Exposure to non-persistent pesticides and puberty timing: a systematic review of the epidemiological evidence

Eur J Endocrinol. 2021 May 4;184(6):733-749. doi: 10.1530/EJE-20-1038.


Background: Numerous modern non-persistent pesticides have demonstrated estrogenic/anti-androgenic activity and have been classified as endocrine-disrupting chemicals (EDCs). Processes involved in puberty development are vulnerable to EDCs, such as compounds that interfere with the metabolism or activity of sex steroids.

Objective: To conduct a systematic review of epidemiological studies on the relationship between early-life exposure to non-persistent pesticides and puberty timing and/or sexual maturation in girls and boys.

Methods: A systematic search was carried out using MEDLINE and SCOPUS databases, including original articles published up to November 2020.

Results: Thirteen studies were selected after excluding non-original and non-human studies. Exposure to different types of pesticides has been associated with altered puberty timing in girls and/or boys in eight studies. In utero exposure to atrazine has been related to earlier age of menarche in girls; exposure to organophosphate (OP) pesticides has been related to delayed sexual development in boys and girls; childhood pyrethroid exposure has been associated with pubertal delay in girls and pubertal advancement in boys; and prenatal/childhood exposure to multiple pesticides has been linked to earlier puberty onset in girls and pubertal delay in boys.

Conclusions: Most of the reviewed studies describe a relationship between pesticide exposure and changes in the age of puberty onset or sex hormone levels, although the quality of the evidence is generally low. Further well-designed longitudinal studies are warranted on specific classes of pesticides and on possible interactions between different types of compounds.

Publication types

  • Systematic Review

MeSH terms

  • Environmental Exposure / adverse effects*
  • Humans
  • Pesticides / adverse effects*
  • Puberty
  • Puberty, Delayed / chemically induced*
  • Puberty, Delayed / epidemiology*
  • Sexual Maturation


  • Pesticides