WHAT IS THE CAUSE OF EARLY PUBERTY IN GIRLS AND BOYS?
A: The past 100 years shows that all US girls and boys are experiencing puberty at earlier ages. Girls’ periods have decreased from 16-17 yrs to 12-13 years of age. And boys are showing signs of puberty 6mo to 2 years earlier as well.
Early puberty or precocious puberty (PP) is when a child’s body begins developing into an adult too soon, that’s before 8 in girls and before 9 in boys. This includes rapid growth of bones and muscles, changes in body shape or size and development of the body’s ability to reproduce. It has health implications such as, shorter adult height, psychological impact with increase risk of depression and anxiety, increase risk of certain cancers, diabetes, and heart disease.
Known causes of early puberty include: problems in the brain, certain tumors, genetic disorders, hormonal disorders, exposure to estrogen or testosterone. In many cases, the cause is unknown. This is an area of ongoing research.
Link to environmental exposures:
- A CDC 2012 analysis found that girls exposed to higher levels of common household chemicals had periods earlier than those with lower exposures.
- Endocrine disrupting chemicals (EDCs) may trigger early puberty. Chemicals in the environment that mimic or interfere with hormones and their actions in the body. Exposure to these chemicals are disproportionate among minority and low-income populations.
- BPA(bisphenol A), phthalates, parabens and phenols found in plastics, canned foods, cleaning and personal care products. Girls appear to be more sensitive and they are disproportionately consumed by African Americans (AA).
- Essential oils, lavender and tea tree have been shown to cause early breast development in boys but is reversible when stopped.
- Phytoestrogens in soy products, consumed in excess are linked to breast development which resolves with decreased consumption.
These chemicals are everywhere in our lives. Be knowledgeable of them and try to avoid them in your everyday products by reading ingredients list and choosing products wisely.
WHAT ARE SOME OF THE SIGNS AND SYMPTOMS OF EARLY PUBERTY?
A: Signs of early puberty include: growth of breast and menses in girls, enlargement of testes and penis, facial hair and deep voice in boys, pubic hair or underarm hair, growth spurt, acne, adult body odor
HOW MUCH DOES OBESITY PLAY A FACTOR?
A: Obesity is a risk factor for precocious puberty, as well as being female and AA. Obesity may trigger early puberty due to higher levels of obesity related hormones. African American (AA) children have higher rates of obesity.
So maintaining healthy weight is important in preventing early puberty.
HOW IS EARLY PUBERTY DIAGNOSED?
A: It’s important that parents notice changes in their child’s body and visit the doctor for concerns. Also regular well visits should detect early signs of puberty. Diagnosis includes a careful history and physical exam, blood tests, X-ray of the hand or wrist to determine bone age, some children may need MRI or ultrasound to help determine the type of early puberty-central vs peripheral. The child may be referred to a pediatric endocrinologist.
ARE THERE TREATMENT OPTIONS AVAILABLE?
A: Yes. Treatment depends on the cause. Sometimes treatment is not recommended, especially when no cause is identified. Then monitoring and follow up is key. Medications are used to stop full pubertal progression under the care of a pediatric endocrinologist.
Many causes are not preventable but maintaining a healthy weight and avoiding hormonal exposures are important to preventing early puberty.
WHAT’S THE BEST WAY TO EXPLAIN TO A CHILD WHAT’S HAPPENING TO THEM?
A: First, it’s very important to already be talking to children about their bodies! Naming body parts properly and discussing them without shame or embarrassment is key. That way, if early puberty occurs, your child will likely tell you what they see and feel comfortable talking about it and having the doctor examine them.
Your pediatrician can help explain early puberty to you and your child. Also, encourage your child to ask questions anytime.
WHEN IS PUBERTY TOO EARLY?
A: Currently, puberty before 8 in girls and before 9 in boys is considered too early. Although AA girls as young as 7 may be acceptable.
DOES DIET AFFECT EARLY PUBERTY?
A: A diet that promotes obesity may increase risk for early puberty. Also, endocrine disrupting chemicals (EDCs) in foods seem to contribute to early puberty. This is an area of ongoing research. See links provided.
WHAT CAN PARENTS DO TO HELP THEIR CHILD DURING PUBERTY?
A: Be proactive and tell your child about puberty before it starts. Read about puberty with your child. They should understand why their voice is changing, acne is on their face and why they smell. If your daughter is showing signs of puberty, get her prepared for the menstrual period. Stock her back pack or purse with personal care supplies and make sure she knows how to use them. Also, puberty, especially early puberty can be an emotional experience. Check in with your child often and listen! Keep the lines of communication open. And don’t forget to utilize your pediatrician.
DO HOUSEHOLD PRODUCTS AFFECT EARLY PUBERTY?
A: Endocrine disrupting chemicals (EDCs) in household products seem to contribute to early puberty. This is an area of ongoing research. See links provided.
Dr. Jones answers your “Text Tom” questions on the next page.