To Your Health

Is there any therapy to help deal with precocious puberty?

Q. My 7-year-old daughter is beginning to develop breasts and even some pubic hair. Her pediatrician did some tests and decided it is "precocious puberty." The pediatrician said to watch her carefully for a few months. Is there any therapy to consider?

A. In girls, precocious puberty means having the signs of puberty, such as pubic hair or breast development, earlier than age 8 years (or age 7 years for African-American girls). Unless the condition begins earlier than that, most pediatricians will not aggressively treat it because the treatment is very uncomfortable and expensive. Also, since more and more young girls are entering puberty early, the psychological trauma of "being different" from peers is now lessened.

The average age that girls (and boys) enter puberty has declined over the past century or so. The reason for this change has not been proven, but there is increasing concern that environmental chemicals have both a direct and an indirect effect on the hormones that coordinate the activity of the various cells of our bodies.

Some environmental chemicals directly mimic the action of the estrogen we produce in our bodies. Many chemicals used in farming have this veiled ability and are thus blamed for some of the changes we are seeing in the wildlife exposed to agricultural runoff. Other chemicals seem to have more subtle effects, such as causing the body to make more of the enzymes we use to destroy foreign chemicals. Making more of these enzymes means that we also destroy more of our own hormones, and this forces our bodies to make even more hormones.

Reducing your daughter's intake of agricultural chemicals may be expensive, but still costs much less than the current medical treatment. Switching to organic produce and meat from animals raised without hormones should help. And don't forget that most "personal care" products such as shampoos and cosmetics are laden with perfumes and other foreign substances that she can well do without. A supplement of N-Acetyl Cysteine, a sort of "universal detoxifier," at 500 milligrams per day, would be safe and potentially helpful.

Perhaps the best way to reduce hormone levels to a desirable level is vigorous exercise. Female athletes have a well-known tendency to have low hormone levels, and a pediatric endocrinologist could help you maintain the necessary balance among those hormones as the total levels are reduced. Exercise would also keep your daughter from becoming overweight, which would worsen the estrogen problem. The detoxification that sweating brings about would be a further bonus.

There are reasons other than better psychological health for preventing your daughter's precocious puberty. When puberty begins too early, growth also starts too early but may also end too early. A child genetically programmed to reach a height of 5 feet 2 inches might instead be 4 feet 10 inches.

On a more serious note, when a girl starts her period before age 12, her lifetime risk for breast cancer increases by about 40%, probably related to the prolonged estrogen exposure. There are other controllable risks (use of estrogen-containing birth control pills, high-fat diet, alcohol use, and radiation exposure) that your daughter should be aware of so she can make informed decisions when she grows up.

Encourage your daughter to participate in her usual activities, and also to discuss with you worries that she may be having.

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