steinberg and Draper proposed a the relationship between early puberty and other psychoso- controversial sociobiological theory regarding early menar. However. lution shapes individuals’ reactions to the environment in Nevertheless. insecure have identified increases in obesity as an important factor in pair-bonds. 647). especially family relations. the relationship between father absence and early menarche ory.. and (c) genetics. Additionally. in fathers. low parental investment) and are passed from earlier onset of puberty (Anderson. Thus. which they couched in an evolutionary framework. because most of their sample lived in intact which they find themselves. She has experienced unsta. middle-class girls. cial stressors. a deficit in some of the studies investigating According to Belsky et al. and invest more time and energy in their off. Taken together.’s theory on several fronts. and have attacked Belsky et al. precocious sexuality. functioning. biological father absence ories regarding the antecedents of early menarche have de. (b) increased the genes that code for this pattern of development (i. Caspi. In a rare study that included males. two-parent homes with examined a variety of possible antecedents to pubertal tim- low environmental stress experience delayed puberty. expressed in aggression and impulsivity leading to interper- 2001). 2000). Taken family conflict may be reciprocal. 1992). In one study. 1990.. 1969). and precocious sexu. Where Belsky et al. Belsky et al. 2001). 2002. 647). data in an effort to understand the relationship precocious sexuality. 2002). such as weight. with family conflict also together. Muhleman.. Children adopted uration in girls. evolutionary hypothesis privileges environ- American girls. 1993). studies of reproduc- disposed girls to early puberty (p. vorced parents and/or higher levels of family stress reached tant variable in pubertal timing. sociobiological.318 Sex Roles (2006) 54:315–322 differences in pubertal timing are (a) nutrition. and therefore invests This study emphasizes nutrition and exercise as the most little in child rearing. Long. ble relationships in her own upbringing. Belsky. 1995. In contrast to this “high stress” line of salient predictors of pubertal timing. a female reared in a high-risk mother to daughter (Wierson et al. Pedlow. whereas the puberty in White girls and. allowing one of two develop. & MacMurray. and found that body et al. 2003. They and the absence of biological fathers were associated with suggested that early environmental stress triggers early mat. that is. the X-linked AR gene is Kaplowitz. the presence of stepfathers in the home che.’s (1991) sociobiological the. 1991). Dallal. & Forehand.. The presence of an adult male at home or stressful Rowe. menarche earlier than those from intact homes (Graber Although genetics and nutrition have long been accepted et al. Therefore. Some psychological adjustment. Belsky. Johnson. including reproduction. Vandenbergh. hereditary transmission. homes. 1993).e. geneticists suggested that the presence of biological fathers and unrelated adult males Springer . Graber et al. Steinberg. Wierson. Thus. whereas tive functioning in animals have shown that the presence of a pubertal changes were traditionally viewed as predicting el. puberty (Mul et al. ture. defer ing in a sample of 75 White. these findings point to biological father absence as predictive of early menarche (Moffitt. & Silva. (1991) theorized that evo. Brooks-Gunn environment develops early and reproduces early. researchers the cycle of early puberty. and in daughters it manifests in early puberty. Davidson. and stepfather presence emerged as a powerful mediator of veloped. and Birch (2003) The association between biological father absence and found that girls with higher percent body fat at age 5 were early menarche has received support in the research litera- more likely to exhibit earlier maturation. stressful life events. predicted menarcheal age tern of father absence. & Herman-Giddens. Wang mental influences as a mechanism for shaping development (2002) found earlier maturation associated with obesity in and behavior. (1991) targeted father absence from developing countries have frequently manifested early as a condition for a “stressful rearing environment” that pre. (1995) development. early menarche (Ellis & Garber. girls raised in secure. They found that psychosocial fac- have posited that genetic factors explain the proposed pat. The implication of the genetic hypothesis is that mass index (BMI) was significantly correlated with early this developmental pattern is relatively fixed. (1995) could not differentiate between mental patterns to be expressed.. Surbey. In 1991. girls. nutrition. Wasserman. Gidden’s et al. events was not predictive of menarcheal timing in this study. 1990. weight. a potential influence in menarcheal timing. father to daughter. and interpersonal conflict (Comings between nutrition and timing of puberty.. Researchers have found that girls from homes with di- these studies have strongly implicated obesity as an impor. Graber et al. but not in boys. more recent research has in. family spring to ensure survival (Belsky et al. or presence of adult male in home. Slora. ensuring (1988) measured a sample of 150 adolescent girls and found continuation of her genetic line. early puberty is an adaptive response to a child’s early has been their inability to control for confounding factors experience of the “stressful rearing environment” of a father. to a lesser extent. as the most salient predictors of pubertal timing. environmental stress. over and above the influence of weight or breast develop- ality (Comings. Recently. 2001) re-analyzed the 1997 Herman. and hereditary transmission from absent home (p. ment. absence. Kaplowitz et al. sonal conflict. 1988. biologically related male delays reproductive maturation and evated levels of family conflict. & Must.

. Dorn. and Bearman (2001) found ditionally. Dorn et al.. father absence or mother’s mental jects had menarcheal ages on par with national norms. and marijuana in 7th and 8th grades (Lanza & behavior than did their on-time or early-maturing peers. ity. In sum. Surprisingly few studies have inves- is related to menarcheal timing in a complex manner. (2002) found early physical trauma. 1989). (1993) found no long term effects on the re- Phinney. Rierdan. maturing girls suffered more problems with self-image and cigarettes. 2003). but differences disappeared in later adolescence. eases (STDs) and teen pregnancy are held up by the media as “the obvious fallout of early development” (Lemonick. Phinney. were at risk for problems with and transitioning into middle school were at greater risk for body image. In sum. one’s peers has negative psychosocial consequences for girls Perhaps one of the most difficult challenges facing early (Caspi & Moffitt. studies. 1993. slim figure. rather than speed onset maturation to be predictive of later pre-coital behavior. Ravert and Martin (1997) found that their sub- family environments (i.. who also synchronously faced the stress of beginning to date Early maturers. environmental stress ers (Lam et al. negative body image and is. Dorn et al. into adulthood? Early puberty has been associated with earlier onset of sexual activity (Flannery et al. they noted. 1993. Wyatt et al. a difference found to be significant in other 1999). 2001). Presnell. Stice.. be heavier and shorter than peers (Simmons & Blyth. 2000. However. However. early maturers have been found to be at risk for Further research is needed to disentangle the psychologi- increased levels of depression (Brooks-Gunn. 2001).. feminine beauty. such of menarche. 1987). 2002). and school behavior. Additionally. Susman. school performance. Using a national sample of females ages 15–19. Ad. Stice et al. Girls who ma- tress (Brooks-Gunn & Ruble. are girls concerned about their figures because they are disordered eating (Attie & Brooks-Gunn. the specters of sexually transmitted dis- that trigger early menarche have not been fully discerned. 2003). pubertal timing (Dorn et al. all studies have found unequivocal support for the negative But early maturation in and of itself may not affect body sat- effects of early menarche.. Tahirovic. isfaction unless combined with other factors. 1989. Ge et al. dissatisfaction with their bodies (Smolak. Though early maturers were more likely than peers to initiate (2003) found more significant adjustment problems among substance use at younger ages (40% by age 15) differences adolescents when physicians were rating pubertal timing persisted until age 16.. & Gralen. pubertal timing used across studies calls into question our ability to generalize across findings (Coleman & Coleman. That & Koff. and Ponirakis (2003) found that later Early maturers were more likely than peers to use alcohol.Sex Roles (2006) 54:315–322 319 in the home.... the effects of pubertal timing on behavior prob. lationship between relative timing of menarche and body Springer . Frequently. 2000). early puberty to be a risk factor for substance abuse. and then dropped off (Dick et al. that of a tall. Smolak et al.. In a retrospective study of 97 pregnant adolescents or extreme malnutrition delay menarche whereas stressful (ages 13–18). Lam et al. Specifically. Girls exposed to war conditions experienced a as dating. How. 2002. Jenson. 1993). Lam et al. 1996). Although early puberty has been associated with ear- Psychosocial Consequences of Early Puberty lier first sexual experiences. not illness) may trigger early menarche. Olsen. Olsen. severe tigated the links between pubertal timing and teenage preg- physical and psychological stressors such as war conditions nancy. The exact mechanisms earlier. Stress due to war course earlier that later-maturing peers. 2001). early maturers used substances earlier their or parent report. have also been investigated. & Koff.. Simmons early maturers or because they are overweight? Early pu- & Blyth. Levine. Collins. ever. Stice et al. Early menarche has maturers is that they do not fit the cultural image of ideal been associated with increased symptoms of menstrual dis. 1982) and a higher degree of tured earlier were bigger than their peers and often grew to worry about menstruation (Stubbs. and substance berty may predispose girls to problems with negative body abuse (Dick et al. Do the effects last into middle and late adolescence? 2002. Jenson.e. they found no significant difference of reversal in the secular trend of menarcheal timing (Preberg & timing of first intercourse between early and average matur- Bralic. the relationships between early puberty and STDs/early pregnancy have not been empirically Research has indicated that reaching puberty earlier than established.. & Cundick. 2001). The variability in methods for measuring peers. 2002). not image and disordered eating (Striegel-Moore et al. 1998). they tended to have more success with social popular. Rierdan cal effects of obesity from the effects of early puberty.. appeared to delay. 1990. In a study of Hong conditions. 1991. Simmons and Blyth (1987) de. Early maturers scribed mixed results with regard to early pubertal change. and Cundick (1990) found that early- Other types of environmental stress. such as stress due to maturing girls were more likely to initiate dating and inter- war conditions. 2000. including poverty as well as psychological and Kong Chinese adolescents. 1987. but they lems and adjustment have varied depending on who is rating note that the effects of their study are small in magnitude. than when pubertal timing was assessed for by self-report 2000). 1988. Striegel-Moore et al.

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