HormonesMelatonin

The COVID-19 pandemic was associated with a marked increase in central precocious puberty (CPP), particularly among girls, with higher odds during pandemic than pre-pandemic periods.

Pooled estimates show higher odds of central precocious puberty (CPP) during the COVID-19 pandemic compared to pre-pandemic periods, especially in girls. The evidence supports a reproducible epidemiological signal but does not establish a single causal mechanism.

Last updated: Aug 11, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Post-COVID-19 rise in central precocious puberty: an integrative Review.

observational

Chen X, Ding S · Journal of pediatric endocrinology & metabolism : JPEM (2026)

Participants: N/A
Duration: N/A
Intervention: COVID-19 pandemic-related lockdowns and lifestyle changes (e.g., sedentary behavior, weight gain, increased screen exposure, sleep disruption, psychological stress, altered healthcare-seeking behavior, environmental EDCs)
Outcome: Incidence of central precocious puberty (CPP)
Effect Size: N/A (pooled estimates show higher odds, but specific effect size not reported in abstract)
Population: Children, particularly girls, during the COVID-19 pandemic compared to pre-pandemic periods

Result:

PubMed: 42515816DOI: 10.1515/jpem-2026-0331

Mechanism Graph

Pandemic-related lockdowns increased sedentary behavior, weight gain, screen exposure, and sleep disruption
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These factors may disrupt melatonin rhythms and increase psychological stress
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Environmental EDCs (e.g., musk ambrette, QACs) may activate KISS1R or GnRHR signaling in experimental systems
↓
Result: Higher odds of central precocious puberty, particularly in girls

Limitations

  • ⚠Causal mechanisms remain unproven; pediatric exposure levels, internal dose, and target-tissue concentrations are not established
  • ⚠The review is narrative and hypothesis-generating, not a systematic meta-analysis with definitive effect sizes

Frequently Asked Questions

What is central precocious puberty (CPP)?▼

CPP is early onset of puberty due to premature activation of the hypothalamic-pituitary-gonadal axis, leading to early development of secondary sexual characteristics.

Why did CPP increase during the COVID-19 pandemic?▼

Proposed mechanisms include lifestyle changes like increased screen time, weight gain, sleep disruption, psychological stress, and exposure to environmental endocrine-disrupting chemicals, but no single cause has been proven.

Is the increase in CPP seen only in girls?▼

The abstract notes a strong female predominance in the rise of CPP during the pandemic, though boys may also be affected.

What are the proposed chemical triggers for CPP?▼

Selected compounds like musk ambrette and some quaternary ammonium compounds (QACs) can activate KISS1R or GnRHR signaling in lab experiments, but human evidence is lacking.

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References

  1. 1.Chen X, Ding S. "Post-COVID-19 rise in central precocious puberty: an integrative Review.." Journal of pediatric endocrinology & metabolism : JPEM, 2026. PMID: 42515816 DOI: 10.1515/jpem-2026-0331
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.