Early Puberty for Girls - A New "Normal"?
Puberty is the time when girls start to grow into young women, typically between the ages of eight or nine and fifteen and boys start to grow into young men, sometime between the ages of nine or ten and fifteen. In girls, puberty starts with breast budding, followed by the growth of pubic hair, the fastest phase of their growth spurt, and then a first period. Boys start with growth of their testicles, followed by pubic hair, penis enlargement, ejaculation and wet dreams, and then the peak of their growth spurt. Typically the changes unfold in that order (although sometimes there is variability in order), and the process takes about two years. While the timetable varies somewhat for each child, there is a genetic component to the timing of puberty, so if a child's relatives developed on the early or late side, there's a good chance she or he will, too.
In recent years, many parents and the medical field are asking whether there is a new "normal" age at which puberty begins, specifically for girls. To endocrinologists, girls who go through puberty early fall into two categories: girls with diagnosable disorders like central precocious puberty, and girls who simply develop on the early side of the normal curve. "There used to be a discrete gap between normal and abnormal, and there isn't anymore," according to Louise Greenspan, a pediatric endocrinologist and co-author of a paper published in August 2010 Pediatrics. Doctors can use a variety of tools to help distinguish between so-called "normal" and "precocious" puberty such as bone-age X-rays, blood and urine tests and medication is available if slowing down puberty is recommended. Research and theory regarding why there may be an increase in precocious puberty relate to possible factors including stress, environmental chemicals and hormones in products and food supply, increased fat tissue or maternal depression.(1)
Research and recent data shows that breast budding in girls is starting earlier. However, while studies have shown that the average age of breast budding has fallen significantly since the 1970s, the average age of first period, or menarche, has remained fairly constant, dropping to only 12.5 from 12.8 years. The medical field is working to understand the meaning behind these changes and to develop strategies for parents to cope with "precocious puberty" - when African American girls start developing breasts or pubic hair before six or seven and when white girls start before age seven or eight. Evidence shows that most girls who start early don't have a medical problem - they're just very early bloomers - but they could also have hormone concerns or another medical problem, so it's best to take a daughter to the clinician if the timing of her development seems abnormal. (2)
The onset of early puberty can be a challenge for young girls. Teasing at school or unwanted attention from older youth can be hard to take. And, often family, teachers and others may assume a level of sexual awareness or interest that is not there or expect a young girl's emotional and intellectual development to be keeping up with her physical appearance.
Many doctors urge parents to focus on their daughters' emotional and physical health rather than on stopping or slowing development. "I know parents can't change the fact that their daughter started developing early, but they can change what happens downstream," says Louise Greenspan. She encourages parents to keep their daughters active and at healthy body weights. They can treat them the age they are, not the age they look. "Most of the psychological issues associated with early puberty are related to risk-taking behaviors," according to Greenspan and parents can mitigate those. "I know it sounds corny and old-fashioned, but if you're in a supportive family environment, where you are eating family meals and reading books together, you actually do have control."
Tips for Parents and Young Girls Coping with Early Puberty
* Give the child a simple, truthful explanation about what's happening. Explain that everyone goes through puberty on their own individual timetable and all of her friends will go through puberty at some point. Even though these girls' bodies are changing, they are still very much young children and emotionally are most likely not ready to talk about some of things a parent might talk to a 12 or 13 year old about. Explain the basics of puberty, the changes that happen to a girl's body and emotions, including the basics of menstruation.
* Invite older cousins or siblings to share their stories of puberty changes so that she has opportunities to talk about the changes.
* Provide age-appropriate and developmentally-appropriate books and websites about puberty facts and information. It's Perfectly Normal by Robie Harris is a wonderful resource.
* Watch for signs that might indicate concerns with a child's emotional development (i.e. poor grades, loss of interest in daily activities, depression, problems at school)
* To create a supportive environment, try to offer praise for achievements in school, sports and other activities rather than focusing comments on a child's appearance.
1. Puberty Before Age 10: A New 'Normal'? Elizabeth Weil, The New York Times, March 30, 2012
2. Everything you Never Wanted Your Kids to Know About Sex, Justin Richardson, M.D., and Mark Shuster, MD, PHD.