Premature Pubarche: A Pragmatic Approach.

Premature pubarche (PP) is a common and usually benign variant of normal puberty most often seen in 5-year-old to 9-year-old children. Some providers routinely order laboratory testing and a bone age to try to rule out other diagnoses including nonclassic congenital adrenal hyperplasia and gonadal or adrenal tumors. I review the natural history of PP and studies which suggest that without clinical features such as rapid growth and progression or genital enlargement, it is unlikely that a treatable condition will be found. Therefore it is recommended that patients with PP not undergo testing unless there are red flags at the time of the initial visit.

Effects of pubic hair grooming on women's sexual health: a systematic review and meta-analysis.

BACKGROUND: Pubic hair grooming involves the partial or complete removal of pubic hair, and it is a common practice among men and women. Grooming is more prevalent in women, who employ various methods such as shaving, waxing and laser removal. However, it is associated with variable rates of post-grooming adverse outcomes including lacerations and sexually transmitted infections (STIs). To the best of our knowledge, this is the first systematic review and meta-analysis comparing women's sexual health outcomes between those who groom and those who don't. METHODS: We followed the MOOSE guidelines and conducted a computerized-based search using (PubMed, Web of Science, Scopus, and Ovid Medline), till June 20th, 2022, for eligible studies using the relevant keywords; (pubic hair grooming) OR (pubic hair removal OR Genital hairless OR Bikini hair removal OR pubic hair depilation). Cross-sectional studies included which compared grooming practices among women in terms of motivation and health outcomes. Women's satisfaction and incidence of STIs were pooled as standardized mean difference (SMD) and odds ratio (OR) respectively. RESULTS: Twenty-Two cross-sectional studies were included in our review with 73,091 participant.The odds of having gram-negative gonorrheal and chlamydial infection in Pubic hair groomers were found to be statistically significant (OR = 1.55, 95% CI [1.31, 1.84], P < 0.001) (OR = 1.56, 95% CI [1.32, 1.85], P < 0.001] respectively. There was no difference between groomer and non-groomer women regarding viral infections such as genital herpes (OR = 1.40, 95% CI [0.56, 3.50], P = 0.47) and Condyloma acuminata (OR = 1.75, 95% CI [0.51, 6.01], P = 0.37). The most common grooming side effect is genital itching (prevalence = 26.9%, P < 0.001). Non-electrical razor (prevalence = 69.3%, P < 0.001) is the most common grooming method. White women (prevalence = 80.2%, P < 0.001) remove pubic hair more frequently compared to black women (prevalence = 12.2%, P < 0.001). Women practice complete grooming (50.3%, P < 0.001) of the pubic hair more frequently than partial grooming (33.1%, P < 0.001). There are no differences in women's satisfaction between the two groups (SMD = 0.12, 95% CI [-0.16, 0.40], P = 0.39). CONCLUSION: This review aligns with previous observational studies regarding sexual health outcomes of pubic hair grooming. There is a need to raise awareness among women regarding the safe practice of pubic hair grooming, emphasizing the clarification of hazards and benefits.

Premature pubarche during minipuberty - literature review and two case reports.

INTRODUCTION: Isolated premature pubarche (PP) in infancy may be the reason for many diagnostic difficulties. This is due to the low incidence and, therefore, the limited number of studies on this subject and the lack of strict laboratory standards because of the physiological variability of gonadotropic hormone and androgen concentrations during minipuberty. MATERIAL AND METHODS: We aimed to present current knowledge about PP in infancy based on the literature review and 2 cases of male infants with scrotal hair during minipuberty. RESULTS: Isolated hair in the pubic region in a boy during the period of minipuberty requires differential diagnosis. After excluding serious aetiology, it seems to be a mild, self-limiting variant of precocious puberty. The phenomenon is probably a result of increased sensitivity of the hair follicles to transiently increased androgen concentration. CONCLUSIONS: Isolated pubic hair in infancy as a mild, self-limiting variant of precocious puberty in infants should be a diagnosis of exclusion. The condition resolves spontaneously, but it absolutely requires further follow-up to exclude serious aetiology in the case of puberty progression.

The surface and internal features of pubic hair: A comparative study with those of scalp hair.

Although pubic hair has been a subject of public interest, little is known about its structure or characteristics beyond its curly and coarse appearance. In this study, we investigated the surface and internal features of pubic hair from Korean males and compared them to those of scalp hair from the same donors. Our findings indicate that the cuticle layer of pubic hair has a greater number of scales than that of scalp hair, resulting in a thicker cuticle layer overall. Fourier-transform infrared (FT-IR) spectroscopy analysis showed that the protein in the cortex layer of pubic hair was less affected by exposure to urine or ammonia than the protein in the cortex layer of scalp hair. This suggests that the cuticle layer of pubic hair, which is thicker and composed of more scales, acts as a physical barrier that protects the hair's internal structure. Furthermore, we observed that the secondary and tertiary structures of keratin in the pubic hair cuticle layer are essentially different from those in scalp hair. Based on these findings, we hypothesize that the thickened cuticle layer in pubic hair may have evolved as a defence mechanism against chemical damage from urine, urea and ammonia.

Changes to pubic hair removal practices during COVID-19 restrictions and impact on sexual intimacy.

Pubic hair grooming (hair removal) has been linked to body image and sexual behaviour and, given the impacts of COVID-19 restrictions on access to sexual partners and beauty salons, we explored these associations. Data derive from a cross-sectional online survey. Participants were aged 18 years or over and in Australia. All genders were included. We explored factors associated with changes to hair removal using logistic regression and analysed free-text responses using content analysis. Of 256 participants, 89 (34.8%) had changed their grooming practices. Multivariable analysis found that female participants had 4.5 times increased odds of changed grooming (95%CI 1.8, 11.0; p = 0.001) compared with males. Individuals who reported 'more' or 'less' oral sex compared with the previous year were more likely to report increased odds of changed grooming (AOR 3.2; 95%CI: 1.4, 7.7; p = 0.009 and AOR: 3.3; 95%CI:1.6, 6.7; p = 0.001, respectively). Most who changed their grooming practices said it had reduced, attributing this to lack of partners, inability to access beauticians, and the mental health effects of the pandemic. For most, this change had no impact on sexual behaviour or body image; however, some spoke of reduced sexual desire and willingness to receive oral sex. Partner expectations influenced whether reduced grooming had negative consequences, and women were more affected than men, highlighting a gendered impact.

Attitudes and practices associated with pubic hair grooming behaviours: A cross-sectional study.

BACKGROUND: Female pubic hair grooming (PHG) habits have changed in the last 20 years. Most studies present findings around female PHG attitudes, practices, and behaviours, lacking data on male attitudes and practices. AIMS: We explored the attitudes and practices of PHG from male and female perspectives. MATERIALS AND METHODS: A cross-sectional convenience survey was conducted online with 1560 male and female young adult participants aged 18 to 25 years. The study was conducted over two time periods (2014 and 2021). The survey explored attitudes, practices, and behaviours around PHG. Descriptive statistics included frequencies and proportions for categorical variables and the median for continuous variables. Males and females were compared using the χ2 test or Fisher's exact test for categorical variables. We used logistic regression to explore independent factors of PHG. RESULTS: Seventy-two percent (n = 471/728) of females and 64.7% (n = 257/728) of males were likely to engage in PHG. Participants were more likely to groom their pubic hair for reasons associated with religion (adjusted odds ratio (aOR): 9.01, 95% CI: 2.87-28.2), comfort when wearing clothing (aOR: 3.85, 95% CI: 1.52-9.71), a neater and cleaner genital appearance (aOR: 3.90, 95% CI: 1.62-9.41) and before attending a healthcare consultation (aOR: 4.79, 95% CI: 2.27-10.09). Moreover, twice as many females compared with male groomers reported watching pornography (69.7% vs 30.3%). CONCLUSION: Several factors can influence PHG. Our findings demonstrate that the reasons participants engage in PHG practices are for hygiene, aesthetics, comfort, and sexual satisfaction.

Measures of puberty in the Avon Longitudinal Study of Parents and Children (ALSPAC) offspring cohort.

Background: When studying the development of children through the preteen years into adolescence, it is often important to link features of their physical and mental health to the stage of puberty at the time. This is complex since individuals vary substantially in the ages at which they reach different pubertal milestones. Methods: The Avon Longitudinal Study of Parents and Children (ALSPAC) is an ongoing longitudinal cohort study based in southwest England that recruited over 14000 women in pregnancy, with expected dates of delivery between April 1991 and December 1992. From 1999, information on puberty was collected using a number of different methods : (a) A series of annual questionnaires were administered when the index children were aged between eight and 17 years; these were mainly concerned with the physical changes associated with puberty; (b) identification of the age at peak height growth using the SITAR methodology; and (c) retrospective information from the girls on their age at onset of menstruation (menarche). Results: The advantages and disadvantages of each method are discussed. Conclusions: The data are available for analysis by interested researchers.

Determination of endogenous GHB levels in chest and pubic hair.

Endogenous nature of GHB represents a critical issue for forensic toxicologists, especially in alleged sexual assaults. Therefore, discrimination between physiologically and additional amounts from exogenous sources of such a substance must be effective and reliable in order to avoid severe misinterpretation. This study aimed to quantify the GHB baseline concentrations in chest and pubic hairs collected from 105 healthy volunteers, non-consumers of any drugs of abuse. The final scope was to investigate if these keratin matrices could represent valid alternative to scalp hair when not available. Moreover, we also evaluated the age and gender influences on the GHB baseline levels. 25 mg of hair were incubated overnight with NaOH at 56 °C. After acidification with H2SO4, the solution was liquid-liquid extracted with ethyl acetate and a trimethylsilyl derivatization was then achieved. Analysis was performed in gas chromatography-mass spectrometry in single ion monitoring mode (m/z 233, 234, 147 for GHB; m/z 239, 240 and 147 for GHB-d6). The endogenous amount in "blank" hair was estimated by the standard addition method (0.301 for chest hair and 0.235 ng/mg for pubic hair). GHB concentration ranged from 0.205 to 1.511 ng/mg for chest hair and from 0.310 to 1.913 ng/mg for pubic hair. These values were consistent with previous studies on scalp hair and on pubic hair. Unfortunately, research on chest hair is not available in literature. T-Test and Linear Regression highlighted no statistically significant differences for the two matrices and for all age/gender sub-groups. However, further studies are required to estimate a reliable cut-off value for these keratin matrices. For the first time, we demonstrated the suitability of chest and pubic hair to detect endogenous levels of GHB.

"You have to be clean:" a qualitative study of pubic hair grooming behaviours among women living in Italy.

The majority of pubic hair and genital self-image research describes women living in the USA, UK and Australia. This may leave attitudes and behaviours across other cultures and geographic regions ambiguous. The purpose of this study was to describe pubic hair removal attitudes and behaviours among reproductive-age women living in Italy. Individual interviews were conducted with 46 women aged 18-45 years between June and July 2017, living in Florence, Italy and currently utilising the Italian healthcare system. Pubic hair removal was popular among participants. Women mainly removed pubic hair by waxing. Sexual partners influenced removal, as did cultural norms and the desire for cleanliness. Most participants indicated pubic hair removal onset during adolescence, often upon puberty. However, most participants had never discussed removal complications with providers. Pubic hair removal often related to a more positive genital self-image because of social norms surrounding hairlessness. Removal among this sample appears to differ from the literature in other contexts, with women living in Italy engaging in more frequent and earlier waxing. Findings offer opportunities for clinicians to proactively address safe pubic hair practices and women's genital concerns during consultations.

Common Childhood Viruses and Pubertal Timing: The LEGACY Girls Study.

Earlier pubertal development is only partially explained by childhood body mass index; the role of other factors, such as childhood infections, is less understood. Using data from the LEGACY Girls Study (North America, 2011-2016), we prospectively examined the associations between childhood viral infections (cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) 1, HSV2) and pubertal timing. We measured exposures based on seropositivity in premenarcheal girls (n = 490). Breast and pubic hair development were classified based on mother-reported Tanner Stage (TS) (TS2+ compared with TS1), adjusting for age, body mass index, and sociodemographic factors. The average age at first blood draw was 9.8 years (standard deviation, 1.9 years). The prevalences were 31% CMV+, 37% EBV+, 14% HSV1+, 0.4% HSV2+, and 16% for both CMV+/EBV+ coinfection. CMV+ infection without coinfection was associated with developing breasts an average of 7 months earlier (hazard ratio (HR) = 2.12, 95% confidence interval (CI): 1.32, 3.40). CMV infection without coinfection and HSV1 and/or HSV2 infection were associated with developing pubic hair 9 months later (HR = 0.41, 95% CI: 0.24, 0.71, and HR = 0.42, 95% CI: 0.22, 0.81, respectively). Infection was not associated with menarche. If replicated in larger cohorts with blood collection prior to any breast development, this study supports the hypothesis that childhood infections might play a role in altering pubertal timing.

La remoción de vello genital en mujeres gestantes en Colombia / Genital hair removal in pregnant women in Colombia

RESUMEN Introducción: La remoción del vello genital es muy común, siendo cada vez más popular la remoción total en mujeres en edad fértil. Los principales motivos para eliminar el vello púbico son la higiene, el atractivo físico y la feminidad; sin embargo, no es una práctica exenta de complicaciones. Actualmente, existe poca información sobre esta conducta en embarazadas. Objetivo: Describir la frecuencia y las características de la remoción del vello genital en gestantes de bajo riesgo obstétrico en una institución de primer nivel de Colombia. Material y métodos: Estudio prolectivo de cohorte que siguió durante todo el embarazo a 60 gestantes de bajo riesgo obstétrico en una institución de primer nivel. Se entregó una encuesta autoaplicable trimestral sobre la práctica de remoción del vello genital. Se compararon los resultados en diferentes trimestres del embarazo. Resultados: La mediana de la edad de las gestantes fue 22 años; 61% estaban en su primera gestación. Más del 95% reportó una conducta de remoción total al menos una vez en el mes previo a cada encuesta; la conducta puede calificarse como remoción permanente en más del 65% de los casos. El método empleado con más frecuencia (94%) fue la remoción con cuchilla de afeitar. No se encontraron cambios en esta práctica a lo largo del embarazo. Conclusión: A pesar de las complicaciones conocidas asociadas a esta conducta muchas mujeres rasuran su vello genital debido a diversas razones socioculturales. Este estudio encontró una alta prevalencia de la práctica de remoción de vello genital en gestantes, sin que se evidenciara que dicha conducta cambiase a lo largo del embarazo.

SUMMARY Introduction: Genital hair removal is very common, with the increasingly popular tendency for total removal in women of childbearing age. The main reasons for removing pubic hair are hygiene, physical attractiveness and aesthetic; however, it is not a complication-free practice. Currently, there is little information about this behavior in pregnant women. Aim: To describe the frequency and characteristics of genital hair removal in pregnant women with low obstetric risk in a first level institution in Colombia. Material and methods: Prolective cohort study was conducted that included 60 pregnant women with low obstetric risk in a first level institution. A self-applicable survey on the practice of genital hair removal was delivered each trimester. The results were compared in different trimesters of pregnancy. Results: The median age was 22 years; 61% were primigestant. More than 95% reported total genital hair removal at least the previous month to survey; this conduct could be considered as permanent in 65% of women. The most frequently used method was razor blade removal (93.8%). No changes were found in this practice throughout pregnancy. Conclusion: Despite the known complications associated with this behavior, many women shave their genital hair due to various sociocultural reasons. This study found a high prevalence of the practice of genital hair removal in pregnant women, without evidencing that such behavior changed throughout pregnancy.

Body hair removal: Prevalence, demographics, and body experience among men and women in Germany.

BACKGROUND: Body hair removal is an increasing trend that has an impact on the individual's body image. AIMS: To characterize current body hair removal practices in Germany and the extent to which body hair removal was related to demographic characteristics, body image, and body mass index. PATIENTS/METHODS: A national survey was conducted from September to October 2016 in men and women in Germany. Body experience was measured by a standardized questionnaire. In addition to sociodemographic data, age, gender, education, marital status, monthly income, and body mass index were collected. RESULTS: A total of n = 2510 participants aged 14 to 94 years (Mage = 48.4 years (SD = 18.2), 53.4% females) were randomly selected from the general population. 69% of the questioned women removed their body hair while only 41% of men do. The gender effect is statistically significant (χ2  = 203.43; df = 1; P < .001). Income, a higher level of education, and living in an urban region were significantly associated with body hair removal in both, men and women. Furthermore, significant differences with regard to body image were found between hair removers and nonremovers which are associated with a different attitude toward the own body. CONCLUSIONS: Germans were likely to remove body hair if they were of younger age, better educated, and with high income. Hair removal is above all a women's issue. Especially, female hair removers experience their body as an esthetic entity with the need of active reshaping. There is a "shift" from ideal of a naturally hairy body to an increased hairlessness in Germany.

A full Brazilian or all natural: understanding the influences on young women's decision to remove their pubic hair.

BACKGROUND: Research indicates that young women are being exposed to increasing pressures to remove pubic hair from their bodies, which has the potential for both negative physical and psychological consequences. Women's personal choice and reasoning for partaking in pubic hair removal is influenced by broader social influences; however, there is little theory-based research drawing from established decision-making models investigating the underlying processes that lead young women to engage in pubic hair removal practices. Based on the Theory of Planned Behaviour, it was hypothesised that 1) attitude, subjective norm, and perceived behavioural control would predict intention to remove pubic hair; 2) additional variables (prototype similarity and favourability) from the Prototype Willingness Model would significantly predict intention to remove pubic hair; 3) feminist values would significantly predict decreased intention to remove pubic hair; and 4) intention and perceived behavioural control would predict future self-reported removal of pubic hair. METHOD: The current study included a sample of 270 young women (17-25 years old), who completed an online survey and a follow up survey 4 weeks later (N = 96). RESULTS: Attitudes, perceived behavioural control, and similarity to prototypical pubic hair removers were significant predictors of intention to remove pubic hair. Intention was significantly positively associated and feminist values were significantly negatively associated with actual pubic hair removal. CONCLUSIONS: These findings align with Theory of Planned Behaviour propositions. Furthermore, the expansion of the model highlights how broader social images impact on young women when deciding whether to engage in a behaviour that is intimately associated with their body image.

"To Shave or Not to Shave": Pubic Hair Removal and Its Association with Relational and Sexual Satisfaction in Women and Men.

BACKGROUND: Pubic hair removal (PHR) is a widespread practice that entails certain health risks; however, there remains a lack of scientific information on the prevalence and antecedents of PHR, as well as on its association with sexual behavior and relational satisfaction. AIMS: To explore women's and men's attitudes regarding PHR and their PHR practices and the associations with demographic, relational, and sexual characteristics. METHODS: A total of 2,687 men and 1,735 women living in Flanders (the Northern part of Belgium) completed an online survey. Participants ranged in age from 15 to 60+ years; they self-identified as heterosexual, bisexual, or homosexual and reported various relationship statuses. MAIN OUTCOME MEASURES: Demographic items (ie, age, religion, partner relationship status), sexuality-related items (ie, sexual activity, sexual orientation, age at first intercourse, number of sexual partners), PHR items (ie, reasons, inclination to have or not have sex after PHR, perceived partner preferences, partner's PHR), and relationship satisfaction, assessed with the Maudsley Marital Questionnaire. RESULTS: Fewer men (39.1%) than women (80.3%) reported (partially) removing their pubic hair. In both men and women, the practice was associated with age, sexual activity, relationship status, and partner's PHR practice and expectations. In men, sexual and relationship satisfaction were correlated with their partner's PHR practices and whether these were in line with the men's expectations. In women, sexual and relationship satisfaction were mostly correlated with whether both partner's expectations were met. Although both men and women reported that the reasons for PHR were related to their sexual experiences and to their partner's preference, only women reported that PHR was a way to enhance feelings of femininity. Finally, the reasons for not engaging in PHR were related to partner preferences and side effects. CONCLUSION: PHR is a widespread practice and seems strongly associated with personal, partner-related, sexual, and relational factors. Strategies to prevent men and women from being confronted with health risks should take all these factors into account. Enzlin P, Bollen K, Prekatsounaki S, et al. "To Shave or Not to Shave": Pubic Hair Removal and Its Association with Relational and Sexual Satisfaction in Women and Men. J Sex Med 2019;16:954-962.

Fluoride exposure and pubertal development in children living in Mexico City.

BACKGROUND: Previous animal and ecological studies have provided evidence for an earlier sexual maturation in females in relation to fluoride exposure; however, no epidemiological studies have examined the association between fluoride exposure and pubertal development in both boys and girls using individual-level biomarkers of fluoride. Capitalizing on an ongoing Mexican birth cohort study, we examined the association between concurrent urinary fluoride levels and physical markers of pubertal development in children. METHODS: We conducted a cross-sectional study of 157 boys and 176 girls at age 10-17 years living in Mexico City. We used ion-selective electrode-based diffusion methods to assess fluoride levels in urine, adjusting for urinary specific gravity. Pubertal stages were evaluated by a trained physician. Associations of fluoride with pubertal stages and age at menarche were studied using ordinal regression and Cox proportional-hazard regression, respectively. RESULTS: In the entire sample, the geometric mean and interquartile range (IQR) of urinary fluoride (specific gravity adjusted) were 0.59 mg/L and 0.31 mg/L, respectively. In boys, our analysis showed that a one-IQR increase in urinary fluoride was associated with later pubic hair growth (OR = 0.71, 95% CI: 0.51-0.98, p = 0.03) and genital development (OR = 0.71, 95% CI: 0.53-0.95, p = 0.02). No significant associations were found in girls, although the direction was negative. CONCLUSIONS: Childhood fluoride exposure, at the levels observed in our study, was associated with later pubertal development among Mexican boys at age 10-17 years. Further research is needed to confirm these findings.

The associations between left-hand digit ratio (2D:4D) and puberty characteristics among Chinese girls.

BACKGROUND: The aim of this study was to analyse the associations of left-hand digit ratio (2D:4D), digit length and puberty characteristics to show the role of prenatal hormones in development among Chinese girls. METHOD: A total of 318 Chinese girls aged 8-15 years were recruited using a stratified cluster sampling method. The index finger (2D), ring finger (4D) of the left hand, oestradiol and testosterone were measured, and age at menarche (AAM), breast (high and low) and pubic hair (high and low) development were recorded. RESULTS: Girls who had experienced menarche had longer left digits (2D and 4D) and higher oestradiol, testosterone than those who had not. The high breast group had longer digits (2D and 4D), and higher oestradiol than the low breast group. With regard to pubic hair development, the high group had high 2D:4D, longer 2D and higher oestradiol, testosterone than the low group. After adjusting for oestradiol and testosterone, 4D length was positively related to occurrence of menarche. In addition, 2D and 2D:4D were significantly correlated with pubic hair development after adjusting for oestradiol, respectively. CONCLUSION: Prenatal hormone level may be related to the development of puberty characteristics among Chinese girls.

Relationships between puberty timing and problem behaviors among 6~11 year-old girls / 中国神经精神疾病杂志

Objective To explore the relationships between advanced puberty timing and frequencies of problem behaviors using two different indexes of pubertal development as cut-off standards. Methods A total of 3003 primary school girls aged 6~11 in Beijing were recruited in the study. Parent-assessed Tanner staging according to the menarche and pubic hair development level and the Achenbach Child Behavior Checklist were applied. Results When timing of menarche and pubic hair development stage were used as reference, the detection rate of girls with advanced puberty timing was 11.2% (337/3003) and 3.4% (101/3003), respectively. The scores of withdrawal problem (Z=-2.23, P=0.03) and physical problem (Z=-2.64, P=0.01) were higher in the advanced menarche group than in the moderate group. The scores of withdrawal behavior problem were higher in the advanced pubic hair development group than in the moderate group (X2=2.53, P=0.03). Scores of social problem (X2=2.71, P=0.02), aggression problem (X2=2.50, P=0.04), total score of problem behavior (X2=2.64, P=0.03) were also higher in the advanced pubic hair development group than in the delayed group. The correlation between the pubertal timing results based on the two different cut-off standards was not significant (r=0.04, P=0.06). Conclusion T he detection rate of girls with advanced puberty timing are different using the two different cut-off standards. The prominent problem behaviors in the advanced group are also different. Compared with girls with advanced menarche, girls with advanced pubic hair development may have more prominent problem behaviors than those with moderate development.

Practices and complications of pubic hair removal among Saudi women.

BACKGROUND: Pubic hair grooming, including the complete removal of pubic hair, has become an increasingly common practice, particularly among young women. Although widespread, there is limited data regarding the methods, products, reasons, and complications of pubic hair removal, particularly among Saudi women. The objective was to examine pubic hair removal practices and the prevalence of its complications among Saudi women living in Jeddah, Saudi Arabia. METHODS: In this cross-sectional study conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, Saudi women between 16 and 60 years of age who had the ability to read and speak Arabic, were eligible to complete an anonymous and self-administered survey on pubic hair removal practices and its complications. RESULTS: Between December 2015 and September 2016, 400 Saudi women completed the survey. The age was 26.3 ± 6.9, 16-58 (mean ± SD, range) years. About three quarters (77.0%) self-removed their pubic hair, while the remainder made use of professional personnel in medical clinics (15.5%), beauty salons (5.3%), and professional services at home (2.2%). Many women (41.8%) used a combination of hair removal methods, with non-electric razor as the most common single method used (33.5%), followed by laser (8.7%), sugaring (6.0%), waxing (4.5%), trimming (2.0%), electric razor (2.0%), and cream (1.5%). Three-quarters of women (75.5%) reported complications, and although they were mostly minor injuries, treatment had to be sought for 17.9% of complications. Multivariable analyses showed that no variables remained correlated with the occurrence of complications (age of starting hair removal, income, BMI, level of education, mode of removal, advice on removal). CONCLUSIONS: Saudi women initiate pubic hair removal in early adolescence. While most complications are minor, close to one in five women experience complications.

Environmental lead exposure and pubertal trajectory classes in South African adolescent males and females.

The effects of environmental lead exposure in the neuro-endocrine system have been shown to impact the maturation and tempo of puberty development in adolescents. In low and middle income countries very little is known regarding the detrimental health effects of childhood lead exposure with regard to the tempo of puberty development. To help address this gap in data, we examined the association between lead exposure and puberty progression in males and females. Study participants from the urban Birth to Twenty Plus (BT20+) birth cohort in Soweto-Johannesburg, South Africa with data for blood lead levels at age 13years, cord blood lead levels, pubic hair development and breast development in females, and pubic hair development and genital development in males, were included in this study. The sample comprised 1416 study participants (n=684 females). Pubertal development trajectory classes were defined using Latent Class Growth Analysis. Data were examined for (i) an association between cord blood lead levels and pubertal trajectory classes; and (ii) an association between blood lead levels at age 13years and pubertal trajectory classes. In females, there was an association between adolescent elevated blood lead levels (≥5µg/dL) and lower level of maturation at age 9years and slower progression of pubic hair and breast development (relative risk ratio (RRR)=0.45, p<0.0001; 95% CI (0.29-0.68)) and (RRR=0.46, p<0.01; 95% CI (0.27-0.77)), respectively. In males, elevated blood lead levels at birth were associated with slower tempo of pubic hair development (RRR=0.20, p<0.05). Findings from this study suggest a possible role for environmental lead in altering pubertal development in South African adolescents as shown by slower tempo of progression through the Tanner stages pubertal development in females and males. There were also gender-differences between the effects of prenatal and postnatal lead exposure during pubertal development.

Age of pubertal events among school girls in Lagos, Nigeria.

BACKGROUND: Globally, there is a secular trend towards the reduced age for sexual maturity and menarche. This study aimed to determine the current age and factors associated with attainment of various stages of puberty in Nigerian girls. METHODS: This study was a cross-sectional study involving 800 girls aged 6-15 years. The subjects were selected by stratified random sampling method from schools in Oshodi Local Government Area, Lagos State. They were interviewed and a physical examination was carried out to classify them into the various Tanner stages of breast and pubic hair maturational stages. RESULTS: The median age of girls at first stage of breast maturation (B2), first stage of pubic hair development (PH2) and at menarche were 9.0, 9.0 and 12.0 years, respectively. Breast development was significantly related to normal nutritional status (adjusted odds ratio [AOR] 4.5, p<0.001), overweight (AOR 40.2, p<0.001), obesity (AOR 154.2, p<0.001) and upper social class (AOR 15.7, p<0.031). Pubic hair development was significantly related only to overweight (AOR 4.7, p<0.007) and obesity (AOR 15.7, p<0.001) while achievement of menarche was significantly related to overweight (AOR 0.1, p=0.005), obesity (AOR 0.1, p=0.0009), high social class (AOR 4.7, p<0.001) and being a member of the Hausa tribe (AOR 35.8, p<0.029). CONCLUSIONS: There is decline in age of pubertal maturation of girls in Nigeria and the major contributory factors appear to be overweight and obesity. These findings are consistent with the pattern in developed countries.