Cheng HL*, Harris SR*, Sritharan M, Behan M, Medlow S, Steinbeck K. The tempo of puberty and its relationship to adolescent health and wellbeing: a systematic review. Acta Paediatrica 2020;109:900–913 (*co-first author)



Aim: Emerging evidence suggests that pubertal tempo, that is rate of passage through puberty, has relevance to adolescent mood and behaviour. However, its wider health and developmental significance remain unclear. This systematic review sought to clarify the relationship of pubertal tempo to indicators of health and development, and to document tempo definitions and pubertal durations reported in the literature.

Methods: Eight electronic databases were searched from earliest record to July 2018. Study eligibility: healthy participants; age 8‐21 years; ≥2 longitudinal measures of puberty; analysis of tempo against a health or developmental indicator.

Results: Thirty‐eight studies met eligibility, and these reported on diverse tempo definitions and seven health‐ and development‐related domains. Data sets with varying tempo definitions converged on an association of rapid pubertal progression to: (a) higher adiposity during childhood and adolescence in both sexes; and (b) lower psychosocial well‐being in adolescent males. Later thelarche unanimously predicted faster progression to menarche in females, but this compensation was largely undetected when alternate definitions of pubertal timing and/or tempo were used. Duration of puberty ranged from 2.5‐4.1 years.

Conclusion: Pubertal tempo may be clinically relevant when considering trajectories of adiposity and psychosocial well‐being among adolescents, especially males. Consensus on the definition of tempo would facilitate between‐study comparisons.

About The Authors


Helen is an Accredited Practising Dietitian and Exercise Scientist by training, and currently holds ...


Dr Sharon Medlow is a Senior Research Fellow in the Discipline of Child and Adolescent Health at the...


Kate Steinbeck is an endocrinologist and adolescent physician, and Professor and Medical Foundation ...