A recent study conducted at Columbia University Mailman School of Public Health found that elevated levels of specific steroid hormones, along with increased psychosocial stress and higher body mass index (BMI), are associated with an earlier onset of puberty in girls. Although previous research has documented a gradual decline in the age of pubertal onset, limited data have explored how hormonal pathways interact with stress and BMI to influence pubertal timing. This study is among the first to evaluate these factors simultaneously using a comprehensive steroid metabolome approach. The findings were published in the Journal of Clinical Endocrinology & Metabolism.1
The researchers observed that higher pre-pubertal urinary concentrations of glucocorticoids, androgens, and progesterone metabolites were strongly associated with earlier breast development (thelarche). Girls with elevated glucocorticoid levels in combination with higher BMI and greater psychosocial stress entered puberty approximately seven months earlier than those with lower levels. These findings suggest that stress-related hormonal pathways may significantly influence pubertal timing.1
Traditionally, research on pubertal onset has focused primarily on oestrogen levels and body composition. However, this study highlights the importance of stress hormones and androgens—commonly considered male hormones—in the regulation of pubertal development in girls. The strongest associations were identified for progesterone, androgens, and glucocorticoids, suggesting that multiple endocrine pathways contribute to the onset and progression of puberty.1,2
Key findings from the study included:
• Elevated glucocorticoid, androgen, and progesterone metabolites were associated with earlier onset of puberty
• Higher androgen and progesterone levels were linked with prolonged pubertal duration
• Oestrogen metabolites were associated with delayed onset rather than acceleration of puberty
• BMI and psychosocial stress significantly modified the relationship between hormone levels and pubertal timing
• Associations remained consistent regardless of family history of breast cancer
The study utilized data from the LEGACY Girls Study, which included 1,040 girls aged 6-13 years recruited across the United States and Canada. Participants underwent clinical assessments every six months, including measurement of height, weight, psychosocial stress evaluation, and collection of biological samples. The analysis focused on 327 girls who were prepubertal at baseline and provided urine samples at least one year before pubertal onset. Hormone metabolites were measured using first-morning urine samples, and pubertal development was assessed using validated clinical staging tools1.
Psychosocial stress was evaluated using maternal questionnaires, including standardized scales measuring anxiety, depression, and behavioural concerns. Additional data on birth history, family medical history, and demographic characteristics were also collected. This comprehensive design allowed researchers to simultaneously examine hormonal, physiological, and environmental influences on pubertal timing.3
These findings may help explain the global trend toward earlier puberty in girls. Early pubertal onset has been associated with several long-term health risks, including metabolic syndrome, psychological challenges, and increased risk of breast cancer later in life. Therefore, interventions aimed at reducing stress and maintaining healthy BMI may help delay early puberty and improve long-term health outcomes.4
The authors concluded that lifestyle interventions targeting stress reduction, emotional well-being, and healthy weight management may play an important role in preventing early pubertal onset. These findings have important implications for paediatric practice, preventive medicine, and public health strategies aimed at improving long-term health in girls.
References:
1. Houghton LC, Terry MB, et al. Steroid metabolome, stress, and BMI in relation to pubertal timing in girls. J Clin Endocrinol Metab. 2026;[Epub ahead of print].
2. Biro FM, Greenspan LC, Galvez MP. Puberty in girls of the 21st century. J Pediatr Adolesc Gynecol. 2012;25(5):289-94.
3. Terry MB, et al. The LEGACY Girls Study: design and recruitment. Cancer Epidemiol Biomarkers Prev. 2015;24(1):94-100.
4. Kaplowitz PB. Link between body fat and the timing of puberty. Pediatrics. 2008;121(Suppl 3):S208-17.
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