Analysis of early puberty in girls leads to physical, psychological, and social consequences
DOI:
https://doi.org/10.53713/nhsj.v5i4.591Keywords:
pornography exposure, fast food, maternal menarche, early puberty, nutritional status, stressAbstract
Early puberty in girls before the age of 9 may lead to physical, psychological, and social consequences, including risks of obesity, menstrual disorders, risky sexual behavior, as well as early marriage and pregnancy. This study aimed to analyze early puberty in girls leading to physical, psychological, and social consequences in Tanah Baru village, Beji subdistrict, Depok, West Java. This mixed-method research applied an exploratory sequential approach. The sample consisted of 100 participants selected through a total sampling approach. Core informants included four respondents, while key informants comprised four parents/guardians and three class teachers, all recruited using snowball sampling. Research instruments included questionnaires and interview guides. The data were analyzed using univariate, bivariate (Chi-Square test), and multivariate (multiple logistic regression) analyses. Qualitative analysis revealed that girls experiencing early puberty expressed feelings of anxiety, confusion, and embarrassment due to faster physical changes compared to their peers. Parents reported difficulties in providing education, particularly in areas such as reproductive health and emotional regulation. Teachers noted challenges in guiding children who appeared physically mature but were still psychologically immature, particularly in social interactions at school. Quantitative analysis revealed that factors significantly associated with early puberty included maternal age at menarche (p = 0.029), nutritional status (p = 0.002), fast food consumption (p = 0.001), physical activity (p = 0.001), stress (p = 0.001), and exposure to pornography (p = 0.001). Multivariate analysis indicated that the most dominant factors influencing early puberty were physical activity, stress, and exposure to pornography. Prevention efforts for early puberty in girls should focus on promoting physical activity, encouraging healthy eating habits, managing stress, and monitoring media exposure.
References
Alvanajati, Hamdanah, & Surawan. (2025). The Role of Positive Vibes in Preventing Academic Stres Among MTsN 1 Palangka Raya Students. G-Couns: Jurnal Bimbingan Dan Konseling, 9(3), 1588–1607. https://doi.org/10.31316/g-couns.v9i3.7537
Arifin, NA, Fatmawati., Fahmi, I. (2020). The Relationship between Nutritional Status and Junk Food Consumption with Early Menarche in Early Adolescence (Case Study in 3 Elementary Schools in Malang City). Journal of Issues in Midwifery, 4(2), 82-90. https://doi.org/10.21776/ub.JOIM.2020.004.02.4
Bauman, D. (2023). Impact of obesity on female puberty and pubertal disorders. Best Practice & Research Clinical Obstetrics & Gynaecology, 91, 102400. https://doi.org/10.1016/j.bpobgyn.2023.102400
Calcaterra, V., Magenes, V. C., Hruby, C., Siccardo, F., Mari, A., Cordaro, E., Fabiano, V., & Zuccotti, G. (2023). Links between Childhood Obesity, High-Fat Diet, and Central Precocious Puberty. Children, 10(2), 241. https://doi.org/10.3390/children10020241
Cemeroglu, A. P., Kaval, D., & Ozcan, O. (2021). Etiology of Increased Referrals for Evaluation of Early Puberty in a Tertiary Care Center in Turkey: True Precocious Puberty, Obesity, or Parental Anxiety and Lack of Knowledge? Global Pediatric Health. https://doi.org/10.1177/2333794X211009096
Çoban, Ö. G., Bedel, A., Önder, A., Adanır, A. S., Tuhan, H., & Parlak, M. (2021). Psychiatric disorders, peer-victimization, and quality of life in girls with central precocious puberty. Journal of Psychosomatic Research, 143, 110401. https://doi.org/10.1016/j.jpsychores.2021.110401
Colich, N. L., & McLaughlin, K. A. (2022). Accelerated pubertal development as a mechanism linking trauma exposure with depression and anxiety in adolescence. Current Opinion in Psychology, 46, 101338. https://doi.org/10.1016/j.copsyc.2022.101338
Demaria, F., Pontillo, M., Di Vincenzo, C., Bellantoni, D., Pretelli, I., & Vicari, S. (2024). Body, image, and digital technology in adolescence and contemporary youth culture. Frontiers in Psychology, 15, 1445098. https://doi.org/10.3389/fpsyg.2024.1445098
Dinkelbach, L., Grasemann, C., Kiewert, C., Leikeim, L., Schmidt, B., & Hirtz, R. (2025). Central Precocious Puberty and Psychiatric Disorders. JAMA Network Open, 8(6), e2516679. https://doi.org/10.1001/jamanetworkopen.2025.16679
Duittoz, A., & Kenny, D. (2023). Review: Early and late determinants of puberty in ruminants and the role of nutrition. Animal, 17, 100812. https://doi.org/10.1016/j.animal.2023.100812
Finigan-Carr, N. M., Cance, J. D., Steward, R., & Johnson, T. (2024). Pubertal Development and Pregnancy Outcomes Among System-Involved Youth. Social Work in Public Health, 39(8), 825–836. https://doi.org/10.1080/19371918.2024.2383690
Gallant, F., Hebert, J. J., Thibault, V., Mekari, S., Sabiston, C. M., & Bélanger, M. (2023). Puberty timing and relative age as predictors of physical activity discontinuation during adolescence. Scientific Reports, 13(1), 1-13. https://doi.org/10.1038/s41598-023-40882-3
Gupta, P., Mahapatra, A., Suman, A., & Singh, R. K. (2021). Effect of endocrine disrupting chemicals on HPG axis: a reproductive endocrine homeostasis. Hot Topics in Endocrinology and Metabolism. https://doi.org/10.5772/intechopen.96330
Howard, S. R. (2021). Interpretation of reproductive hormones before, during and after the pubertal transition—Identifying health and disordered puberty. Clinical Endocrinology, 95(5), 702-715. https://doi.org/10.1111/cen.14578
Khizer, A., Warrier, A., Jamir, I., & Prasad, M. (2025). Precocious Puberty in Girls: Impact of Nutritional, Health, Psychological, and Socioeconomic Factors in Urban and Rural Settings on Reproductive Health. Journal on Applied and Chemical Physics, 4(1). https://doi.org/10.46632/jacp/4/1/1
Kythreotis, A. K., Nicolaou, M., Mitsinga, E., Daher, H., & Skordis, N. (2025). The Interplay Between Body Weight and the Onset of Puberty. Children, 12(6), 679. https://doi.org/10.3390/children12060679
Li, W., Feng, L., Song, P., Wang, L., Zhang, S., Li, W., Zhu, D., Du, Y., & Leng, J. (2024). Joint association of overweight/obesity, high electronic screen time, and low physical activity time with early pubertal development in girls: A case–control study. Scientific Reports, 14(1), 1-9. https://doi.org/10.1038/s41598-024-60345-7
Li, Y., Wang, S. S., Yu, Y., Zuo, M., Li, J., Ling, X. B., Tao, F. B., Liu, D. Y., & Sun, Y. (2025). Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi, 46(3), 469–475. https://doi.org/10.3760/cma.j.cn112338-20240714-00424
Lopez-Rodriguez, D., Franssen, D., Heger, S., & Parent, A. (2021). Endocrine-disrupting chemicals and their effects on puberty. Best Practice & Research Clinical Endocrinology & Metabolism, 35(5), 101579. https://doi.org/10.1016/j.beem.2021.101579
Maione, L., Bouvattier, C., & Kaiser, U. B. (2021). Central precocious puberty: Recent advances in understanding the aetiology and in the clinical approach. Clinical Endocrinology, 95(4), 542-555. https://doi.org/10.1111/cen.14475
Migueles, J. H., Cadenas-Sanchez, C., Lubans, D. R., Henriksson, P., Torres-Lopez, L. V., Rodriguez-Ayllon, M., ... & Ortega, F. B. (2023). Effects of an exercise program on cardiometabolic and mental health in children with overweight or obesity: a secondary analysis of a randomized clinical trial. JAMA Network Open, 6(7), e2324839-e2324839. https://doi.org/10.1001/jamanetworkopen.2023.24839
Muganwa, K., Bazirete, O., Uwimana, M. C., Sandra Musabwasoni, M. G., Tengera, O., Bahumura, J., Chinwe, H. N., Uwingabire, E., Muteteri, E., Mujawamariya, F., Habyarimana, E., Mukeshimana, E., Ndimurukundo, B., Abagirinana, V., Nsengiyumva, R., Wabenya, C. M., Mugisha, V., Kaberuka, G., Ishimwe Bazakare, M. L., . . . Uhawenimana, T. C. (2025). Adolescent awareness and experience of the pubertal changes: A qualitative study from Rwanda. PLOS ONE, 20(6), e0325502. https://doi.org/10.1371/journal.pone.0325502
Novalia, K., Sumasto, H., Saadah, N., Surtinah, N. (2022). Factors Influencing Age at Menarche, a School-Based Cross-Sectional Study. International Journal of Advanced Health Science and Technology, 2(4). https://doi.org/10.35882/ijahst.v2i4.131
Nurmayani, W., Utami, K., Mulianingsih, M., Romadonika, F., & Syafraini, B. (2021). Pornographic and socioeconomic exposure affect the age of menarche. Jurnal Kebidanan Dan Kesehatan Tradisional, 95–102. https://doi.org/10.37341/jkkt.v0i0.251
Papadimitriou, A., & Papadimitriou, D. T. (2021). Endocrine-Disrupting Chemicals and Early Puberty in Girls. Children, 8(6), 492. https://doi.org/10.3390/children8060492
Paparella, R., Bei, A., Brilli, L., Maglione, V., Tarani, F., Niceta, M., Pucarelli, I., & Tarani, L. (2025). Precocious Puberty and Benign Variants in Female Children: Etiology, Diagnostic Challenges, and Clinical Management. Endocrines, 6(2), 29. https://doi.org/10.3390/endocrines6020029
Ramraj, B., Subramanian, V. M., & G, V. (2021). Study on age of menarche between generations and the factors associated with it. Clinical Epidemiology and Global Health, 11, 100758. https://doi.org/10.1016/j.cegh.2021.100758
Rapee, R. M., Magson, N. R., Forbes, M. K., Richardson, C. E., Johnco, C. J., Oar, E. L., & Fardouly, J. (2022). Risk for social anxiety in early adolescence: Longitudinal impact of pubertal development, appearance comparisons, and peer connections. Behaviour Research and Therapy, 154, 104126. https://doi.org/10.1016/j.brat.2022.104126
Sari, L. P., Dewi, F. S., & Maryanti, E. (2021). Analysis of the Effect of Social Media on Teenage Premarital Sex at SMAN 8 in Jambi City. Journal La Medihealtico, 2(4), 14-23. https://doi.org/10.37899/journallamedihealtico.v2i4.368
Shalitin, S., & Gat-Yablonski, G. (2022). Associations of obesity with linear growth and puberty. Hormone research in paediatrics, 95(2), 120-136. https://doi.org/10.1159/000516171
Spaziani, M., Tarantino, C., Tahani, N., Gianfrilli, D., Sbardella, E., Lenzi, A., & Radicioni, A. F. (2021). Hypothalamo-Pituitary axis and puberty. Molecular and Cellular Endocrinology, 520, 111094. https://doi.org/10.1016/j.mce.2020.111094
Stathori, G., Tzounakou, A., Mastorakos, G., Vlahos, N. F., Charmandari, E., & Valsamakis, G. (2022). Alterations in Appetite-Regulating Hormones in Girls with Central Early or Precocious Puberty. Nutrients, 15(19), 4306. https://doi.org/10.3390/nu15194306
Street, M. E., Ponzi, D., Renati, R., Petraroli, M., Lattanzi, C., Ferrari, V., Rollo, D., & Stagi, S. (2023). Precocious puberty under stressful conditions: New understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic. Frontiers in Endocrinology, 14, 1149417. https://doi.org/10.3389/fendo.2023.1149417
Street, M. E., Shulhai, A., Rollo, D., Rossi, M., Petraroli, M., Ferrari, V., Del Medico, G., Bruzzi, P., Righi, B., Sartori, C., Iughetti, L., & Stagi, S. (2025). Changes in Coping Strategies of Parents and Girls with Central Precocious Puberty Before and After the COVID-19 Lockdown: Data from Four Italian Pediatric Endocrinology Centers. International Journal of Environmental Research and Public Health, 22(7), 981. https://doi.org/10.3390/ijerph22070981
Sun, Y., Liu, H., Mu, C., Liu, P., Hao, C., & Xin, Y. (2024). Early puberty: A review on its role as a risk factor for metabolic and mental disorders. Frontiers in Pediatrics, 12, 1326864. https://doi.org/10.3389/fped.2024.1326864
Wu, T., Yang-Huang, J., Vernooij, M. W., Rodriguez-Ayllon, M., Jaddoe, V. W. V., Raat, H., Klein, S., & Oei, E. H. G. (2023). Physical activity, screen time and body composition in 13-year-old adolescents: The Generation R Study. Pediatric obesity, 18(11), e13076. https://doi.org/10.1111/ijpo.13076
Wu, X., Wang, L., Xue, P., Tang, J., Wang, H., Kong, H., Lin, C., Chang, B., & Liu, S. (2024). Association of screen exposure/sedentary behavior and precocious puberty/early puberty. Frontiers in Pediatrics, 12, 1447372. https://doi.org/10.3389/fped.2024.1447372
