The covid-19 pandemic may be causing early puberty in some girls. Several studies suggest the outbreak is increasing the number of girls experiencing premature sexual development, and experts aren’t sure why.
In the latest in a series of studies, researchers at the University of Bonn, Germany, report how the number of girls diagnosed with early puberty at a single medical center remained constant between 2015 and 2019, at fewer than 10 cases per year.
This more than doubled to 23 in 2020, when the Covid-19 outbreak took hold across the world, rising further to 30 in 2021, according to results presented today at the 2022 European Society for Pediatric Endocrinology meeting.
German researchers are not the only ones to see double cases. “In the year before Covid, we had 28 kids start treatment, and in the Covid year, 64 kids started treatment,” says Karen Klein of Rady Children’s Hospital and the University of California, San Diego.
Early puberty is rare affecting one in 5,000 to 10,000 children in pre-pandemic times. For every boy, it affects 10 girls. The reasons behind this sexual disparity are unclear.
Regardless of a person’s gender, early puberty is linked to short stature in adulthood, as well as serious health conditions, such as heart disease, type 2 diabetes, and some types of cancer.. Early puberty has also been associated with certain mental health problemssuch as anxiety in boys and depression in girls.
Sezer Acar at Dr. Behçet Uz Children’s Education and Research Hospital in Izmir, an author of the Turkish study, says: “Previously, [treated] one or two patients per month due to early [early] puberty, but during this period [the early stages of the pandemic before his study was published]I had to treat two or three patients a week.”
In addition to a higher number of girls starting puberty earlier, the age of onset may also have decreased.
In the German study, the onset of puberty before the pandemic occurred at 6.8 years, on average, compared to 7.6 among those diagnosed during the Covid-19 outbreak. A statistical analysis suggests that this was not a chance finding.
“We know that stress can cause earlier puberty, so it’s definitely high on the list of what’s going on,” says Klein.
“The other thing people immediately started thinking about was, well, everyone’s at home not exercising as much and maybe it’s because of weight gain, because we know rapid weight gain can cause earlier puberty. . But in our study and a couple of other studies, we didn’t see kids gaining weight.”
Increased screen time and changes in sleep cycles due to remote learning could also be at play, says Paul Kaplowitz of Children’s National Hospital in Washington DC.
These factors were not assessed in all studies. Nevertheless, in a follow-up study of the Italian articleThe researchers found that girls diagnosed with early puberty during lockdown had more sleep disturbances and went to bed later than those diagnosed before the pandemic.
Some have questioned whether SARS-CoV-2 itself could be to blame. Inflammation of the nasal cavity has been documented in both cases of covid-19 and the people passing by early puberty. Although this hypothesis cannot be ruled out, especially since many cases of Covid-19 in childhood are mild and can be missed, it seems unlikely, says Kaplowitz.
“I don’t think the effect of covid on female puberty is limited to girls who actually had the infection,” says Kaplowitz. “Especially because, in the early stages of the pandemic, children were much less likely to be infected than adults.”
Aside from the pandemic, the age of onset of puberty has been decreasing about three months per decade since 1977, although there is little data on the effect of other traumatic events such as wars or recessions.
Medications can lower hormone levels and stunt sexual development for several years. Nevertheless, this is generally only recommended if early puberty is expected to cause emotional or physical problems.
Some doctors hope that the return of face-to-face education and the adaptation of children to the challenges related to the pandemic will decrease the rate of early puberty.
“When you look at the data from the past year, particularly in places where almost all children went back to school and life became more normal again, I would predict that the rate of precocious puberty will go back to what it was before,” says Kaplowitz. . “But obviously we don’t know.”
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