Is your daughter growing up too soon?

Early puberty in daughters may soon be something more parents will have to be prepared for.

As growing numbers of girls reach puberty even before they’re ten, a frank chat and, in some cases, hormonal intervention, can help young girls deal with the ways their bodies are changing.

Eight-and-a-half-year-old Viveka Chinoy is dealing with changes that her vocabulary doesn’t even include. Recently, her areolae grew in size, followed by slight but definite breast tissue development - enough for her to need a second layer of clothing under her school uniform.

Her mother, Sonia is stunned. “I thought Viveka had at least two more years until her body goes through these changes, as was the case with me and my peers.”

Alarmed by the changes, Sonia took Viveka to a gyaenacologist who told her they were part of the hormonal changes that indicate puberty.

“It felt as if a precious two years had been taken off her childhood. It worries me that, soon, she will be worried about her periods when most girls her age would still be ‘kids’,” says Sonia.

Here to stay
Although several international studies have documented the rising number of girls hitting puberty before the age of 10, a definitive Indian study is yet to be conducted.

A 2006 survey, conducted by the Federation of Obstetrics’ and Gynaecologists’ Societies of India, reported that girls were reaching puberty at 11 on an average — earlier than the global average which was 13 at that time.

But experts say there is enough evidence on the ground of an even earlier onset of puberty.

Obstetrician and gynaecologist Dr Kiran Coelho says the trend is conclusive. “More girls are hitting puberty earlier than before, but the message that needs to go out to parents is that it is not something ‘alarming’. “Whether we like it or not, this is here to stay. Nothing is ‘wrong’ with your daughter’s body, though the anxiety that comes with it is completely understandable. This calls for open communication channels between a mother and daughter and more responsibility on mothers to look after their daughters’ physiological and psychological needs,” she says. 

Sonia was told the same thing by her gynaecologist, and subsequently the endocrinologist, after her daughter’s hormonal profile and growth chart were found to be normal, but she says she doesn’t feel much better.

“It was shocking to know this may just be the new ‘normal’ of tomorrow. This is hardly an age to tell our daughters to be careful about their bodies — where do I even begin?” she dreads.
 

Obesity, chemicals trigger puberty
According to experts, there are many contributing factors. Early puberty, termed as precocious puberty, is associated with better nutrition, improved medical access in urban areas and increased mental stimulation.

While there’s not much anybody can do about these, there are some less benign factors which bear watching.

Dr Seema Gulati, who is in charge of childhood nutrition at the Centre for Diabetes, Obesity, and Cholesterol Disorders (CDOC), Gurgaon, says there is a direct link between childhood obesity and precocious puberty.

“Children who are hooked to junk food or a high-protein diet, especially non-vegetarian, are generally found to hit puberty earlier than those who are not. These foods stimulate the production of the hormone leptin, which in turn triggers puberty. Couple these factors with the lack of exercise most of our children are guilty of, and you have the factors that have contributed to this trend,” she says.

The hormone leptin regulates the storing of fat, and it’s only after the body has stored enough fat can it enter puberty. So there’s a double whammy in consuming junk food, which not only provides excess fat but also stimulates the body to store more of it.

Separate studies in 2004 and 2008, in the UK and at Florence University respectively, have also established a link between increased television viewing and early puberty.

Surprisingly, it wasn’t viewing sexual content, as much as the radiation emitted, which triggered puberty in young girls and boys. Watching too much television suppresses production of melanin, a hormone that slows down the progress to sexual maturity. 

“Not just TV, our children today are at great risk from endocrine disruptors - chemicals found in certain cosmetics, prescription drugs, plastic and pesticides - that trigger puberty well in advance,” says Phulrenu Chauhan, consulting endocrinologist at the Hinduja Hospital.

Dr Chauhan explains that we have evolved in a way that even the slightest imbalance in a girl’s hormones, or her circumstances, can lead to early puberty. 
 

Tell her she’s not alone
These seemingly inevitable changes offer little solace to young girls like Viveka, who are clearly dealing with more than they can handle.

“Viveka realises she is ‘different’ now. There’s a sudden spurt in her height so she stands out, and overall is more careful about her appearance,” says Sonia.

Viveka’s mood swings, which are perhaps a part of, or a result of, precocious puberty, make matters more complicated around her friends.

Recent research conducted by Cambridge University has established a link between when a girl first menstruated and symptoms of depression.

Girls who started their periods before the age of 11.5 years had the highest rates of depression at 13 and 14. This is not surprising, given the physical, hormonal and social changes that come with the onset of puberty.

Early puberty also increases the risk of breast cancer in later life.
 Some parents even explore the possibility of administering hormone injections to increase the gap between the onset of puberty and menarche (the first menstrual cycle).

“GnRH injections block pubertal development and are administered after a thorough body check-up and study of hormonal patterns in a girl,” explains Dr Chauhan.

Sonia says she hasn’t considered the hormone treatment yet, but plans to discuss options with her doctor soon. “It is all so disorienting considering how young Viveka is.”

Sonia says the situation demands a lot of understanding and patience from her. “For instance, I recently came to know that this height growth is temporary and will suddenly cease, making Viveka shorter than what she would have been had she reached puberty later. It wasn’t easy to cope with that knowledge.”

Once, when Viveka came home unusually preoccupied, Sonia discovered how her classmates had asked her uncomfortable questions about the additional layer of clothing. “I sat down with her and explained that she needn’t feel out of place, and that everyone will need the same — only at different times,” says Sonia. 

The only way to ease girls into this change is to let them know that they can confide in their parents about their confusions, say doctors.

“You may not be able to explain everything, given her age, but your daughter needs to be guided well for her to know that this can be dealt with, that she’s not alone in this,” says Dr Gulati.