Sonali Rao* was distraught when her 8-year-old daughter Vedika* started her period. At just 8 years old, Sonali felt that Vedika was too young for such a big life change. She had noticed a few physical changes in Vedika over the last year but had assumed she was too young for puberty.
Anjali Kapur* started panicking when she saw the first signs of puberty in her daughter Alisha*. Alisha was only 7 and had begun developing breast buds and body hair. She was becoming increasingly self-conscious and embarrassed about the changes in her body. She’d confided in her mother about how a few of her friends were ostracizing her because of this. Not wanting to take any chances, Anjali consulted her family gynecologist, who diagnosed Alisha’s case as precocious puberty.
There are an increasing number of cases of girls as young as 7 and 8 years getting their first period, a trend that has left doctors alarmed. Many paediatricians and gynecologists across India are reporting a rising trend in precocious puberty, and anecdotal evidence supports this as well. So what is causing this growing incidence of early puberty in girls? And as parents what can we do about it?
First things first, what is the meaning of precocious puberty?
Precocious puberty, also known as early puberty, is when a child’s body begins to change into an adult’s body too soon. Puberty is the process of becoming sexually mature and both boys and girls develop the sexual and physical features of an adult when they go through this phase. Children who experience precocious puberty start developing these sexual and physical features at a relatively younger age, which can be confusing and alarming for both the kids and parents.
Puberty typically starts between the ages of 8 and 13 years in girls and 9 and 14 years in boys. A study published in the scientific journal Nature documents the average age of menarche (the first menstrual period) as approximately 13 years in Indian women. As per the report, while 66% women experience menarche between the ages of 13-14 years, the age of menarche can vary widely, ranging between 10-17 years. The study further states that there has been a decline over a period of time in the age of menarche in India. The average age of menarche is now 12-13 years, from 14-16 years previously, among the middle-class and above socio-economic strata of society.
The experts we spoke to told us that precocious puberty is when puberty begins in girls before the age of 8 years. There are an increasing number of girls who are experiencing their first period as early as 6 or 7 years of age. The pandemic has also had an impact on the incidence of precocious puberty. While there isn’t enough data to support the COVID effect, anecdotal evidence from doctors does support the theory of an increasing number of young girls getting diagnosed with precocious puberty after COVID.
What are the signs or symptoms of precocious puberty?
Girls are more likely to have precocious puberty, compared to boys. In girls, the signs of precocious puberty include:
- Breast development before age 7 or 8
- Rapid growth in height (growth spurt) before age 7 or 8
- First period before age 10 (this typically happens 2-3 years after the other symptoms)
Other signs like facial, underarm, or pubic hair, acne, or body odour can be a sign of early puberty, but these can also be normal sometimes.
If you are worried about early puberty and have noticed any of these symptoms, it’s a good idea to consult your daughter’s paediatrician. Your doctor can help diagnose whether your daughter has early puberty, by checking her medical history, through a physical exam, or a blood test.
What are the causes of precocious puberty?
Many of the experts we spoke to agreed that genetics can play a significant role in the timing of puberty. So girls who have a family history of early puberty, are likely to go through it themselves. If you’re worried about early puberty, a good way to estimate the timing of your daughter’s first period is to check when you and your mother started your first period. Your daughter will likely get her first period at around the same age.
In some cases precocious puberty can also be caused due to medical causes like tumours in the adrenal glands or ovaries, a seriously underactive thyroid, or a brain injury. However such instances are rare.
Does your lifestyle play a role in precocious puberty?
Yes, your lifestyle can have an impact on hormonal health and early puberty. The good news is that unlike genetics and rare causes of precocious puberty, lifestyle factors are within our control.
The experts we spoke to indicated several possible causes for the rising trend of precocious puberty in girls. One of them is an increasing rate of childhood obesity. An increasingly sedentary lifestyle coupled with a higher intake of processed and high-sugar foods, has led to an increased BMI among kids. Plus, kids these days are more susceptible to eating junk food which has high levels of unhealthy fats. Excess body fat can lead to an increase in estrogen production, which may trigger early puberty in girls.
Exposure to products containing endocrine disruptors- chemicals that can interfere with hormone function- can also cause precocious puberty. For example, bisphenol A (BPA) which can be found in food packaging, plastic water bottles, and tiffin boxes. Or phthalates, which may be present in food packaging or plastics.
Another reason can be chronic stress. Recent research has identified that stress and anxiety, early in life, can trigger early puberty. Chronic stress may disrupt the neuroendocrine system, the hypothalamic-pituitary-adrenal (HPA) axis that regulates our body’s stress response. This in turn can influence the timing of puberty. This correlates with the rising incidence of early puberty during COVID, which had a lot of psychological impact on children.
Can precocious puberty cause any complications?
Early puberty can be a stressful and confusing time for young girls. They are not emotionally mature enough to deal with this challenging phase, and may feel embarrassed and worried. Plus, it is difficult to go through the many physical and hormonal changes that early puberty brings with it.
In girls who experience precocious puberty, it can also lead to a shorter adult height. While the growth spurt during puberty may make them taller than their peers, the rate of growth of height slows down post menarche. And once puberty is over, the growth stops. Since precocious puberty ends earlier than normal puberty, the height stops growing at an earlier age.
So, as parents, what can we do?
One of the experts we spoke to while researching this article told us something that really struck a chord. As parents, it can be easy to start panicking if you suspect precocious puberty. However, it is important to remember that signs that may sometimes seem like early puberty are often unrelated and will clear up on their own. So if you’re a parent reading this, and are worried about early puberty, remember that stressing over it may often be detrimental. What you can do is be watchful and mindful, and focus on the following lifestyle practices for your child to prevent precocious puberty:
- Ensure that your daughter gets an hour of physical activity every day. Pick an activity she likes- a sport, dance, or yoga. If she has a group of friends to play with every evening, that is ideal. Encourage them to run and play games, or play some sport. Try to get in some outdoor time at least thrice a week. Walking, cycling, swimming, or trekking are some activities you can engage in as a family on weekends and holidays.
- Minimize, or eliminate consumption of ultra processed and junk food, to the extent possible. You should avoid processed meat and eat red meat not more than twice or thrice a week. Focus on a nutrient dense diet comprising of high quality vegetarian protein, healthy fats, whole grains, and fruits and vegetables.
- Stick to organic milk and dairy products. The exploitation of animals to enhance milk production is well documented. It is common practice to inject the animals with hormones, to improve the milk production. These hormones in turn get into the dairy products we consume. Some research indicates that drinking large quantities of milk can cause early menarche. It’s a good idea to drink milk in balanced quantities and not overdo it. You can also explore other sources of calcium such as almonds, pumpkin seeds, sesame seeds, chia seeds, leafy greens, broccoli, sweet potatoes, oranges, and ragi (finger millet).
- Be careful about introducing any new supplements in your child’s diet. Check with your child’s paediatrician before starting any supplements, even the Ayurvedic ones. Avoid protein powders or protein shakes or supplements, unless they are specifically recommended by your doctor.
- Excessive screen time and exposure to social media have also been linked to precocious puberty. Through social media and other content sources, children can often get exposed to content that is not age appropriate. Such content can affect a child’s brain, specifically the pituitary gland. When stimulated, the pituitary gland secretes hormones, which can trigger the ovaries to produce estrogen (the sex hormone) in girls. This in turn can affect the timing of puberty.
- Some of the measures you can take to reduce exposure to endocrine disruptors are:
- Choose wholesome, homemade food over processed food or take-out
- Choose stainless steel or glass and avoid plastic to the extent possible
- Buy organic produce, if possible. If not, wash and peel fruits and vegetables thoroughly
- Use basic cleaning products like vinegar and baking soda where possible. Read the labels on cleaning products and choose wisely
- Read labels on cosmetics, skincare products, and body care products and choose wisely. Avoid exposure to products with phthalates. Many girls today are using make up and cosmetics at a very early age. Talk to your child about product usage, and research brands together before you pick such products. You may find our handy guide on Indian clean beauty brands useful.
Summing up…
Puberty can be a challenging and confusing phase, and precocious puberty even more so. As a parent, you can help by talking to your daughter about puberty at the right time and explaining the changes that she can expect. Let your daughter know that you are there for her, and she can come and talk to you, no matter what. Boost her self-esteem and confidence by focusing on things other than her appearance. One of the best pieces of advice I’ve heard from a fellow parent was how she would tell her daughter that she loved watching her play tennis, or play the piano. Just hearing the words “I LOVE watching you play” made a world of difference to her daughter.
Finally, if you are struggling with precocious puberty, don’t be too hard on either yourself or your child. Many of the doctors we spoke to assured us that kids who experience precocious puberty do just fine in life whether it is psychologically, emotionally, or socially.
If you have any questions you’d like answered on precocious puberty, do let us know in the comments below or connect with us on Instagram. We’d love to hear from you!
*Names have been changed to protect privacy