Hi, remeber me?
I was pseudo no mail, deleteing without reading for awhile.
Being caught up with other things I started reading again.
There was a question about onset of puberty and menses and normal ages.
Hopefully the following helps.
The average age of menarche in white American girls has changed by less than
1 year in the last 3 generations. The following is an extract from a guide
to evaluation of early puberty which the endroniology attending were I
trained wrote for the residents and primary care docs. Enlarge your window
if the columns don't line up.
"The following 3rd, 50th, and 97th percentiles for attainment of selected
stages (B2 is thelarche, the beginning of breast development, and PH2 is
first pubic hair) by American girls were reported in 1985. [Tanner JM,
Davies PS. Clinical longitudinal standards for height and weight velocity
for North American children. J Pediatr 1985; 107:317-29.]
3rd % 50th % 97th%
B2 8y 10m 10y 11m 13y 0m
PH2 9y 0m 11y 3m 13y 6m
Menarche 10y 10m 12y 9m 14y 7m
Peak height velocity 9y 11y 6m 14y
However, a more recent survey by a group of primary care pediatricians
suggests both a slightly earlier average onset, greater range, and more
importantly, a significant difference between white and African-American
girls at some stages. [Herman-Giddens ME, Slora EJ, Wasserman RC, et al.
Secondary sexual characteristics and menses in young girls seen in office
practice: a study from the pediatric research in office settings network.
Pediatr, 1997; 99:501-12.]
White girls 3rd % 50th % 97th%
B2 6y 5m 10y 0m 13y 7m
PH2 7y 2m 10y 5m 13y 8m
Menarche 10y 6m 12y 10m 15y 3m
Peak height velocity 10y 12y 2m 14y
African-American 3rd % 50th % 97th%
B2 5y 0m 8y 11m 12y 10m
PH2 4y 9m 8y 9m 12y 9m
Menarche 9y 10m 12y 2m 14y 6m
A third set of observations from the late 1970s is slightly later than both.
It is possible that the newer report overstates the percentage of girls in
puberty at the earlier ages, but agree that our evaluation thresholds can be
lowered, especially for African-American girls. It should be emphasized that
rapid progression or discordance of development is a more important
indication for evaluation than the particular population percentiles
preferred."
I realize this may be more than you wanted to know about timing.
Rob
Rob Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
mailto:[log in to unmask]
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