Socio-Environmental Factors Associated With Pubertal Development in Female Adolescents: The Role of Prepubertal Tobacco and Alcohol Use

Abstract

Purpose-Alcohol administered to laboratory animals has been shown to suppress pubertyrelated hormones and delay puberty by interfering with ovarian development and function. The effects of early substance use on human pubertal development are relatively unexplored.Methods-This cross-sectional study of 3106 females, ages 11-21, evaluates the association between prepubertal alcohol and tobacco use and onset of puberty. Ages at initial breast development, body hair growth and menarche were self-reported. Prepubertal alcohol and tobacco use were defined as age at first use preceding the age of pubertal development and accompanied by regular use. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazard models. Logistic regression was used to estimate the association between substance use and delayed puberty, defined as lack of breast development by age 13.Results-Unadjusted models indicated prepubertal tobacco use was associated with longer time to breast development (HR=0.74; 95% CI 0.65-0.85) and body hair growth (HR=0.81; 95% CI 0.71-0.93). Prepubertal alcohol use was associated with later breast development (HR=0.71; 95% CI 0.57-0.88). The direction of the observed associations remained consistent after adjusting for covariates, but the magnitude of effects were attenuated and the upper bound of the 95% CIs exceeded the null value. Girls who used alcohol before puberty had four times the odds of having delayed puberty (OR=3.99; 95% CI 1.94-8.21) compared to non-users. Conclusion-The results of this study suggest the endocrine-disrupting effects of alcohol and tobacco use may alter the timing of pubertal development. These cross-sectional findings warrant further investigation.

Regulation of prepubertal dynorphin secretion in the medial basal hypothalamus of the female rat

“…Other investigators have shown that the administration of anti‐DYN caused increased serum LH, and that a kappa opioid receptor (KOR‐1) antagonist increased the pulsatile secretion of LH and advanced puberty . Conversely, we revealed that prepubertal alcohol administration stimulates the hypothalamic synthesis and secretion of DYN; hence, DYN is suggested to be an important component of the prepubertal inhibition in GnRH/LH release that accompanies the delayed pubertal development in rats, monkeys and humans caused by chronic alcohol use.…”

Differential Effects of Alcohol on Excitatory and Inhibitory Puberty‐Related Peptides in the Basal Hypothalamus of the Female Rat

“…Alcohol (ALC) is known to diminish the secretion of LHRH and delay signs associated with the onset of female puberty in rodents (Dees and Skelley, 1990) and primates (Dees et al, 2000; Dissen et al, 2004), including humans (Peck et al, 2011; Richards and Oinonen, 2011). Specifically, these studies show that in rodents ALC delays vaginal opening (VO) markedly beyond the time when controls show VO, in primates, it significantly delays the development of regular monthly pattern of menstruation, and in human, it causes delayed breast development and menarche.…”

Elevated phthalates' exposure in children with constitutional delay of growth and puberty

“…Gonadotropin releasing hormone (GnRH) stimulation tests, nuclear magnetic resonance and physical examinations were performed to exclude clinical, radiological or biochemical evidence of congenital hypogonadism syndrome, endocrinopathy, chronic disease or skeletal dysplasia. We excluded 13 boys with alcohol abuse or tobacco smoking (Peck et al, 2011). Our subjects comprised 57 cases and 110 controls.…”