2023-11-12 14:33:54
Researchers indicate that obesity, stress, changes in diet and exposure to chemicals may be causes
THAIS PORSCHE
SÃO PAULO, SP (FOLHAPRESS)
Bárbara Winter was 7 years old and playing at her grandmother’s house when she got her first period. She remembers thinking she “was dying.”
No one had explained to her what was happening and how her body would change from then on. In 2004 there was no TikTok, Instagram and internet access was restricted. Her friends and relatives had never spoken about the subject.
“I ran next door and lifted my skirt in front of everyone, shouting that I was dying. My grandmother and mother explained to me that I was menstruating, and said that I shouldn’t tell everyone at school.”
The young woman went to an endocrinologist and discovered that she had in fact entered precocious puberty, as she already had characteristics such as breast enlargement and pubic hair before the age of seven. Treatment to delay menarche (first menstruation) would begin in May 2005, but the bleeding arrived earlier, in December 2004, making it impossible to start treatment with medications that temporarily block the hormones involved in pubertal development.
According to pediatric endocrinologist Ludmila Pedrosa, the first menstruation should occur from the age of 10 or 11, and the first signs of puberty at the age of 8 or 9 – initially with the appearance of the breast bud. Before that, it is considered early.
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A study conducted in JAMA Pediatrics between 1977 and 2013 confirms that in dozens of countries, the age of puberty in girls has decreased by about three months per decade since 1970.
Sonir Roberto Rauber Antonini, professor at the Faculty of Medicine at USP in Ribeirão Preto and president of the Department of Pediatric Endocrinology at the Brazilian Society of Endocrinology and Metabology (SBEM) explains that at the beginning of the 19th century menstruation was between 14 and 17 years of age. In the first half of the 20th century, it fell to around 14 years of age. In 1950, he reached 12 and 13 years.
According to a publication by Fiocruz’s National Institute of Women’s, Children’s and Adolescent’s Health, in around 90% of cases precocious puberty is a disorder with no defined cause. However, it is already known that some factors can interfere with this happening.
According to the same JAMA Pediatrics research, obesity is an important factor, although it does not fully explain the change.
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Factors such as stress, abusive home environments and greater exposure to endocrine-disrupting chemicals are also hypothesized.
“What is definitely known is that being overweight does advance puberty. One of the reasons is that adipose tissue, fat, produces a hormone called leptin, which acts on the Central Nervous System and stimulates the hypothalamus to start puberty earlier”, says Antonini.
What are the risks of an early period?
The main consequence of early menstruation is that the child’s final adult height will be smaller than their potential genetic height. In other words, she may stop growing prematurely and have short stature in adulthood, says Pedrosa.
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But the risks can go further. An article published in the Journal of Pediatric and Adolescent Gynecology in May 2022 found that early puberty puts girls at greater risk of obesity, type 2 diabetes, breast cancer and heart disease. Therefore, according to Pedrosa, frequent medical monitoring from an early age is essential.
“A very important fact when we talk about early puberty is the greater risk of sexual abuse and pregnancy”, says the president of SBEM. “Studies show that precocious girls have higher levels of anxiety and stress.”
Talking about the subject is important
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A key point so that young people do not suffer so much when entering this new phase, according to Pedrosa, is for the family and school to be open to dialogue.
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On the eve of a school trip, 9-year-old Mariana Stocco from São Paulo got her first period. Her mother had already explained what menstruation was and what would happen to her body. “It was a surprise for it to happen so early, but not a surprise for menstruation itself.”
Ana Carvalho, 24, entered puberty early and used her experience with early menstruation to help colleagues. “The first time I talked about it with someone at school was when another girl got her period in class and then I talked to her to tell her that I knew.”
Menarche is a natural process and should be seen as part of a child’s life as they enter adolescence. When this happens early, the child is often not yet psychologically prepared for menstruation. Therefore, it is essential that there is no shame when talking about it.
“It’s an issue that has to be built from an early age. She was raised in a family, with confidence, being able to talk, being able to expose her fears. The sooner we start to approach this issue of our own body’s sexuality and self-care in a very natural way, the better”, says Pedrosa, the pediatric endocrinologist.
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