Precocious puberty in girls and Covid: Why did the rates rise?

Certainly, the Covid-19 pandemic has brought many changes in our lives, not only in our country, but in the entire planet. These changes made their appearance in other levels of our health as well, as recent studies reveal.

According to data from several studies presented at the 60th ESPE Conference 2022 (European Society for Pediatric Endocrinology), several girls appeared to enter puberty earlier during the pandemic, with rates more than double in 2020 and increasing further in 2021!(1 )

What the studies showed

• Germany

More specifically, researchers from the University of Bonn in Germany reported that while the number of girls entering puberty early remained stable during the years 2015-2019, with about 10 cases per year, in one medical center, this changed dramatically in 2020, with incidents rising to 23 per year, reaching 30 in 2021.(1)

At the same time, the average age of entering precocious puberty seems to have decreased, by almost 1 year!(1)

• United States

Also in the US it seems that there is an increase in cases, perhaps even more. According to Dr. Karen Klein, from Rady Hospital in San Diego, who specializes in pediatric endocrinology, in the year before Covid they had 28 children, while in the pandemic these increased to 64, who needed treatment.(1)

• Turkey

Dr. Cesar Akar, from the Children’s Hospital in Izmir and author of the Turkish study, stated that while before the pandemic he saw 1-2 children per month in early puberty, during Covid the patients increased to 2-3 per week!(1)

What is precocious puberty?

Puberty appears between 8-13 years for girls and 9-14 years for boys.(2)

Precocious puberty (early puberty) begins earlier than these ages, i.e. before age 8 in girls and before age 9 in boys. More specifically, sex hormones – estrogen in girls and testosterone in boys – begin to be secreted in the ovaries and testes respectively. (2) From that moment the body slowly begins to change.

What are the causes?

• Stress

According to experts, stress plays a key role in the early onset of puberty, a factor that was particularly elevated during the pandemic. (1)

• Weight gain

Although weight gain has been linked to early puberty in girls (3) and would be expected to occur during the lockdown period, this was not the case in the children who took part in the studies. (1)

• Changes in Sleep

Something that is very likely to have led to this situation is the changes in sleeping hours, but also the long hours in front of screens, as in the case of online education, but also the use of mobile phones or tablets.

Although this was not common across all studies, in the Italian study, girls diagnosed with precocious puberty in the lockdown had more disturbed sleep and later bedtimes, compared to those diagnosed with pre-lockdown puberty. (4)

• Could Covid-19 be to blame?

Several experts dispute that the virus itself may be to blame. However, there was one thing in common between the Covid cases and those going through early puberty: inflammation in the nasal cavity. Therefore, this hypothesis cannot be ruled out. (1)

More generally, most agree that the main cause seems to be the change in lifestyle and especially the intense stress experienced by the children.

Is precocious puberty dangerous?

Often, early puberty appears to be associated with the following problems later in life (1,3):

• Low height
• Cardiovascular diseases
• Type 2 diabetes
• Depressive disorders (in girls)
• Anxiety (in boys)
• Eating disorders (in girls)

It is almost expected that the child’s psychology will be affected, which is why behavioral problems are also common.

The positive scenario is that these rates will return to normal, with the return of children to schools and adaptation to any changes brought by Covid-19, as many doctors estimate. However, the rest is yet to come!

Sources

1. Covid-19 pandemic linked to early onset of puberty in some girls
2. Precocious puberty
3. Precocious (Early) Puberty
4. Central precocious puberty during COVID-19 pandemic and sleep disturbance: an exploratory study