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    HomeHealthGirls are going through puberty earlier now - setting them up for...

    Girls are going through puberty earlier now – setting them up for lifelong problems

    Young girls in America are going through puberty at earlier ages than before, and while the causes are still in question, some experts fear this could have negative effects on young women’s health later in life – both mentally and physically.

    The average age of puberty in the U.S. has dropped from the typical, biologically recognized, age of 12, to 10 for females. Black and Hispanic girls in particular are going through puberty around year earlier on average.

    Experts tell that America’s growing obesity crisis could be the root cause, blaming poor diets for pushing up puberty. Others think it could be caused by violent childhoods, and there is also the theory that it is linked to imbalance of certain hormones. 

    There are also the negative long-term downsides, like an association between early puberty and developing cancer – which remains unexplained for now – and the traumatic experiences caused by a young girl growing up just a little too quickly. 

    The phenomena was first detected by Dr Marcia Herman-Giddens, a public health expert at the University of North Carolina, when she began to gather data on more than 17,000 girls in the mid-1990s.

    She found that the average age of puberty was dropping, falling to ten years old, with some girls developing as early as age six. Her findings spurred continued research into the topic, with experts across many fields investigating what caused this shift, and what its long-term effects may be. 

    Both the causes and effects of precocious puberty, when a child undergoes the process too early, are wide-reaching, and can not just be explained with a simple, one-size-fits-all solution.

    Instead, the age of puberty shifting forward could be the result of a variety of factors. And the after-effects it can have on a girl’s life can be wide reaching. 

    Growing obesity rates could be at the heart of early puberty in girls 

    Dr Paula Newton (pictured), an endocrinologist at the University of Maryland, explains that fat cells release hormones that cause puberty, which can help spur early development in overweight children

    America is currently undergoing an obesity crisis, and the nation’s children have not been spared.

    According to most recent data from the Centers for Disease Control and Prevention (CDC), around 20 percent of all Americans aged two through 19 years old are considered obese.

    For ages six to 11, where early puberty is a risk, the obesity rate is also right at 20 percent.

    The obesity rates have corresponded with this rise in precocious puberty, and Dr Paula Newton, a pediatric endocrinologist at the University of Maryland, explained to that it may not just be coincidence.

    She explained that fat cells have hormonal properties, and that young girls that are overweight or obese will begin to produce the chemicals that trigger puberty at earlier ages.

    Once those chemicals move into the blood stream, and eventually accumulate in the ovaries, they will produce estrogen.

    Estrogen then triggers the development of breasts, and other physical changes that outwardly show a young girl is going through the process of maturing.

    This could also explain why precocious puberty rates have grown during the COVID-19 pandemic.

    A study published in April in the Italian Journal of Pediatrics found that rates of precocious puberty jumped 2.5 fold during 2020 and 2021 when compared to previous years.

    Newton said that her clinic has also seen increases in not just pediatric obesity, but also in pre-diabetes and type 2 diabetes in children during Covid – both also conditions tied to weight gain and unhealthy diets.

    ‘As far as what we’re seeing, and during this pandemic, its more so the sedentary activity and lack of activity, increased snacking, more unhealth snacking, more ordering out,’ Newton said, explaining the increased prevalence of this conditions.

    Covid forced many children to spend more time indoors, and not out playing and getting regular exercise that they would otherwise.

    Not being at school, and instead doing education virtually, allows for less structured eating habits as well, with a child at home able to easily unhealthily snack throughout the day – an opportunity they would not get in a school environment.

    Around one-fifth of U.S. children are obese, according to the Centers for Disease Control and Prevention, a growing crisis in America (file photo)

    Around one-fifth of U.S. children are obese, according to the Centers for Disease Control and Prevention, a growing crisis in America (file photo)

    But Newton does not entirely blame obesity for the shift noticed by experts in recent decades, and even believes the change may have less to do with shifts in biology – and more to do with shifts in demographics.

    The original research performed decades ago was on a group of children that was entirely white.

    That is not a representative sample of the United States, though, and every decade the share of white people in the country has fallen. 

    Research from Giddens and many others on the subject has found that black and Hispanic girls go through puberty at younger ages than their white peers.

    Why exactly this is the case has not yet been determined, but it means that a representative sample that slowly includes more-and-more black and Hispanic children – as those groups make up larger portions of the U.S. population – would naturally shift the average age of puberty up by at least a few months over time.

    ‘I wonder if some of this that we’re capturing is changes in the population demographics.’ Newton speculated. 

    For a variety of systemic reasons, younger minority children are also more likely to suffer from obesity than their white peers. This means that a growing part of the study population has a clear risk factor for precocious puberty. 

    Young girls with traumatic childhoods are more likely to go through puberty early – and a precocious puberty could lead to lifelong mental health issues 

    Another phenomena noticed by experts is the link between childhood adversity, and specifically violent abuse, and precocious puberty.

    ‘The timing of puberty is multifactorial – there’s a lot of things that contribute to it,’ Dr Megan Gunnar, a distinguished child development professor at the University of Minnesota told

    Dr Megan Gunnar (pictured), a child development expert at the University of Minnesota, explained that children with violent trauma in childhood are more likely to go through early puberty

    Dr Megan Gunnar (pictured), a child development expert at the University of Minnesota, explained that children with violent trauma in childhood are more likely to go through early puberty

    Research published in 2020 found that children who suffered from violence and abuse in their youth are more likely to go through precocious puberty.

    There has also been a long-known link between young girls who suffer sexual abuse and early puberty as well.

    But not all children who have rough childhoods go through puberty early, though, and it seems to be a trend specifically with physical or sexual abuse.

    If mental adversity was the main factor at play, Gunnar notes, then there would likely be many children in foster care going through puberty early, for which there are not.

    This is because the abuse seems to affect the body on a cellular level, causing rapid aging and speeding up some biological processes.

    Gunnar also believes obesity is a key factor, though, and even more so than abuse is in the early development of young girls.

    In the same way trauma in young age is tied to precocious puberty, girls who go through puberty earlier than their peers are at an increased risk of depression, anxiety and being afflicted with severe emotional trauma from their peers.

    Dr Stephen Hinshaw, a distinguished professor of developmental psychopathology at the University of California, Berkeley, told that while early puberty can be beneficial for boys, it can be emotionally devastating for young women.

    ‘For boys who reach physical maturity early… if anything that might be a slight protective factor against being bullied or being picked on,’ he explained. 

    ‘But for girls, there is such an association, especially with depression, anxiety, self-injury, self-harm, that is particularly pronounced for girls in co-ed secondary education.’ 

    This is because girls who are bigger, and more developed, than their peers at young ages become easy targets for bullying, and their bigger frames as generally seen as unwieldy and even manly. 

    Dr Stephen Hinshaw (pictured), a distinguished professor at Cal-Berkeley, said that young girls are put into a harmful 'triple-bind' by society in their adolescence

    Dr Stephen Hinshaw (pictured), a distinguished professor at Cal-Berkeley, said that young girls are put into a harmful ‘triple-bind’ by society in their adolescence 

    He explained that this phenomena can be seen in trends in mental health issues by gender.

    In early ages, boys are actually more likely than girls to suffer from anxiety and other issues than their female peers.

    At age 11, though, the trends flip. Girls become more likely than boys to suffer from mental health issues.

    For their remainder of life, women are more likely to suffer from mental health issues than men, Hinshaw says. 

    This is because of the impact that puberty has on girls, and how society views them, he explains.

    In 2009, Hinshaw published ‘The Triple Bind’, a book discussing the roles and expectations facing young girls after puberty that he says is even more relevant today – over a decade later.

    Young girls are impossibly tasked with excelling in three separate fields in their adolescence, Hinshaw explains, placing them into this triple bind.

    First, they are expected to play a role in the home. As a woman, they are expected to take care of younger siblings and others in the family and perform other household chores.

    There is also pressure from the media – and in recent years now social media – to keep up appearances and be ‘attractive’ as well, with harmful beauty standards pushed onto America’s girls from a young age.

    Finally, they is also an increased pressure at school for all adolescents, as getting into a prestigious university seems like a standard for living out a successful career in America, and even one bad grade in high school could cost a teen their chance at future success.

    This is untenable for many young girls, as it is impossible to be perfect looking, the perfect homemaker and the perfect student all between the ages of 12 and 17.

    ‘If that’s the standard you are going by, you feel like you failed,’ Hinshaw says.

    Many young girls end up developing feelings of inadequacy as a result, which parlays into poor self-esteem, depression and anxiety. 

    This ‘triple bind’ starts right at puberty for many young girls, and corresponds with an already confusing time in their life where they are experiencing new hormones and their body is actively changing, another confusing process.

    As puberty moves earlier in life, girls are entering this bind earlier in life, and the disasters effects it has on their mental health moves up with it.

    Early puberty and cancer: A devastating link experts cannot quite figure out 

    One of the most devastating consequences of an early puberty may be the increased risk of developing breast or uterine cancer later in life.

    While it had been speculated on in previous years, ground breaking research in 2020 established the association between early puberty and breast cancer later in life. 

    Experts can not exactly pin-point why a there is a association between these dangerous, deadly, cancers and early female development, but they it is a well-known phenomena among experts

    ‘We’ve known for a while that having a younger age at first menstrual period (early age at menarche) is associated with increased risk of developing breast cancer,’ Dr Dale Sandler, chief epidemiologist at the National Institute of Environmental Health Sciences, told

    Dr Dale Sandler (pictured), of the NIH, says that while the phenomena of early puberty and cancer has been documented, a true mechanism has not yet been detected

    Dr Frank Biro (pictured), one of the world's lead experts on the subject, believes the link between early puberty and cancer is tied to a hormone called IGF 1

    Dr Dale Sandler (pictured, left), of the NIH, says that while the phenomena of early puberty and cancer has been documented, a true mechanism has not yet been detected. Dr Frank Biro (pictured, right), one of the world’s lead experts on the subject, believes the link between early puberty and cancer is tied to a hormone called IGF 1

    ‘While less well-studied than menarche, onset of breast development, or thelarche, is an early marker of puberty that usually occurs a couple of years before menarche and may also be related to breast cancer risk.’

    Sandler says that experts have not yet nailed down the cause, though, and the link is still tenuous. She continues:

    ‘We don’t know for certain what mechanisms link early puberty to cancer later in life. Girls experience hormonal changes during puberty, along with changes to the breast tissue itself, that we think could affect breast cancer risk. 

    ‘The breast is thought to be more vulnerable to carcinogens during periods of rapid development, like during puberty.’

    Dr Frank Biro, who led the 2020 research and was formerly a pubertal maturation expert from Cincinnati Children’s Hospital and is regarded as one of the world’s leading experts on the subject, has a theory, though.

    He explained to that early age of menarche, the first period a woman goes through in her life, is linked to a hormone called insulin-like growth factor 1 (IGF 1).

    Young girls who have higher levels of IGF 1 in their youth are more likely to go through puberty, and they maintain high levels of the hormone throughout their life.

    The hormone is also linked to higher estrogen, which regulates many female functions relevant to reproduction, levels throughout life.

    Women who have higher estrogen levels develop larger breasts and have thicker uterus lining than others. 

    As Biro explains, more growth opens the door for more cancer risk: ‘when a cell is driven to grow, then you increase your risk of having a bad copy made of the cell that’s growing.’

    This would mean that the early puberty itself is not causing the cancer, but the just have the same risk factor – which Biro describes as an ‘association’.

    Sandler agrees that this is a possibility, but it is too early to tell what the actual link is.

    ‘It’s possible that there are shared factors that increase the risk of both early puberty and cancer,’ she said. 

    ‘Unfortunately, we still don’t know very much about what factors are associated with early puberty. We need more research on factors that occur early in life that could potentially influence the timing of puberty and cancer risk.’

    Biro says the same, adding that research into this topic is still in fairly early stages. Further research will need to find what exact biomarkers, if any, identify a girl as at higher risk for going through puberty, and suffering from cancer later in life as a result.

    What parents can do to protect their children – both before and after an early puberty 

    The question of precocious puberty remains unanswered for the most part. What exactly causes it, and if the problem even exists at all and is not just a result of demographic changes, remains unsettled.

    While there is belief that it is tied to cancer risk later in life, research into the topic is still limited and non-definitive. 

    More studies, more research, and more papers will be written at the academic level tackling the topic, and it could be decades before the medical intelligentsia figures out what is going on.

    In the meanwhile, rates of precocious puberty are increasing. Young girls are going through this process earlier than expected, and dealing with devastating short and long-term consequences.

    Newton says that any families worried about precocious puberty because there is a family history of it – or one of its risk factors like mental health issues or breast cancer, should make changes to their daughter’s diet.

    High fat foods, junk food and sugars should be replaced with healthier options – general advice that applies to all children.

    Soy-based food should be dumped as well, including milk, tofu and some meat replacements.

    If a young girl begins to show early signs of puberty, she recommends taking the child to a pediatrician, and even a pediatric endocrinologist like herself and asking about puberty blockers.

    There are ways to manage early puberty, experts say. Newton recommends puberty blockers to potentially delay it to a more standard time. Hinshaw says that parents can help their daughters manage the stressors that come with it, and make sure to keep their daughters mental health in check (file photo) 

    While the drugs may have earned a bad reputation from serving as a center-point in the trans-debate, their original use was to limit precocious puberty, and the potential negative effects that come with it.

    Their effects are not permanent, and once a child lets their blocking treatment lapse, puberty will just continue as normal.

    If a young girl is starting to feel the early effects of puberty at an extremely early age like six or seven, a few years of blockers could push it back to a more standard time.

    Hinshaw believes that some systemic changes need to be made as well in how we view young women, and the messages we send them throughout their lives.

    Most importantly, they should be allowed to understand that no one is perfect, and that its ok. 

    ‘The pursuit of relentless perfection is really going to put girls at risk,’ he says.

    Changing rigorous school grading to be less harsh to young people whose brains are still developing, and even shifting some classes to a pass-fail system instead of the typical grading scale could be of use.

    Girls are also not getting enough sleep in young ages either, as the ‘triple bind’ has many skipping on rest to keep up appearances, complete tasks around the house and keep their grades up as well.

    Not getting enough sleep every night puts a girl at a higher risk of developing depression or anxiety.

    Hinshaw also explains that people who do not receive enough sleep at night also generally have negative thinking patterns

    ‘What often happens is a girl tends to internalize why [problems in her life are] her fault,’ he said. 

    Combine these factors with the bullying and increased hostility from their peer groups, and early puberty can lead to torment for some young women.

    Parents should be active in their child’s life, and make sure to regularly check in with them emotionally and mentally to make sure things are ok at school, in the home, and in other peer groups.

    This will require children to first trust their parents, Hinshaw explains, so they should allow their kids to have boundaries and maintain privacy.



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