Are American Girls Reaching Puberty Earlier?
Puberty…ah, every parent’s favorite memory—and a time each can’t wait to get over with their children. It’s a challenging, hormonal, crazed time which is hard to decipher, harder still to predict—perhaps hardest yet when it finally hits your home.
The hormones should occur sometime during adolescence. The average age is 10 for girls, but no earlier than 7 or 8. Unfortunately, there is a different phenomenon occurring, according to a 2009 research study in Pediatrics journal: American girls are entering puberty much earlier than in the past.
Precocious Puberty (Very Early)
The American Academy of Pediatrics (AAP) says, “Precocious puberty, which can be manifested by the appearance of breast buds in a girl under the age of six or seven, affects approximately 1 in 160 otherwise healthy youngsters. No underlying disease is detected in about 90 percent of these girls.” Initial signs are:
- Breast development
- Pubic or underarm hair
- Growth spurt
- Menstruation
- Acne
- Body odor
Dr. Sherri Martin, a pediatrician with Shawnee Mission Pediatrics, says she sees numerous cases of precocious puberty every year. “What I sometimes see are 5-year-olds with breasts and 6-year-olds with pubic hair,” she says. “You need to perform a thorough exam. Do they have body odor, pubic hair, underarm hair, breasts, or are they growing in height too quickly? Then check their bone age, several hormone blood levels and their thyroid.”
A bone age test, which is an x-ray of the hand and wrist, determines the overall maturity of the child’s bones. If results are advanced, she will send the child to an endocrinologist for further testing and treatment.
“Our world is getting fatter and BMIs (body mass index) are going up,” says Dr. Martin. “Almost always (these patients) are overweight.”
Other Causes: (AAP)
- Tumor, abnormality of the ovary or thyroid gland
- Disorder of the central nervous system
- Delayed effect of radiation therapy to the brain and/or spinal cord
- McCune-Albright syndrome
Typically, these girls are referred to a pediatric endocrinologist who provides hormone suppressive therapy. This treatment prevents the child from having stunted overall growth, because when puberty finishes, growth in height ceases.
Treatment
If a girl’s height potential is not going to be reached because of early puberty and will cause physical or social problems, there are ways to temporarily stop the child’s menses. This allows the child to continue growing in height.
“Depo Lupron will not reverse the breast development or the pubic hair, but will delay the period and will allow the child to grow to their appropriate height while receiving the injection,” Dr. Martin says. Typically, the endocrinologist will monitor this carefully. As soon as the monthly shots are stopped, puberty will resume as before.
Early Puberty “There's also thought to be a connection between obesity and early puberty, especially in girls,” says Nemours Foundation. “Overweight kids tend to grow faster and enter puberty earlier, and obesity might play a role in earlier onset of breast development, usually the first sign that a girl is entering puberty.” Kristi, an elementary school nurse in south Kansas City says she see quite a few students dealing with puberty in the 4th grade. While she doesn’t claim to know the specific causes, she suspects that obesity and inactivity are contributing factors. “They don’t go outside and just veg out to video games,” she says. “Girls are getting breast buds in the third grade, too.” Another Kansas City, MO, suburb elementary school nurse, Kelly, says, “I see girls with breast buds in second grade – a good percentage of them. And I know of two third graders on their periods. In 4th and 5th grade, I expect it, but both girls are overweight.” Kelly says, “I do have concern over kids having such high fat diets, and there is some evidence it could be a link. Look at ballerinas and gymnasts who are so physically active and have delayed periods versus kids who are not active and start earlier.”
While some evidence may suggest a link between obesity and early puberty, there is not a proven link between the two.
Controversial Theories
Theories abound about the root causes of early puberty in American girls. And although various concerned groups passionately oppose different substances and products, direct links between any of them and the early onset of puberty remain unproven. Here are some of the main topics of study:
- Soy, a natural phytoestrogen, is present in much of our prepackaged food. It’s difficult to find food without some sort of soy product in it nowadays. Some research on mice has shown that accelerated mammary gland development has occurred, but the studies are inconclusive on humans, and there are no boys who are developing breasts from infant soy formula.
- Bisphenol A is used in the interior lining of food and beverage cans and has been shown to alter mammary gland growth in mice. Exposure to such agents has also been shown to advance pubertal development in animals. Still inconclusive – but interesting.
- Growth hormones in dairy and meat are often debated. These are given to the cattle and chickens to produce larger cuts of meat for the consumer, but is this hormone good for human consumption, especially children who have not gone through puberty yet?
We want to protect our children, but have no definitive answers about what causes early puberty. And research hasn’t yielded data that warrants any regulation changes. Nonetheless, AAP recommends “encouraging self-acceptance and downplaying the importance of physical characteristics.” By teaching children true beauty is a “combination of personality and how they treat others,” and that the media distorts images in the entertainment and fashion business, parents can give children a strong introduction to a healthy body image. Remember, too, that children learn by example and will model attitudes and lifestyle choices – good and bad. Incorporating healthy balanced meals and increasing daily exercise will also battle many potential health issues.
Stacey Hatton is an Overland Park freelance writer.