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More girls experience early puberty
(WebMD) -- Like many girls who enter puberty earlier than most, Kathy Pitts was confused and scared when she got her period at 9. "My mother never mentioned the changes that go along with puberty -- maybe she thought I was too young," says Pitts, now 35 and the mother of a 9-year-old son and a 2-year-old daughter in Bellevue, Washington. "It would have really helped if my mom had talked to me about what to expect."
These days, Pitts would have had plenty of company. More young girls are showing signs of puberty as early as 7 or 8 and beginning to menstruate two to three years later. As a result, parents are increasingly faced with the difficult task of talking to young children about topics that had traditionally been reserved for preteens and teens.
While previous studies have found that girls typically began showing signs of puberty at 10 to 11, a new report by the Lawson Wilkins Pediatric Endocrine Society (LWPES), a nationwide network of physicians headquartered in Stanford, California, suggests that it is normal for white girls as young as 7 and black girls as young as 6 to start developing breasts. This conclusion was based on a study of 17,000 girls between the ages of 3 and 12 conducted by the Pediatric Research in Office Settings (PROS) network of 1,500 pediatricians nationwide and published in the April 1997 issue of "Pediatrics."
"This study is significant because it gives us a marker for when parents should be concerned about physical development that is truly too early and may be a sign of a hormonal imbalance," says Paul Boepple, M.D., associate professor of pediatric endocrinology at Massachusetts General Hospital in Boston and at Harvard Medical School. "It also gives parents a heads-up that they need to talk about the physical and emotional changes of puberty with kids possibly as young as age 5."
Nobody knows for certain why girls are entering puberty earlier, but the most popular theory involves insecticides, which can break down into compounds that may have estrogenic activity in young girls, thus triggering the onset of puberty.
Others attribute the drop to in increase in childhood obesity. "My own bias is that a major contributor to earlier puberty is the increasing prevalence of obesity over the past 25 years ... especially in 6- to 11-year-old girls," says Paul Kaplowitz, M.D., associate professor of pediatrics at Virginia Commonwealth University School of Medicine in Charlottesville, Virginia, and author of the LWPES report. "It has long been known that overweight girls tend to mature earlier and thin girls tend to mature later."
As for African-American girls maturing even earlier, Boepple believes this may be due to a higher cultural tendency toward obesity, while Kaplowitz hypothesizes that there may be genetic differences within the African-American population that predispose them to an earlier onset.
If a child is showing early signs of puberty, an evaluation by an endocrinologist is recommended to rule out other risks. "In a few cases, early puberty can be indicative of a tumor of the reproductive organs or that the brain has erroneously triggered the production of estrogen," says Boepple. "The great majority of girls are just developing early. But if a girl has unusual symptoms including headaches, abdominal pain, and weight loss, or if there isn't the growth spurt associated with puberty, there may be trouble."
While researchers speculate on reasons for the drop, parents must contend with broaching the subject of sexual development with children while they are still in grade school.
According to Helen Egger, M.D., a child psychiatrist in Duke University's department of psychiatry, once you've noticed signs, it's important to let your child take the lead. Egger's own daughter started showing signs of puberty at 8, so she gave her daughter some books about puberty geared to pre-teens as a catalyst for discussion. Then she waited for her daughter to approach her with questions.
"Our daughter wanted to talk about some of the topics that the books brought up, such as menstruation and breast development," Egger says. "She recognized on her own that her body was changing before her friends', and that naturally led to discussions about how she felt about that."
When it comes to talking about sex education with young girls, Egger suggests that parents proceed with care.
"Even though these girls' bodies are changing, they are still very much young children and emotionally are probably not ready to talk about some of things you might talk to, say, an 11-year-old about," she says. "Start by talking about the physical changes your daughter is going through, without going into details about having sexual relations. Most 8-year-olds haven't even considered dating, let alone having sex."
One bonus to talking to a child early about puberty is that she is more likely to be open to a discussion at 8 than she will be at 10.
"When my youngest girl started to enter puberty at 8, we talked a lot about the changes she was going through -- like getting hair under her arms and the beginnings of breasts," says Mary Weisnewski, the mother of two girls, 11 and 16. "But once they reach 10, they clam up and don't want to talk about these things with their parents -- they'd rather talk with their friends."
© 2000 Healtheon/WebMD. All rights reserved.
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