Download PDF
Horm Metab Res 2005; 37(11): 708-710
DOI: 10.1055/s-2005-870586
Original Clinical
© Georg Thieme Verlag KG Stuttgart · New York

Reconsidering the Sex Differences in the Incidence of Pubertal Disorders

A.  Papadimitriou1 , G.  P.  Chrousos2
  • 1First Department of Pediatrics, Penteli Children’s Hospital, Athens, Greece
  • 2First Department of Pediatrics, “Aghia Sophia Children’s Hospital”, University of Athens School of Medicine, Athens, Greece
Further Information

Publication History

Received 8 October 2004

Accepted after revision 13 June 2005

Publication Date:
25 November 2005 (online)

Also available at
    Permissions and Reprints

Abstract

The age range of normal puberty is determined statistically; therefore, a similar percentage of boys and girls should present early or late puberty. However, far more girls present with precocious puberty and more boys with delayed puberty. We suggest that the gender differences in the incidence of pubertal disorders may be due to the following: The signs of puberty are more readily detected in girls, whereas male genitalia may not be examined during a physical examination. The description of the onset of puberty in boys is not uniform. The secular trend towards earlier pubertal maturation is more intense in girls than in boys. Therefore, there may be a fall in the age that correspond to the 3rd and 97th centiles for onset of puberty in girls while the ages at these centiles remain practically unchanged in boys. The high ratio of males to females with constitutional delay of puberty may also be attributed to the late appearance of the pubertal growth spurt in boys. The sex differences in the incidence of pubertal disorders may be due to gender dimorphism in the secular changes of pubertal maturation, to the difficulty of detecting the onset of puberty in boys and to the physiological sex differences in the timing of the pubertal growth spurt.

Key words

Precocious puberty - delayed puberty - secular trend - boys - girls - childhood

References

  • 1 Bridges N A, Christopher J A, Hindmarsh P C, Brook C G. Sexual precocity: sex incidence and aetiology.  Arch Dis Child. 1994;  70 116-118
    PubMedGoogle Scholar
  • 2 Chemaitilly W, Trivin C, Adan L, Gall V, Sainte-Rose C, Brauner R. Central precocious puberty: clinical and laboratory features.  Clin Endocrinol (Oxf). 2001;  54 289-294
    CrossrefPubMedGoogle Scholar
  • 3 Bourguignon J P. Constitutional delay of growth and puberty. In: Kelnar CJH, Savage MO, Stirling HF, Saenger P (eds) Growth Disorders: Pathophysiology and Treatment. London; Chapman and Hall Medical 1998: 673-689
    Google Scholar
  • 4 Sedlmeyer I L, Palmert M R. Delayed puberty: analysis of a large case series from an academic center.  J Clin Endocrinol Metab. 2002;  87 1613-1620
    CrossrefPubMedGoogle Scholar
  • 5 Palmert M R, Boepple P A. Variation in the timing of puberty: clinical spectrum and genetic investigation.  J Clin Endocrinol Metab. 2001;  86 2364-2368
    CrossrefPubMedGoogle Scholar
  • 6 Tanner J M. Growth at Adolescence. Oxford; Blackwell Scientific Publications 1962
    Google Scholar
  • 7 Largo R H, Prader A. Pubertal development in Swiss boys.  Helv Paediatr Acta. 198;  338 211-228
    PubMedGoogle Scholar
  • 8 NHANES III, NHANES III Reference manuals and reports (CD-ROM) .Analytic and reporting guidelines: the Third National Health and Nutrition Examination Survey (1988 - 94). Hyatsville, MD; National Center for Health Statistics, Centers for Disease Control and Prevention 1997
    Google Scholar
  • 9 Styne D. The physiology of puberty. In: Brook CGD, Hindmarsh PC (eds) Clinical Pediatic Endocrinology. Oxford; Blackwell Science 2001: 140-164
    Google Scholar
  • 10 Wilson D M, McCauley E, Brown D R, Dudley R. Oxandrolone therapy in constitutionally delayed growth and puberty. Bio-Technology General Corporation Cooperative Study Group.  Pediatrics. 1995;  96 1095-1100
    PubMedGoogle Scholar
  • 11 Marshall W A, Tanner J M. Variations in the pattern of pubertal changes in boys.  Arch Dis Child. 1970;  45 13-23
    PubMedGoogle Scholar
  • 12 Marshall W A, Tanner J M. Variations in pattern of pubertal changes in girls.  Arch Dis Child. 1969;  44 291-303
    CrossrefPubMedGoogle Scholar
  • 13 Garn S M. The secular trend in size and maturational timing and its implications for nutritional assessment.  J Nutr. 1987;  117 817-823
    PubMedGoogle Scholar
  • 14 Rees M. Menarche when and why?.  Lancet. 1993;  342 1375-1376
    CrossrefPubMedGoogle Scholar
  • 15 Papadimitriou A, Gousia E, Pitaouli E, Tapaki G, Philippidis P. Age at menarche of Greek girls.  Ann Hum Biol. 1999;  26 175-177
    PubMedGoogle Scholar
  • 16 Papadimitriou A. Sex differences in the secular changes in pubertal maturation.  Pediatrics. 2001;  108 E65
    CrossrefPubMedGoogle Scholar
  • 17 Papadimitriou A, Stephanou N, Papantzimas K, Glynos G, Philippidis P. Sexual maturation of Greek boys.  Ann Hum Biol. 2002;  29 105-108
    PubMedGoogle Scholar
  • 18 Roche A F, Wellens R, Attie K M, Siervogel R M. The timing of sexual maturation in a group of US white youths.  J Pediatr Endocrinol Metab. 1995;  8 11-18
    PubMedGoogle Scholar
  • 19 Biro F M, Lucky A W, Huster G A, Morrison J A. Pubertal staging in boys.  J Pediatr. 1995;  127 100-102
    PubMedGoogle Scholar
  • 20 Mul D, Fredriks A M, van Buuren S, Oostdijk W, Verloove-Vanhorick S P, Wit J M. Pubertal development in the Netherlands 1965 - 1997.  Pediatr Res. 2001;  50 479-486
    PubMedGoogle Scholar
  • 21 Aristotle .On the History of Animals. Book VII, http://www.philosophy.ru/library/aristotle/history_anim_en/;
    Google Scholar
  • 22 Nielsen C T, Skakkebaek N E, Richardson D W, Darling J A, Hunter W M, Jorgensen M, Nielsen A, Ingerslev O, Keiding N, Muller J. Onset of the release of spermatozoa (spermarche) in boys in relation to age, testicular growth, pubic hair, and height.  J Clin Endocrinol Metab. 1986;  62 532-535
    CrossrefPubMedGoogle Scholar
  • 23 Schaefer F, Marr J, Seidel C, Tilgen W, Scharer K. Assessment of gonadal maturation by evaluation of spermaturia.  Arch Dis Child. 1990;  65 1205-1207
    PubMedGoogle Scholar
  • 24 Ji C Y, Ohsawa S. Onset of the release of spermatozoa (spermarche) in Chinese male youth.  Am J Human Biol. 2000;  12 577-587
    PubMedGoogle Scholar
  • 25 Grumbach M M, Styne D M. Puberty: ontogeny, neuroendocrinology, physiology, and disorders. In: Wilson JD, Foster DW, Kronenberg HM, Larsen PR (eds) Williams Textbook of Endocrinology. Philadelphia; WB Saunders Co 1998: 1509-1625
    Google Scholar
  • 26 Kaplowitz P B, Slora E J, Wasserman R C, Pedlow S E, Herman-Giddens M E. Earlier onset of puberty in girls: relation to increased body mass index and race.  Pediatrics. 2001;  108 347-353
    CrossrefPubMedGoogle Scholar
  • 27 Wang Y. Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls.  Pediatrics. 2002;  110 903-910
    CrossrefPubMedGoogle Scholar
  • 28 Mann D R, Plant T M. Leptin and pubertal development.  Semin Reprod Med. 2002;  20 93-102
    PubMedGoogle Scholar
  • 29 Terasawa E, Fernandez D L. Neurobiological mechanisms of the onset of puberty in primates.  Endocr Rev. 2001;  22 111-151
    CrossrefPubMedGoogle Scholar
  • 30 Baron S, Battin J, David A, Limal J M. Precocious puberty in children adopted from foreign countries.  Arch Pediatr. 2000;  7 809-816
    CrossrefPubMedGoogle Scholar
  • 31 Mul D, Oostdijk W, Drop S L. Early puberty in adopted children.  Horm Res. 2002;  57 1-9
    PubMedGoogle Scholar
  • 32 Sockalosky J J, Kriel R L, Krach L E, Sheehan M. Precocious puberty after traumatic brain injury.  J Pediatr. 1987;  110 373-377
    CrossrefPubMedGoogle Scholar
  • 33 Kletter G B, Kelch R P. Clinical review 60: Effects of gonadotropin-releasing hormone analog therapy on adult stature in precocious puberty.  J Clin Endocrinol Metab. 1994;  79 331-334
    CrossrefPubMedGoogle Scholar

Anastasios Papadimitriou, M. D.

Endocrinology Clinic · Penteli Children’s Hospital · Palea Penteli ·

Athens 152 36 · Greece

Phone: +30 (210) 803 64 81

Fax: +30 (210) 613 11 73

Email: lix@ath.forthnet.gr