Tuesday, April 17, 2012

What would you do?

Here's an interesting article about puberty before age 10! What do you think is causing this early sexual development? There are a lot of physical and social implications - if you had a child developing early what would you do?


  1. This is a difficult question because there are so many different variables at play. Sexual development is expressed both emotionally and physically, so the causes of development outside of the "normal" curve could be anywhere from increased exposure to hormone-mimicking chemicals to living in an unstable household. There does not seem to be one single conclusive reason that these children's hormones seem to be different. I really liked what Lustig had to say about how if the body is not producing GnRH, the symptoms are not related to puberty.

    If I were to have a child developing early, I would not put them on "counteractive" drugs. I feel that this would teach the child that there is something wrong with them and that they needed to be "fixed." In addition, these medications create unwanted side-effects that can be completely avoided by simply accepting and processing the situation. I understand that this choice would probably lead to more complicated social situations, but I also feel that parents should be open with their children and that if they have a close relationship that prepares the child for what is happening, the social pressures and anxieties will be lessened.

  2. What do you think is causing this early sexual development? There are a lot of physical and social implications - if you had a child developing early what would you do?

    I think the early development in these girls is caused by not one, but a combination of all these factors. Individually, "xeno-estrogens", estrogens from fat tissue, genetics, or environmental stressors might not be enough to trigger early development, but in conjunct with one another they could create "the perfect storm" to bring about the premature onset of puberty.
    If I had a child who started developing extremely early (like the patient mentioned who started at 4) I'd probably ask to have her put on Leuprolide, despite the risks. However, if my child started, say, around 9, at a point where precocious development would not put her at risk for breast cancer or stunted growth, I might not medicate her.

  3. It seems that there are a variety of factors at play in the early onset in puberty. Most convincing to me was the idea of xeno-estrogens that could be found in the environment and mimic natural estrogens to spur early development. I find it hard to believe that stressful situations could cause precocious development. This cannot be proven easily and may well be simply a correlation rather than a causal link.

    I am not sure what my course of action would be if I had a child developing early. I think it depends on how early. If I had a child like the four year old mentioned, I would probably try to medicate her. Four is not a manageable age to go through those emotional and physical developments. Of course then the question arises of where the brightline is. When is it too early or "unnatural"? I think if the child was a bit older I would try to not medicate them. The use of medication to prevent an early development worries me because it gives the parents the power to decide when their child will be taken off the medication and be allowed to develop. It ought not be the role of the parents to make that decision.

  4. As the article clearly expressed, there seems to be a number of factors that contribute to precocious puberty in girls. However, i think one must distinguish between simple breast development and full-on puberty. Emotional, physical, and psychological changes all occur in puberty, so simply observing physical development is a rather inaccurate analysis. If it were possible to observe the amount of GnRH production in early-developing girls compared to normal-developing girls, perhaps a more stable hypothesis could be reached
    I think that environmental factors must definitely be playing a role in precocious puberty, because of the change over time. Hormones in food, drinks, and household items would definitely have an effect on a widespread group of girls. Emotional factors, however, seem to have a much more vague effect in regard to precocious puberty. Although the data shows that stressful households or broken homes do produce earlier-developing girls, what really causes this seems to be unclear. Perhaps psychological maturation is influencing physical maturation? As I said before, I believe that puberty is not simply physical, but also emotional and psychological. This means, however, that the number of factors contributing to precocious puberty is much larger and the reasoning behind them more complex.
    Depending on how early my child's development was, there is a chance that if i thought something was seriously wrong, i might medicate. However, if my daughter was simply developing on the early side, or even very early side of the curve (not outrageous "developing at age 3") I would just try to help her understand what was going on and prepare her for maturation. The physical preparation is fairly simple and straightforward, in my opinion, but the emotional preparation is more complex and just as, if not more, important. If my daughter looked older than she was (for example, 15 as a 10 year old), she would be under more social pressure to act older and sexualize herself like many teenagers do. Supporting her and helping her fit in with her peers is essential to her success in the long term.

  5. I think one convincing reason for early development, is that young children are exposed to hormone-mimicking chemicals. Because, as Lustig argues, GnRH is not being released, the early development can't exactly be puberty; the body is not making the hormones itself. I think hormones in the surroundings must be the explanation.

    If I had a kid that was undergoing development early, I wouldn't do anything to stop it. Based on reading this article, I don't think that the physical element of undergoing puberty is such a danger. I think the danger is more in the emotional side of developing early. I would make my kid feel as accepted as possible and make sure that they didn't feel uncomfortable about their body. As some doctors cited in the article suggested, I would treat the kid his or her own age, not the age he or she looked. I think the most important thing is to be open minded and accepting and alter what your definition of normal might be.

  6. I think the most plausible arguments for early puberty are estrogen-mimicking substances in foods, plastics, etc, and the familial/social pressure. If there is something like estrogen entering a girl's body, she'll start developing whether or not she's ready. Even though her body isn't producing it yet, she'll still react to it. I think I understand how a girl could start puberty earlier if she is in a stressful or depressing situation in her family. Evolutionarily, it seems plausible, because if her family life is bad, she should get away and go out on her own as soon as possible, which would mean she'd have to start puberty and mature sooner.

    If I had a girl suffering from premature puberty, I wouldn't try to stop it. Nothing seems to work. I think that Ainsley's mother was overly dramatic. It's a hard few years, but after a while, everyone is developed, so her daughter will be normal in just a few years. Also, the mothers who tried keeping their daughters away from products with BPA and other bad estrogen-like chemicals were a little too crazy. The article was right; girls will encounter those chemicals even if they don't at home.

  7. The causes for going through puberty early seem to be more environmental. The article discusses many estrogen-like chemicals that are in plastics and beauty products that could contribute to an irregularity in the level of someone's hormones. Developing early because of puberty doesn't seem to be what the girls bodies doing, since they aren't producing GnRH. Instead it seems to be their reactions to the chemicals in the environment around them.
    If I had a child that was developing early I wouldn't try to give them any medications to try to stop it. It what there are going through isn't actually causing them any physically harm, I wouldn't want to put them at risk for it either. I would also do my best to make sure my child isn't emotionally harmed by their piers and would be there to support them in the ways I can.

  8. There are two primary causes for precocious puberty mentioned in this article. The first, estrogen mimicking chemicals, is the most likely, as supported by the applied kinesiologist mentioned in the article, Jared Allomong. Dr. Allomong states in his diagnosis of Aisley, that “[The estrogen’s in Aisley’s body] doesn’t test like it’s her own estrogens” (through his scientific analysis). It would therefore seem likely that these external sources of estrogen present could be responsible for causing Aisley’s precocious puberty. Estrogen mimicking chemicals would in fact trigger the second effects of puberty – they would have the same effect on Aisley’s body as estrogen normally would. It thus seems possible that these chemicals, which Aisley is somehow being exposed to, could be the possible culprit for her early puberty. The second primary cause, stress, is supported by a body of evidence. The article cites multiple empirical studies which have demonstrated links between stress (i.e. no dad, abusive/alcoholic dad, living in poverty, etc.) and early puberty. Though the article does not discuss Aisley’s home life, it would seem probable that the harassment she receives in school would at least add to or create a stressful environment, only further exacerbating her precocious puberty.

    If I had a child suffering precocious puberty, I would do two things. I would first attempt to see if GnRH analogs could perhaps help with their situation. GnRH analogs would decrease the secretion of GnRH, perhaps halting further development if the reason for the precocious puberty was for some reason secretion of GnRH. I would also immediately take my child to emotional support. I would maintain a positive atmosphere at home and all the time I was around my child, trying to reinforce the notion that they were “normal.” I would assist them in coping with any social anxieties and would make sure to keep an eye on their school lives.

  9. I think everyone assumes there is one answer, one specific cause of this early sexual development. I doubt that is actually the case. While one cause may be affecting people more, I feel like there are a variety of different factors playing into this phenomenon. The two main causes seem to be estrogen mimicking chemicals, and stress. Knowing that the body is incredibly complex, there are probable a number of other factors affecting the age at which puberty begins that have not been considered or are not understood yet. In any case, whether or not this is actually puberty or puberty like symptoms varies from person to person. While much of the article was anecdotal, there were studies mentioned and cited, which are all averages of vast amounts of data collected. This does not necessarily imply one single thing happening, only a trend among all the people studied. There could be multiple causes or abnormalities with similar symptoms, ie something causing early puberty like symptoms versus actual early onset of puberty. All of the causes mentioned in the article probably have an effect to varying degrees if only to a select group of young girls.

    If I had a child that was going through precocious puberty, I would not go strait to medications or attempt to slow the onset without plenty of time to discuss the implications. What i would do would depend on the specific scenario, my bias right now would be to go with explaining what is happening to the child and helping them through it without significant medical or artificial intervention. Unless the situation was compelling enough, I would also not want large amounts of tests done, as whatever the cause it is probably too late to have a significant effect. Having gone through the process (from a male perspective) relatively recently (as compared to the parents of these children), I understand the emotional strain it has and would want to help my child go through that process the best I could, through emotional support rather than telling them something is wrong with them that needs to be fixed.

  10. The possibility of estrogen mimicking chemicals sounds promising. It may not be true, but it is a logical explanation. We have changed the environment we live in, and it is certain that there are health effects. Changes in the processes of development may certainly be one. But whatever the cause, the trend of precocious puberty does not sound realistically escapable at the moment, and for the affected individuals, the best course of action is to accept the changes. The one point that I particularly find strange is the difference in numbers between races. This occurrence could be entirely based in genes and typical characteristics of the different populations. Is that the order that they always have been? On average white girls develop first, then black girls, and then Asians? If so, then perhaps this detail isn't very significant.

    I think that puberty at age 12 sucks. Starting earlier is even worse. I understand the evolutionary advantages to a species to develop early, but in the age we have created, I feel like childhood is marred by puberty. In society as I know it, it's comfortable and enjoyable to be a developed somewhat-adult body at 15-16-whatever age. But I think that human society has established restraints that make puberty inevitably awkward and uncomfortable. It's as if we cannot comfortably appreciate our grown bodies until a couple years after they develop, or begin to develop. Unfortunately (or is it fortunate?) it takes a little while, not just a week and BAM that's puberty. Perhaps there's no way around uncomfortable inbetween stages where we wander to find ways to appreciate our physical selves. Anyways, my point is that puberty is not cool. And I could go on for a long time about how I don't like aspects of human development. Unfortunately that is not something we can change to help these girls deal with their bodies. And until we truly figure out whats happening within their bodies, i don't think there's much but social solutions and methods of coping. I do feel really sorry for all of these girls. Given the rules and norms that we are accustomed to and what seem to be our natural responses of backing away from those that are different, early puberty is really tough. Especially if this isn't the case in boys. Girls already begin really growing earlier. If this trend steepens, and if there was a serious difference in mental development and capabilities between the genders, we could just send boys to school a couple years later and change our ideas about children. Okay, maybe that wouldn't work. You can't just change all of society.

    Like the article said, I guess the best you can do is to explain as much as possible, and help them cope the best you can. It would be much easier socially and psychologically to deal with if ALL GIRLS were developing earlier. Then it would be up to us as a community to change the way we view childhood and aging.

  11. It seems like early puberty may be caused by different factors. I think that obesity probably has something to do with it, especially because the obesity rate in children keeps rising as the age of breast development keeps lowering. The evidence of the hormones that accidentally got into the meat shows that estrogen-mimicking hormones could be causing the early puberty, but in general I think the government is good about regulating harmful hormones in the environment. The problem probably isn’t from using plastics and pesticides. I sort of like Lustig’s argument that GnRH levels are not rising so breast development in young girls has a cause other than puberty, but it seems tough to trust him seeing as how he believes that sugar is a poison. It’s too bad that this is a case where experiments aren’t possible, or are at least they’re morally wrong.

    If I had a child that was developing really early, from a diagnosable problem most likely, I would give her drugs. If she was just a bit on the early side and the doctors said she was fine I wouldn’t insist on giving her drugs, or take her to a doctor who makes her lift bottles of cortisol and estrogen. It’s not really clear whether or not early puberty is actually harmful. I would just trust the doctor’s decision, as long as it’s a trustworthy doctor.

  12. Scientists have noticed that girls who are overweight tend to undergo puberty before other thinner girls. The fat tissue starts a feedback loop that triggers puberty. Cattle were also accidentally fed grain contaminated with PBB, a flame retardant. PBB mimics estrogen when ingested, and the girls who ate cattle laced with PBB found that they underwent puberty significantly earlier than expected. BPA, another estrogen-mimicking chemical, is found in many plastics and also can induce precocious puberty. Family stress can also cause early puberty – kids who had difficult home lives and lived with abusive fathers or divorced parents were noted to have underwent puberty early.

    If I were the parent of a child undergoing precocious puberty, I would leave the decision up to my child (assuming that she is old enough and has the mental capacity to make a rational, informed decision). There are arguments both for and against giving the child drugs to inhibit her precocious puberty, and it is up to the child to decide which arguments are more convincing. If the child were not old enough to make a decision on her own, I would evaluate how ostracized the child was becoming from her peers and make my decision based off of that.

    My question is: why does precocious puberty only affect girls? Why doesn’t the article mention anything about boys – does this mean precocious puberty is caused by xeno-estrogen in the environment?

  13. This is a difficult question because there are so many possible factors for why a child might be developing early.
    I think some of the most fascinating theories for this occurrence are the home and family problems that can cause stress for the child. "If life is hard, best to mature young" is an intriguing and yet saddening statement. Although finding evidence for the theory that girls who are adopted from third world countries or who are living with a stepfather (or no father at all) hit puberty earlier is hard to find, I think there is something there.

    If I had a child who was hitting puberty at the age of four like one of the instances in the article, I would definitely try to take action against it in order to prevent hormonal imbalance or to lower the risk of breast cancer. However, if the child was simply developing on the very early end of the puberty spectrum, I wouldn't try to stop it. I think it's important to lower the amount of stress for a child in his or her environment and giving them shots and medication will only add to it. As long as children are comfortable in their bodies and there aren't serious health risks involved, there shouldn't be a problem with them developing earlier than their peers.

  14. I don't know what I would do, but it seems as though it has reached a point where it's become a problem. I feel like everyone else has hit the nail on the head, though, in that treatment may only make things worse.

  15. The most convincing cause of early and precocious puberty are the effects of foreign products and body fat. Heightened obesity rates reflect the lower average puberty rates, and should be considered as a factor. Increased fat tissue in young children leads to higher levels of leptin, triggering high estrogen levels, resisting insulin, cyclically prompting more sugar stored as fat. Consuming estrogen-mimicking chemicals may also play part in early maturation. Unless children have become significantly more stressed over recent years, I would not consider stress to be a leading factor in this epidemic.
    If I had a child who was undergoing precocious puberty (and not simply early puberty), the hardest decision to make would be whether or not to be medically involved. Whether to allow puberty to occur without interfering, or to alter the course of puberty with hormones, is difficult to evaluate. The most compelling reasons for treating the case are the long-term effects that my child would experience long past puberty, such as hormone imbalance and stunted growth. However, it is uncertain which option is the more "natural." Similarly, I would need to consult my offspring. He or she may feel more comfortable without taking treatments over being like other kids at school. In this way, I have decided on the less exciting opinion of “it depends.”

  16. There appear to be a myriad number of things that could be causing early development. It seems that there are most likely multiple causes for early-onset puberty. Since it is impossible to ethically perform a test with a control group, however, we are bound by circumstantial evidence. I was intrigued by the concept of xeno-estrogens (and the accident in which the food was contaminated provides the closest thing to an experiment on humans as is possible), that would mimic estrogen and disrupt the normal hormonal balance, thus beginning puberty early. It also appeared that hormones that could potentially have an effect are found everywhere: plastics, various food items, or fire retardant found in furniture (among others). Thus there appears to be no clear solution to the problem.

    Personally, unless there was a significant risk of stunted growth, I do not think I would try to alter the natural course of things. It seems to me that the emotional impact of medication, indicating that what my hypothetical daughter is going through is "not normal," would have a restrictively detrimental effect.

  17. I don't think there's much to do about the situation right now because there is still so much we don't know about precocious puberty. It makes sense that it is correlated or caused by body fat. A certain amount of body fat would be a cue to your hypothalamus that you are ready to have a baby. There appears to be nothing to do about the problem because a singular cause has not yet been identified, making a response to precocious puberty difficult for doctors and parents.

    I don't think it is necessary to put your child on medication for sole the purpose of postponing puberty. If I were a parent, I might consider it if early puberty might cause growth problems, as the article mentioned girls who have precocious puberty don't grow as tall.

    The possible hormones and chemicals in our environment should be investigated. We should know the possible risks of plastics, for example. That being said, I feel that there is generally too much skepticism of scientifically enhanced or synthetic products.

  18. I think the most likely cause of this precocious puberty is a raised body mass in young girls. Puberty is started when the body reaches a certain mass. At this mass leptine (an appetite increaser) is released because the body needs more energy to keep up with growth. Leptine then triggers the release of GnRH and so puberty. Raised mass in per-pubescent (by obesity or abnormal size) could signal the body to release leptine prematurely, causing early puberty.

    If I had a child with premature puberty I would be honest with them, and let them know that what is happening to them is normal,it is just happening early in their case. I would keep them up to date with treatments, and make sure they are not being bullied at school.