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The Second Puberty in Your 20s No One Talks About

Sara Geiger

This article is discussing the term “second puberty” from the lens of cisgender women, however, the term “second puberty” can be used within the LGBTQ+ community to describe the changes experienced during HRT. For more on coping with body image changes during gender-affirming transitional periods, check out fedupcollective.org/resources."


If you are a cisgender woman approaching your mid-20s, there’s a chance your body is going through some puzzling changes right now. These changes look and feel different for each person but for many of us, unexpected bodily changes are less than welcome. The journey into adulthood brings with it a plethora of changes. In addition, taking on new roles in interpersonal relationships and in our career can have physical, emotional, and psychological impacts on the body. Just when you thought you had left the pimples and pubic hair of adolescence in the dust, another wave approaches: second puberty. This phenomenon, while not officially acknowledged in the medical community, is a second wave of hormonal shifts that can be accompanied by weight gain, changes in body shape, stretch marks, cystic acne, menstrual shifts, hair loss or growth in unexpected areas, and more.




Maybe, you’re thinking… “FINALLY someone acknowledges what I am experiencing right now. Why has a doctor never spoken to me about this?!” As I mentioned before, you will not find the term “second puberty” in any biology textbook or research journal. In this article, I will explain this unspoken phenomenon with evidence-based science and link to similar articles to further your reading.


It is impossible to talk about a “second puberty” without a proper synopsis of the first one! Puberty, a widely recognized developmental surge in early adolescence, happens because of internal AND external changes to your body. The age of puberty onset varies from 8-14 years old, depending on biological sex (Breehl & Caban, 2023). Hormones play an integral role in the cascade of bodily changes. Gonadotropin-releasing hormone (GnRH) stimulates the gonadotropic cells in the anterior pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH) (Breehl & Caban, 2023). This initial catalyst is responsible for the rise in sex steroid hormone production, which respectively leads to a variety of hair growth, tissue, bone, and muscle growth, vocal deepening, and menstruation for those assigned female at birth (Breehl & Caban, 2023). 


Have I lost you yet?


No? Let’s continue!


Maybe you knew these facts about the first puberty. Between your parents, family, friends, and primary care doctor, hopefully someone along the way sat you down and told you things that might have made prepubescent you say, “ew GROSS!” 


When it comes to the “second puberty” in our mid-20s, cisgender women are much less prepared. 


Unexpected doctor’s visits, experimenting with new birth control, return of acne, old favorite clothes no longer fitting, and endless Google rabbit holes. How did we get here in the first place? 


Why is the maturation of 20-something cisgender women’s bodies healthcare’s best-kept secret?


Undeniably, there is no secret that cisgender women are expected to be in a straight-size*, static body. Reproductive health has a hush-hush taboo that keeps women in searching for the “fix” to their body, keeping them wrapped up in the pursuit of “better.” I often hear clients say… “I wish I could still wear those outfits from college/high school.” The underlying core belief among cisgender women remains that our bodies should not change from roughly age 18 to 25 and so on. Understanding how hormonally and biologically the body continually matures into adulthood is not only crucial; it’s health literacy that can save us time and money!


You earn significant adult milestones in your 20s. There’s legal drinking, the ability to rent a car, and my personal favorite.. peak bone mass and prefrontal cortex development! Yes, that is correct. At the ripe age of 25, you settle into your body both physically and mentally. One of the hallmarks of the “second puberty” phenomenon is a widening of the pelvis in womxn of reproductive age (Huseynov et al., 2016). While you may not be ready to reproduce, evolutionarily, your body is ready to lineage alive (For more on this topic, I highly recommend Sarah E. Hill PhD’s This is Your Brain on Birth Control). In the journal article, “Developmental evidence for obstetric adaptation of the human female pelvis”  “…it says that the female pelvis attains its obstetrically most favorable morphology around the age of 25–30 y, i.e., at the age of highest fertility” (Huseynov et al., 2016). Your bone structure continues to mature into adulthood, even if you would rather scream into a pillow than talk about your 401k.


Aside from the widening of the hips, you may recognize the hormonal fluctuations at play more obviously. Cystic acne, mood swings, chin hair are harder to ignore as hormonal than your favorite jeans being a bit snug one day. Another important mechanism the metabolism employs to prepare for reproduction is an increase in estrogen. First, let’s explain estrogen and its relevance in “second puberty.” Estrogen is a sex steroid hormone that signals crucial systems of the body, including (but not limited to) reproductive, metabolic (think lipid panel and blood sugars), psychological, and dermatological (Lephart & Naftolin, 2021). The target of estrogen is dependent on the specific metabolite, or a derivative of the hormone. As we know from the previous paragraph, our pelvis takes full advantage of the optimal fertility in cisgender women’s mid-20s. Estrogen follows a similar pattern. According to the Journal of Cosmetic Dermatology, “Estrogen levels peak in the mid- to late 20s in women and then decline by 50% by 50 years of age and dramatically decrease further after menopause” (Lephart, 2018). This hormonal surge can contribute to the typical symptoms associated with “second puberty,” like skin, mood, or weight changes.



For folx with an active eating disorder or with any history of disordered eating, seeing your weight increase can be enough to ruin your entire day. New stretchmarks can feel unfathomable, and it can feel like you are losing the self-perceived “control” over your body. While someone without a hyperfixation on bodies and appearance may see a “second puberty” as a natural part of development, someone with an ED may deem themselves flawed. The anxiety that any shape or size fluctuations provoke in the ED population may be enough to spiral into relapse. As with eating disorders, there is a serious taboo around tolerating your bodily changes gracefully in your 20s. A sense of belonging and clarity has been kept from cisgender woman, replaced by a confusing game of hormonal Whack-A-Mole. 


Okay, I am feeling empowered and all, but… are my symptoms still normal?


There are diagnosable hormonally-disruptive conditions that exist outside the normal realm of “second puberty” changes, such as PCOS, endometriosis, and Hashimoto’s thyroiditis. If your health leaves you with more questions than answers, it’s time to check in with a medical professional. A blog post cannot replace one-on-one care with a specialized dietitian or doctor. Any serious concerns about new symptoms should be addressed with your OBGYN or PCP. At New Paths Nutrition, we are open to working WITH you to support your reproductive health and relationship with food and body image. If that is a conversation you’d like to start, head to our “Contact” tab. Thanks for reading!



*Straight-size body: the most commonly stocked sizes, 6-14.


References: 


Breehl, L., & Caban, O. (2023). Physiology, puberty. In StatPearls. StatPearls Publishing. Available from https://www.ncbi.nlm.nih.gov/books/NBK534827/

Clearblue. (n.d.). What is second puberty? https://www.clearblue.com/menstrual-cycle/what-is-second-puberty

Dodds, L. (2023, March 15). What is second puberty? SELF. https://www.self.com/story/what-is-second-puberty

Huseynov, A., Zollikofer, C. P. E., Coudyzer, W., Gascho, D., Kellenberger, C., Hinzpeter, R., Ponce de León, M. S., & Mayor, A. (2016). Developmental evidence for obstetric adaptation of the human female pelvis. Proceedings of the National Academy of Sciences, 113(19), 5227–5232. https://doi.org/10.1073/pnas.1517085113

Lephart, E. D. (2018). A review of the role of estrogen in dermal aging and facial attractiveness in women. Journal of Cosmetic Dermatology, 17(3), 282–288. https://doi.org/10.1111/jocd.12508

Lephart, E. D., & Naftolin, F. (2021). Menopause and the skin: Old favorites and new innovations in cosmeceuticals for estrogen-deficient skin. Dermatology and Therapy (Heidelberg), 11, 53–69. https://doi.org/10.1007/s13555-020-00468-7

Project HEAL. (2022, September 14). Second puberty. https://www.theprojectheal.org/blog/second-puberty

Wise Heart Nutrition. (n.d.). Second puberty. https://www.wiseheartnutrition.com/blog/second-puberty

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