March 29, 2022 -- Overwhelming numbers of early puberty cases among girls have been reported during the pandemic, according a report co-published by The Washington Post and The Fuller Project.

Early puberty is uncommon, affecting about one in every 5,000 to 10,000 children, with cases about 10 times higher in girls than boys. But since the pandemic started, doctors and parents around the world have noted a substantial surge in early puberty.

In some cases, girls as young as 5 have begun developing breasts and girls younger than 8 have started menstruation.

“I noticed that quite a few of my [girl patients] got their period after a lockdown,” Adiaha Spinks-Franklin, MD, a pediatrician at Texas Children’s Hospital, told the news outlets.

The condition, also called precocious puberty, is defined as puberty-related changes earlier than normal or expected, which starts around age 8 for girls and age 9 for boys. It can sometimes be caused by genetic syndromes, central nervous system issues, or tumors on the ovaries, adrenal glands, pituitary gland, or brain.

Pediatricians across the world have reported more precocious puberty cases, the news outlets reported, including in the U.S., India, Italy, and Turkey.

A recent study found that more than 300 girls were referred to five pediatric endocrinology centers in Italy between March and September 2020, as opposed to 140 referrals during the same time period in 2019.

In another study, in Turkey, a pediatric endocrinology clinic reported 58 cases during the first year of the pandemic, as compared with 66 total cases during the three previous years.

Early puberty tends to mean there are other mental and physical issues, though in most cases, an exact cause can’t be found. Doctors have tied the current uptick to the stress of the pandemic and lockdowns, including reduced physical activity and increased consumption of unhealthy food, which are things linked to a higher risk of early puberty.

“I think it’s directly related to the amount of stress that the children have gone through,” Vaishakhi Rustagi, MD, a pediatric endocrinologist in Delhi, India, told the news outlets.

In a typical year, Rustagi sees about 20 patients with early puberty. Since mid-2020, she’s seen more than 300 girls with the condition. Imaging scans and ultrasounds haven’t found tumors, and the cause has been mostly unidentifiable, though Rustagi attributes it to stress and grief.

“These children have lost family members,” she said.

Early puberty is known to increase depression, eating disorders, substance abuse, and antisocial behavior, the news outlets reported.

The main treatment for the condition, a form of hormone therapy known as GnRH analogue therapy, is known to work very well. But some patients and families may not seek treatment due to a lack of awareness or stigmas that come with menstruation.

Show Sources

The Washington Post: “Early puberty cases in girls have surged during covid, doctors say.”

The Fuller Project: “Early puberty cases in girls have surged during covid, doctors say.”

Endocrine Connections: “Sedentary lifestyle and precocious puberty in girls during the COVID-19 pandemic: an Italian experience.”

Journal of Pediatric Endocrinology and Metabolism: “Increased frequency of idiopathic central precocious puberty in girls during the COVID-19 pandemic: preliminary results of a tertiary center study.”

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