Earlier, Precocious puberty was estimated to affect 1 in 500 girls. But when we look into the study recently published in the Italian Journal of Paediatrics, researchers found that in a tertiary hospital in Italy in the year 2020, 246 patients were referred for suspected Precocious Puberty, compared with 118 consultations recorded in 2019. Forget about Italy, in a cross-sectional study on precocious puberty among girls in the age group of 11- 15 years, in two schools at Kollam, Kerala, the prevalence was found to be 10.4%. This shows that the number of cases is increasing day by day. Going through a simple search in google itself reveals how it has turned into a burning issue.
The term Precocious puberty is reserved for girls who exhibit any secondary sexual characteristics before the age of eight or menstruate before the age of ten. When we refer to our classical textbooks, only Acharya Kashyapa in the Sareera sthana Jathisutreeyam adhyaya, tells us about the factors that can influence the pravyaktha avastha of sukra and sonita. Just like a phala is present in pushpa and agni is present in daaru in sookshma roopa, sukra and sonita are present in purusha and stree respectively which expresses itself or comes to pratyaksha avastha due to kaala and karma. Usually, 16 years or shodasha varsha is described as the age for this. But due to the influence of aahara and aarogya, it can happen before 16 years.
In this era, there are several factors that can influence this phenomenon. Nutrition, environment, stress, certain diseases like CNS lesions, Encephalitis, Meningitis, Myelomeningocele and even genetics can play a crucial role in this. What makes the first three factors stand out from the crowd is that they are modifiable entities, which can be used to prevent precocious puberty to a great extent.
Regarding nutrition, from the research papers on the effect of phytoestrogen on sexual development, we come to know that, Soy milk; one among the most used supplements instead of breast milk, contains phytoestrogens. They act as estrogen mimics and have a significant affinity towards the estrogen receptors ER Alpha and ER Beta. In simple words, when the estrogen is released, fat in the connective tissue begins to get collected. This causes the breast to enlarge, and the duct system also starts to grow. This estrogen also acts through the HPO axis and induces menstruation. This means that the baby when exposed to estrogen in early stages of life can attain puberty even at the age of 2-3 years.
Another culprit is Junk food, otherwise known by the nickname fast food. They are rich in calories, fat, sugar and are poor sources of dietary fibers. Meat products injected with hormones are the next hidden villain in the current scenario. Foods like these can cause obesity by acting at the level of Leptin in the body, which can in turn act on the Hypothalamo-Pituitary-Ovarian Axis, Adrenal glands and can even trigger epiphyseal growth plate.
Environmental pollutants can also cause precocious puberty. Endocrine-disrupting chemicals (EDC) have the capacity to enter the maternal blood pool. Some of them are Bisphinols and Phthalates. They can pass from mother to fetus through dermal absorption, inhalation and ingestion. These chemicals can interfere with signalling pathways and cause endocrine disruption. Studies have shown that the changes created in the genes by these chemicals can even pass on to seven generations. Phthalates particularly target thyroid glands, causing a lack of Thyroxine production, which elevates Thyroid Stimulating Hormone and acts at the HPO axis to cause Precocious Puberty. These EDCs are commonly seen in the vegetables cultivated using pesticides, that you force your child to eat in the name of ‘nutrition’, fire extinguishers, coatings of cans in which tinned foods are packed, and the packages of junk foods. Industrial wastes also contain EDCs. Before thinking that your home is away from the industrial area, the Brahmi that you or your child took the day before might have been taken from such premises. Studies have shown that bioaccumulation can occur in plants like Brahmi which can easily affect young children. The fishes from water bodies near factories, the water bottles if not made of good plastic and even makeup products are reservoirs of EDCs.
Mental aspects cannot be neglected regarding this issue. Stress in the family, sexual abuse in the early stages of life, war and migration can act at higher centers of the brain and can trigger precocious puberty.
As future risks, those with precocious puberty are prone to Obesity, Polycystic Ovarian Disease, Diabetes Mellitus and even breast cancer in the early stages of life. Some tend to have depression due to a lack of proper awareness and initiation of hormones in a very tender age. Survey studies show that children around South Africa and South Asia, having precocious puberty are at risk of child marriage, unprotected sexual intercourse, teenage pregnancy and even sexual abuse.
To prevent precocious puberty to a certain extent, what can be really done? Utmost care should be given by the mothers to breastfeed their babies, which acts at the level of cortisol receptors. Cultivate organic vegetables and fruits in your own backyard and terraces. Shift to organic meat products and organic cosmetics which can be a solution to this issue. Studies have shown that children who live in happy families tend to attain puberty at the right time. Try to lead a healthy and happy family with less stress. Even if stressed include Yoga, Pranayama, and simple exercises to cope up with them. Seek the help of a medical professional if you are not able to give proper counselling to your child about Puberty related matters. Precocious puberty is not completely the fate of your child and can be prevented in at least 50% of the cases by modifying the lifestyle.
Children are like flowers. Let them bloom at the right time.
