By Dr. Billy Goldberg and Mark Leyner
Dr. Billy Goldberg:
I was working overnight in the ER last week and I saw a simple case that left me rattled and worried. This wasn’t some gruesome trauma or a heart-wrenching medical story. It was simply the case of a 10-year-old girl whose parents brought her in for what turned out to be her first menstrual period.
What disturbed me was when the pediatrics resident mentioned that they consider the normal range of menarche, the onset of menstruation, to be anywhere from 8 to 14 years. Eight years old!
I have mentioned in this blog that I have two young children at home – a 2-year-old boy and a 3-month-old girl. Eight just doesn’t seem that far away. This sent me on a quest to investigate what happened to the innocence of youth.
It turns out that experts agree that the average age at menarche has dropped by 2.5 to 4 months over the past 25 years – and is now 12.5 years. Eight is still very early but it doesn’t necessarily get doctors scurrying to search for a cause of what is called precocious puberty.
There are many theories about what is causing earlier puberty. Pre-pubertal obesity has been shown to lower the age of menarche. Also linked to early menstruation are chemicals such as phthalate esters, which are added to vinyl to make it flexible, and are found in toys, vinyl floor and wall coverings, food packaging, pesticides, detergents, pharmaceuticals, and personal care products such as nail polish, sunscreen, shampoo and lotions. Hormones in meat and milk, and other “environmental estrogens” have been implicated.
One of the most intriguing theories is that stressful family situations can lead to early maturation and puberty. The evidence isn’t overwhelmingly strong for some of these theories, but that doesn’t keep me from worrying about my little girl.
Earlier onset of puberty is associated with health concerns beyond the loss of youthful innocence. Girls with premature puberty are at a higher risk fordeveloping obesity,type 2 diabetes, heart disease. Early age of menarche also is a risk factor for breast cancer. Young girls with early puberty are also at risk for early sexual activity, potentialsexual abuse, and a variety of behavioraldisorders duringadolescence.
Well, maybe for now I will try not to be alarmist and just focus on getting my little girl to sleep through the night.
Mark Leyner:
Billy recently broached this whole subject of precocious menstruation and the early onset of puberty and I’ve been thinking about it ever since. There is this pang you feel… this notion of lost innocence.
Most of us think of childhood as something precious and idealized. We talk about childhood as something that can be “stolen” from us. Many of us ardently long for this time of our lives as a kind of ancestral homeland – pastoral, idyllic. Some of us might even be guilty of the Disneyfication of our own childhoods. The sublime consciousness of childhood can be a powerful force to the increasingly sclerotic consciousness of adulthood.
Although our culture promotes sexual awakening as a kind of “liberation,” seen in another light, being sexual can be a restrictive and regimented way to live, especially compared to one’s life as a child. In a sense, one’s burgeoning sexuality is really like being “on drugs.” In puberty we marinate in our hormones – all those estrogens and androgens. We become more similar in the ways we behave and in the ways we view the world.
A friend, a single woman in her mid-40s made me realize how much more expansive the consciousness of a pre-sexual person might be. She is absolutely fixated with finding a boyfriend and completely appraises her happiness based on whether or not she is in a relationship. She is oblivious to the infinite splendors of the world because – like many adults – she cleaves to the sad paradigm of shopping and relentlessly striving to enhance her appearance so that she’ll be more attractive when she’s out foraging for potential mates.
When does this dismal state of affairs kick in? Puberty! The incipiently sexualized adolescent is the capitalist’s dream come true. What can’t be sold to a teenager? He or she is the world’s most vulnerable consumer.
In a culture as perverse as ours, sexual awakening is polluted by the pornography of merchandising and celebrity culture, a pornography that literally drives people crazy by producing all sorts of unsatisfiable desires and thwarts those very desires with pervasive images of unattainable bodies and luxuries. The result can be self-loathing and obsessive shopping.
So this phenomenon of precocious menstruation, for me, conjures up immediately all sorts of paranoid fantasies of corporate conspiracy. THEY are putting SOMETHING in the water. Perhaps it’s the phthalate esters. Or more likely, it’s our culture’s campaign to colonize and establish new markets in the psyches of our children that’s causing this dispiriting phenomenon of early-onset puberty.
Weigh in, parents: Are you concerned about precocious puberty in your precious daughters?