What is the relationship between melatonin and puberty?

From the Guidelines

Melatonin supplementation should be used cautiously in children and adolescents approaching or going through puberty, as it may potentially influence pubertal timing. When considering the relationship between melatonin and puberty, it is essential to weigh the potential benefits of melatonin supplementation against the possible risks to reproductive development.

Key Considerations

• Melatonin is a hormone that regulates sleep-wake cycles, with levels typically rising at night to promote sleep.
• During puberty, there is a natural decline in nighttime melatonin production, which may be part of the biological trigger for pubertal development.
• A study published in the Journal of Clinical Sleep Medicine in 2015 1 found no significant differences in pubertal development among children using melatonin (mean dose ~3 mg) compared to non-melatonin users in the general population.

Recommendations

• Parents should prioritize non-pharmacological approaches to sleep problems first, such as consistent sleep schedules, limiting screen time before bed, and creating a sleep-conducive environment.
• If melatonin is needed, it should be used at the lowest effective dose for the shortest necessary duration, ideally under healthcare provider supervision.
• Children with certain conditions like autism spectrum disorder or ADHD may particularly benefit from melatonin for sleep issues, but the potential effects on puberty should still be considered in the risk-benefit assessment.

Important Notes

• The evidence regarding the effects of melatonin on puberty is limited and inconclusive, and more research is needed to fully understand the relationship between melatonin and pubertal development.
• Caregivers should be aware of the potential concerns related to growth hormone regulation and reproductive function/development when using melatonin supplements in children and adolescents.

From the Research

Relationship Between Melatonin and Puberty

The relationship between melatonin and puberty is complex, with some studies suggesting a potential link between the two, while others find no significant association.

• Melatonin is known to have effects on the reproductive systems of various animals, including rodents, sheep, and primates 2.
• However, studies in humans have yielded mixed results, with some suggesting that melatonin may play a role in regulating pubertal onset, while others find no evidence to support this claim 3, 4.
• One study found that the 24-hour profile of plasma melatonin was similar in prepubertal, pubertal, and adult males, suggesting that melatonin may not play a significant role in the initiation of normal or precocious puberty in humans 4.
• Another study found that long-term administration of melatonin to prepubertal children may affect the timing of puberty, although the evidence is limited and more research is needed to fully understand this potential relationship 3.
• A systematic review and GRADE assessment found that melatonin was not associated with serious adverse events, but may be associated with non-serious adverse events, and that the long-term consequences of melatonin treatment on pubertal development and bone health are uncertain 5.

Effects of Melatonin on Pubertal Development

The effects of melatonin on pubertal development are not fully understood and require further research.

• Some studies suggest that melatonin may play a role in regulating pubertal onset, although the evidence is limited and inconclusive 3, 4.
• One study found that melatonin treatment was not associated with significant deviations in pubertal development in children with delayed sleep-wake phase disorder 2.
• Another study found that long-term administration of melatonin to prepubertal children may affect the timing of puberty, although the evidence is limited and more research is needed to fully understand this potential relationship 3.
• A systematic review and GRADE assessment found that the long-term consequences of melatonin treatment on pubertal development and bone health are uncertain, and that more research is needed to fully understand the potential effects of melatonin on these outcomes 5.

Melatonin and Sleep Disorders

Melatonin has been shown to be effective in treating sleep disorders, including insomnia and circadian rhythm sleep-wake disorders.

• Melatonin has been found to synchronize circadian rhythms, improve sleep onset, duration, and quality, and has anti-oxidation, circadian rhythmicity maintenance, sleep regulation, and neuronal survival properties 6.
• Melatonin treatment has been found to be effective in improving sleep latency and sleep quality in children and adolescents with delayed sleep-wake phase disorder 2.
• A systematic review and GRADE assessment found that melatonin was not associated with serious adverse events, but may be associated with non-serious adverse events, and that the long-term consequences of melatonin treatment on pubertal development and bone health are uncertain 5.