Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
    • Supplements
    • Publish Supplement
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
    • Supplements
    • Publish Supplement
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network

Marcia E. Herman-Giddens, Eric J. Slora, Richard C. Wasserman, Carlos J. Bourdony, Manju V. Bhapkar, Gary G. Koch and Cynthia M. Hasemeier
Pediatrics April 1997, 99 (4) 505-512; DOI: https://doi.org/10.1542/peds.99.4.505
Marcia E. Herman-Giddens
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Eric J. Slora
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard C. Wasserman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Carlos J. Bourdony
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Manju V. Bhapkar
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gary G. Koch
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cynthia M. Hasemeier
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

Objective. To determine the current prevalence and mean ages of onset of pubertal characteristics in young girls seen in pediatric practices in the United States.

Methods. A cross-sectional study was conducted by 225 clinicians in pediatric practices belonging to Pediatric Research in Office Settings, a practice-based research network. After standardized training in the assessment of pubertal maturation, practitioners rated the level of sexual maturation on girls 3 through 12 years who were undergoing complete physical examinations.

Results. Data were analyzed for 17 077 girls, of whom 9.6% were African-American and 90.4% white. At age 3, 3% of African-American girls and 1% of white girls showed breast and/or pubic hair development, with proportions increasing to 27.2% and 6.7%, respectively, at 7 years of age. At age 8, 48.3% of African-American girls and 14.7% of white girls had begun development. At every age for each characteristic, African-American girls were more advanced than white girls. The mean ages of onset of breast development for African-American and white girls were 8.87 years (SD, 1.93) and 9.96 years (SD, 1.82), respectively; and for pubic hair development, 8.78 years (SD, 2.00) and 10.51 years (SD, 1.67), respectively. Menses occurred at 12.16 years (SD, 1.21) in African-American girls and 12.88 years (SD, 1.20) of age in white girls.

Conclusions. These data suggest that girls seen in a sample of pediatric practices from across the United States are developing pubertal characteristics at younger ages than currently used norms. Practitioners may need to revise their criteria for referral of girls with precocious puberty, with attention to racial differences.

  • puberty
  • secondary sexual characteristics
  • growth and development
  • precocious puberty
  • menses
  • menstruation
  • adrenarche
  • thelarche
  • Received January 23, 1996.
  • Accepted May 6, 1996.
  • Copyright © 1997 American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 99, Issue 4
1 Apr 1997
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network
Marcia E. Herman-Giddens, Eric J. Slora, Richard C. Wasserman, Carlos J. Bourdony, Manju V. Bhapkar, Gary G. Koch, Cynthia M. Hasemeier
Pediatrics Apr 1997, 99 (4) 505-512; DOI: 10.1542/peds.99.4.505

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network
Marcia E. Herman-Giddens, Eric J. Slora, Richard C. Wasserman, Carlos J. Bourdony, Manju V. Bhapkar, Gary G. Koch, Cynthia M. Hasemeier
Pediatrics Apr 1997, 99 (4) 505-512; DOI: 10.1542/peds.99.4.505
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Abstract
    • METHODS
    • RESULTS
    • DISCUSSION
    • APPENDIX
    • ACKNOWLEDGMENTS
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Delivery and Impact of a Motivational Intervention for Smoking Cessation: A PROS Study
  • Mental Health and Timing of Gender-Affirming Care
  • Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation
  • Precocious puberty
  • Unique Needs of the Adolescent
  • Case 5: A Very Tall 7-year-old Boy with Medulloblastoma
  • Childhood Socioeconomic Position and Pubertal Onset in a Cohort of Multiethnic Girls: Implications for Breast Cancer
  • Beyond hormone replacement: quality of life in women with congenital hypogonadotropic hypogonadism
  • The follicle-stimulating hormone (FSH) and luteinizing hormone (LH) response to a gonadotropin-releasing hormone analogue test in healthy prepubertal girls aged 10 months to 6 years
  • Adult Consequences of Self-Limited Delayed Puberty
  • Lessons Learned From Australia: Social Disadvantage and Pubertal Timing
  • Disparities in the Context of Opportunities for Cancer Prevention in Early Life
  • Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With the PanCareSurFup Consortium
  • 30th Anniversary of Pediatric Research in Office Settings (PROS): An Invitation to Become Engaged
  • Comparison of Clinical, Maternal, and Self Pubertal Assessments: Implications for Health Studies
  • Pubertal Development
  • Pubertal Development and Prepubertal Height and Weight Jointly Predict Young Adult Height and Body Mass Index in a Prospective Study in South Africa
  • Early Life Growth Predicts Pubertal Development in South African Adolescents
  • Evaluation and Referral of Children With Signs of Early Puberty
  • BMI percentile-for-age overestimates adiposity in early compared with late maturing pubertal children
  • Milk Consumption after Age 9 Years Does Not Predict Age at Menarche
  • A new pathway in the control of the initiation of puberty: the MKRN3 gene
  • Maintenance of Certification Part 4 Credit and Recruitment for Practice-Based Research
  • Associations between Estrogen Receptor-Negative Breast Cancer and Timing of Reproductive Events Differ between African American and European American Women
  • Early Puberty, Negative Peer Influence, and Problem Behaviors in Adolescent Girls
  • Onset of Breast Development in a Longitudinal Cohort
  • Male pubertal development: are endocrine-disrupting compounds shifting the norms?
  • Female Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: Guidelines for the Assessment and Management of Female Reproductive Complications
  • Menstrual Disorders
  • Secondary Sexual Characteristics in Boys: Data From the Pediatric Research in Office Settings Network
  • Growth failure and outcome in Rett syndrome: Specific growth references
  • Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures
  • Alteration in Neonatal Nutrition Causes Perturbations in Hypothalamic Neural Circuits Controlling Reproductive Function
  • Period problems: disorders of menstruation in adolescents
  • The Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center: A Unique Resource for Defining the "Molecular Histology" of the Breast
  • Premature adrenarche: novel lessons from early onset androgen excess
  • Puberty and Influencing Factors in Schoolgirls Living in Istanbul: End of the Secular Trend?
  • Normal Pubertal Development: Part II: Clinical Aspects of Puberty
  • Hebephilia Is Not a Mental Disorder in DSM-IV-TR and Should Not Become One in DSM-5
  • Obesity and the pubertal transition in girls and boys
  • Pubertal Assessment Method and Baseline Characteristics in a Mixed Longitudinal Study of Girls
  • Blood Lead Levels and Delayed Onset of Puberty in a Longitudinal Study of Russian Boys
  • Onset of Breast and Pubic Hair Development and Menses in Urban Chinese Girls
  • Recent Decline in Age at Breast Development: The Copenhagen Puberty Study
  • Thelarche, Pubarche, and Menarche Attainment in Children With Normal and Elevated Body Mass Index
  • The use of GnRH agonists in precocious puberty
  • Bone Metabolism in Adolescent Athletes With Amenorrhea, Athletes With Eumenorrhea, and Control Subjects
  • Gynecomastia and Premature Thelarche: A Guide for Practitioners
  • Weight Status in Young Girls and the Onset of Puberty
  • Changes in Dietary Fat and Fiber and Serum Hormone Concentrations: Nutritional Strategies for Breast Cancer Prevention over the Life Course
  • Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign
  • Growth and Health in Children With Moderate-to-Severe Cerebral Palsy
  • Patient Visits to a National Practice-Based Research Network: Comparing Pediatric Research in Office Settings With the National Ambulatory Medical Care Survey
  • Early Puberty-Menarche After Precocious Pubarche: Relation to Prenatal Growth
  • Prevalence and Incidence of Precocious Pubertal Development in Denmark: An Epidemiologic Study Based on National Registries
  • The Histrelin Implant: A Novel Treatment for Central Precocious Puberty
  • Early Puberty and Adolescent Pregnancy: The Influence of Alcohol Use
  • Onset of breast and pubic hair development in 1231 preadolescent Lithuanian schoolgirls
  • Economic, Racial, and Cultural Influences on the Growth and Maturation of Children
  • The neuroendocrine timing of puberty
  • Relationship of Lead, Mercury, Mirex, Dichlorodiphenyldichloroethylene, Hexachlorobenzene, and Polychlorinated Biphenyls to Timing of Menarche Among Akwesasne Mohawk Girls
  • Navigating Recent Articles on Girls' Puberty: Where Should Our Patients Go for Evaluation?
  • Effects of Anorexia Nervosa on Clinical, Hematologic, Biochemical, and Bone Density Parameters in Community-Dwelling Adolescent Girls
  • Fifty-year trends in serial body mass index during adolescence in girls: the Fels Longitudinal Study
  • Physiologic Growth and Development During Adolescence
  • Navigating the Recent Articles on Girls' Puberty in Pediatrics: What Do We Know and Where Do We Go from Here?
  • Obesity and the Development of Insulin Resistance and Impaired Fasting Glucose in Black and White Adolescent Girls: A longitudinal study
  • Evidence of Effects of Environmental Chemicals on the Endocrine System in Children
  • Relative Weight and Race Influence Average Age at Menarche: Results From Two Nationally Representative Surveys of US Girls Studied 25 Years Apart
  • PROS studies violence, child abuse prevention
  • Percent Body Fat at Age 5 Predicts Earlier Pubertal Development Among Girls at Age 9
  • The CYP3A4*1B Variant Is Related to the Onset of Puberty, A Known Risk Factor for the Development of Breast Cancer
  • Timing of Puberty in US Girls
  • Age at Menarche and Racial Comparisons in US Girls
  • Are Pubertal Changes in Girls Before Age 8 Benign?
  • Secondary Sexual Characteristics in Children With Cerebral Palsy and Moderate to Severe Motor Impairment: A Cross-Sectional Survey
  • National Estimates of the Timing of Sexual Maturation and Racial Differences Among US Children
  • Is Obesity Associated With Early Sexual Maturation? A Comparison of the Association in American Boys Versus Girls
  • Self-Assessment of Pubertal Stage in Overweight Children
  • Relation of Age at Menarche to Race, Time Period, and Anthropometric Dimensions: The Bogalusa Heart Study
  • Ethnic Differences in the Presence of Secondary Sex Characteristics and Menarche Among US Girls: The Third National Health and Nutrition Examination Survey, 1988-1994
  • Body composition in children with sickle cell disease
  • Precocious Puberty in Girls and the Risk of a Central Nervous System Abnormality: The Elusive Search for Diagnostic Certainty
  • Splitting hairs
  • Central Precocious Puberty in Girls: An Evidence-Based Diagnosis Tree to Predict Central Nervous System Abnormalities
  • Sex Differences in the Secular Changes in Pubertal Maturation
  • Earlier Onset of Puberty in Girls: Relation to Increased Body Mass Index and Race
  • Google Scholar

More in this TOC Section

  • Racial and Ethnic Diversity in Studies Funded Under the Best Pharmaceuticals for Children Act
  • Clinical Impact of a Diagnostic Gastrointestinal Panel in Children
  • Intrapartum Group B Streptococcal Prophylaxis and Childhood Allergic Disorders
Show more Article

Similar Articles

  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics