Over the past two decades, multiple cohort studies have documented a gradual decline in the age of pubertal onset, particularly earlier thelarche and menarche in girls. In several populations, mean age of menarche has shifted downward, with a notable rise in central precocious puberty referrals. This trend is not merely developmental variation; it carries long-term implications for cardiometabolic risk, reproductive health, and even hormone-related cancers.
Emerging evidence points toward metabolic drivers, especially childhood obesity and insulin resistance, as key accelerators of pubertal timing. Adiposity influences leptin signaling, hypothalamic–pituitary–gonadal (HPG) axis activation, and sex steroid metabolism. Parallelly, increasing exposure to endocrine-disrupting chemicals (EDCs), including bisphenol A (BPA), phthalates, and persistent organic pollutants, has raised concern.…
