How Early Puberty can Affect Mental Health

There is increasing evidence that early puberty influences mental health, behavior, and emotional well-being in young people in a variety of ways. Starting puberty before their peers can be confusing and disruptive to children, often damaging their confidence and self-esteem. Moreover, early puberty has been linked to early sexual behavior, substance abuse, criminal behavior, and higher rates of psychiatric problems [1].

What is Early Puberty?

Puberty is a time of great change for children, as they transition from childhood to adolescence. It affects males and females in slightly different ways but is generally marked by physical maturation, changes in hormone levels, and hair growth. Usually, girls hit puberty between ages 8 and 13, while boys reach puberty between ages 9 and 15. While the visible physical signs of puberty can be alarming and even distressing for young people, it is often the invisible changes, such as hormone production and brain development, that can cause the most profound changes. Sex hormones – estrogen and progesterone for girls and testosterone for boys – play a crucial role in brain development during puberty. If puberty begins early, a child may not be physically and emotionally prepared for these changes, which can have wide-ranging consequences [1].

Early puberty occurs before the age of eight for girls and before nine for boys. The exact causes of early puberty are unknown; however, it is shown to be more common in females, overweight or obese children, and those exposed to sex hormones. Certain medical conditions are also linked to early puberty, and studies have recently found that girls with autism spectrum disorder (ASD) get their period over nine months earlier on average than those without ASD [2]. As ASD can also affect emotional well-being and mental health, awareness of the impact of early-onset puberty is important.

Signs of Early Puberty

The signs of early puberty differ in males and females because the hormones released by the pituitary gland are different for each sex.

In females, early puberty is marked by the following signs before the age of 8 years old:

  • Developing breasts
  • Growing pubic hair 
  • Growing armpit hair
  • Growing significantly in height in a short amount of time
  • Starting menstruation (bleeding once a month, or irregularly)
  • Developing pimples or acne
  • Changing body odor
  • Secreting more oil in the face and scalp

For males, the following signs before the age of 9 years are a sign of early puberty:

  • Enlarging testicles or penis
  • Growing pubic, armpit, and/or facial hair
  • Growing significantly in height in a short amount of time
  • Changing voice, including a gradual deepening
  • Developing pimples or acne
  • Changing body odor

It is also possible to experience certain signs of puberty and not others. For example, a girl’s breasts may develop, yet her period doesn’t start until much later. In addition, a boy may develop acne and body odor yet grow no facial hair. 

Impacts of Early Puberty 

Puberty – even when commencing at the standard age relative to sex – is associated with increased behavioral issues in males and increased anxiety, depression, and self-harm in females [3]. Puberty also causes fatigue, irritability, somatic complaints, and a generally lower sense of well-being [1]. It is predicted that these issues are further exacerbated when puberty begins earlier. Young people are less likely to have the skills to deal with these challenges, which can lead to maladaptive coping mechanisms. 

Early maturation increases the risk of negative status outcomes in adolescence, such as running away, substance-related dangerous behavior, and sexual behavior, according to one study [1]. Depression and criminal charges during adolescence were also notably higher with early puberty, and substance abuse was the strongest notable behavioral effect of early maturation. The exact causes of these outcomes are the topic of much speculation, and many researchers discuss the interrelationship among environment, mental health, and biology.

For young girls in particular, reaching developmental milestones earlier may lead to certain expectations or assumptions with respect to their age. Being socialized too early as young women may impact young girls’ senses of self. For example, unrealistic expectations of how they should respond to certain situations, stressors, or academic problems or how they should self-manage their emotions, can put unnecessary stress and pressure on young people who feel unable to live up to others’ expectations. Moreover, girls who appear older than they are as a result of early puberty may be treated as if they were ready for sexual experiences when they are not. Studies show that female and gender-nonconforming adolescents who reach puberty earlier receive unwanted sexual attention in earlier adolescence than their peers [4]. Sexual harassment can impact mental health at any phase of development into adulthood. However, it is hypothesized that unwanted sexual advances and harassment as a teenager can be more impactful because young people have less resilience to trauma.

Early puberty may also lead to socialization with older adolescents, who have better-developed impulse control and emotional regulation. Feeling “stuck” between those who are their age but look younger and those who are more mature but look developmentally the same can cause isolation and lead to depression and poor self-esteem. 

This is also true for young boys.  However, because physical developmental changes are often less evident and they tend to reach puberty later than girls, boys are more likely to be at a similar stage of physical development to children their age or be in the same class at school. For gender-nonconforming children, including those who are transgender, this can be particularly confusing. In some cases, reaching puberty means coming to terms with parts of their identity that they had not previously thought about. Going through this as young as 8 presents a significant challenge to understanding and navigating a changing body that they may not identify with. A similar difficulty is faced by intersex children, who may be socialized as male but possess female sex hormones. Early puberty can make this more difficult to adapt to and explain to peers.

Another significant impact of early puberty is that young people feel different from their peers, struggle with not “fitting in,” and become embarrassed about their appearance. This can greatly affect mental health and result in higher rates of disordered eating, self-harm, anxiety, suicide attempts, and distorted self-image [5]. 

Most people can look back on their early teenage years and remember – whether with great joy or anxiety – the confusing process of navigating life in a changing body. For many, there are memories of heightened emotional responses, lower tolerance to stress, and even anger. For young people who experience early puberty, this process can be even more confusing and isolating. Ensuring they have resources to understand the changes they are experiencing and stable support from parents or caring professionals can help mitigate the development of maladaptive coping mechanisms and mental disorders.

If you or a loved one is struggling with anything you have read in this blog, please contact Heather R. Hayes & Associates – call 800-335-0316 or email today.


[1] Copeland, W., Shanahan, L., Miller, S., Costello, E. J., Angold, A., & Maughan, B. (2010). Outcomes of early pubertal timing in young women: A prospective population-based study. American Journal of Psychiatry, 167(10), 1218–1225. 

[2] Corbett, B. A., Vandekar, S., Muscatello, R. A., & Tanguturi, Y. (2020). Pubertal timing during early adolescence: Advanced pubertal onset in females with autism spectrum disorder. Autism Research, 13(12), 2202–2215. 

[3] Viner, R. (2015). Puberty, the Brain and Mental Health in Adolescence. In: Bourguignon, JP., Carel, JC., Christen, Y. (eds) Brain Crosstalk in Puberty and Adolescence. Research and Perspectives in Endocrine Interactions, vol 13. Springer, Cham.

[4] Skoog, Therése & Bayram Özdemir, Sevgi. (2016). Explaining why Early-Maturing Girls are More Exposed to Sexual Harassment in Early Adolescence. The Journal of Early Adolescence. 36. 490-509. 10.1177/0272431614568198. 

[5] Kaltiala-Heino, R., Marttunen, M., Rantanen, P., & Rimpelä, M. (2003). Early puberty is associated with mental health problems in middle adolescence. Social Science & Medicine, 57(6), 1055–1064. 

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