Age of Puberty Onset Among Girls in Asyut, Egypt

Age at Onset of Puberty Among Girls in Asyut Governorate, Egypt

Puberty is a critical transition from childhood to adulthood. Over the past two decades, studies worldwide have shown a trend toward earlier pubertal onset, which is thought to be influenced by factors such as lifestyle changes, improved nutrition, and environmental exposures. However, there is currently a lack of local data regarding the timing of puberty in Upper Egypt.

The main purpose of this observational study is to determine the average age at which puberty begins among girls living in the Asyut governorate, Egypt. The study specifically focuses on thelarche (breast development), which is the earliest clinical sign of pubertal onset. Additionally, the study aims to identify possible genetic, demographic, physical, and environmental factors that might influence the timing of this developmental milestone.

The study will include approximately 600 girls aged 6 to 13 years from both urban and rural areas of Asyut. Researchers will collect data during a single visit using a structured questionnaire administered through personal interviews with the participants and their parents or caregivers. The questionnaire will gather information on early life history, family history, dietary habits, physical activity, sleep patterns, screen time, stress, environmental exposures, and pubertal history. Researchers will also take basic physical measurements, including height, weight, and waist circumference to calculate Body Mass Index (BMI).

Participants will not be exposed to any invasive procedures or additional clinical risks beyond their routine care. The findings will help establish local reference values for pubertal development and support evidence-based adolescent health strategies in Egypt.

Inclusion Criteria:

• Girls aged 6-13 years showing progressive breast development.
• Reside in Asyut governorate.
• Parents/caregivers agreed to provide informed consent (and child assent when appropriate).

Exclusion Criteria:

• Premature thelarche.
• Any pathological or iatrogenic factors that will be known by history.
• Puberty due to central nervous system (CNS) lesions such as hypothalamic or pituitary tumor, hydrocephalus, etc.
• Peripheral causes of puberty such as ovarian cyst or tumor, adrenal disorders, etc.
• Endocrine disorders affecting puberty such as thyroid disorders or congenital adrenal hyperplasia.
• Chronic systemic disease affecting puberty.
• Current use of hormonal therapy.
• Incomplete clinical data or refusal to participate in the study.