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Blossoming Too Early?

American girls are reaching puberty younger than ever. Why?

WebMD Feature

April 3, 2000 (Bellevue, Wash.) -- 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, Wash. "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, Calif., 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."

Why Is the Age of Puberty Dropping?

Nobody knows for certain why girls are entering puberty earlier, but the most popular theory involves insecticides, such as PCB, 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, Va., 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."

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