Premature puberty: Causes, problems due to it, treatment

The Covid-19 pandemic had an impact on everyone’s life and it did not spare children either as the doctors have seen a huge impact of the sedentary lifestyle, change in eating habits, etc. that have led to increased rates of obesity and type 2 diabetes. One more concerning change is increased rates of ‘premature puberty’ especially among the girls.

In an interview with HT Lifestyle, Dr Sweta Budyal, Consultant – Diabetology and Endocrinology at Fortis Hospital in Mulund, explained what is premature puberty and said, “The average age for onset of puberty in girls and boys is 9 to 12 years. If the onset of puberty is before the age of nine in boys and below the age of eight in girls, then it is considered as 'premature puberty’. Since the Covid-19 lockdown, which ensured that children remain homebound, the phenomenon of premature puberty has particularly increased in girls. When compared to the number of young girls attaining premature puberty in the pre-Covid-19 times, there is huge increase in the number of girls attaining premature puberty in the past 1.5yrs. There are five stages of puberty for girls; the earliest sign of puberty in girls is breast bud development, followed by growth spurt, pubic and axillary hair development; last stage is onset of menses.”

Talking about the impact of the Covid-19 pandemic on puberty, she said, “There are many presumptions for the rise in the number of young girls to hit premature puberty, some of these are rapid weight gain, unmonitored diet, stress, and the lack of play time. There are also numerous studies that highlight that exposure to chemicals that children these days are exposed to. With increased exposure to chemicals, the Endocrine system is disrupted, this has been linked to premature puberty. Puberty centre in the brain kick starts when it notices the body showing signs of physical maturity.”

Recommending when should parents consult the doctor, she suggested, “The earliest sign of puberty in girls is breast bud development (generally between the ages of 9 and 11 years), parents should visit the doctor if they see physical development earlier than 9 years of age. Usually, parents bring in their young daughters when they notice pubic and armpit hair growth. Sometimes, parents bring in their children when the child has crossed the first four stages of puberty (with visible physical growth) and is merely six to eight months away from their menses; this is when it becomes difficult to treat them optimally.”

Problems caused by premature puberty:

According to Dr Sweta Budyal, at younger age, it becomes difficult for parents to explain the stages of puberty and menstruation to their children. She highlighted, “Self-consciousness about the changes occurring in their bodies impacts girls who attain premature puberty before their friends and peers. Fear of getting their menses in a social setting, may also cause fear and anxiety. Also, in premature puberty cases, bones mature quickly, height is therefore often impacted. Because of premature growth spurt these girls look taller in the beginning, however, their height may get curtailed up to 15-20cms depending on age at onset of puberty and rapidity of progression. Premature puberty could also lead to development of other health issues like Obesity and Polycystic Ovary Syndrome (PCOS).”

Treatment:

Dr Sweta Budyal concluded, “In a small percentage of girls the premature puberty may the result of underlying complex endocrine problem. Hence all girls with premature puberty require systematic evaluation by an Endocrinologist. This condition can be safely and effectively treated with certain medicines to delay the onset of menses. Puberty can be delayed till the child reaches an appropriate age. For parents it is important to understand the body changes that happen during puberty in the initial stages itself so that medical attention can be sought at an appropriate time.”