From: Sacramento (Calif.) Bee, Sept. 15, 2007

*EARLY PUBERTY IN GIRLS TROUBLING*

*The trend raises the risk of breast cancer, emotional problems.*

By Dorsey Griffith, Bee Medical Writer

American girls are entering puberty at earlier ages, putting them at
far greater risk for breast cancer later in life and for all sorts of
social and emotional problems well before they reach adulthood.

Girls as young as 8 increasingly are starting to menstruate, develop
breasts and grow pubic and underarm hair -- biological milestones that
only decades ago typically occurred at 13 or older. African American
girls are especially prone to early puberty.

Theories abound as to what is driving the trend, but the exact cause,
or causes, is not known. A new
report<http://www.breastcancerfund.org/site/pp.asp?c=kwKXLdPaE&b=3266509>,
commissioned by the San
Francisco-based Breast Cancer
Fund<http://www.breastcancerfund.org/site/pp.asp?c=kwKXLdPaE&b=43969>,
has gathered heretofore
disparate pieces of evidence to help explain the phenomenon -- and
spur efforts to help prevent it.

"This is a review of what we know -- it's absolutely superb," said Dr.
Marion Kavanaugh-Lynch, an oncologist and director of the California
Breast Cancer Research Program in Oakland, which directs tobacco tax
proceeds to research projects. "Having something like this document
put together that discusses all the factors that influence puberty
will advance the science and allow us to think creatively about new
areas of study."

The stakes are high: "The data indicates that if you get your first
period before age 12, your risk of breast cancer is 50 percent higher
than if you get it at age 16," said the report's author, biologist
Sandra Steingraber, herself a cancer survivor. "For every year we
could delay a girl's first menstrual period, we could prevent
thousands of breast cancers."

Kavanaugh-Lynch said most breast cancer cells thrive on estrogen, and
girls who menstruate early are exposed to more estrogen than normally
maturing girls.

Steingraber's paper, "The Falling Age of Puberty in U.S. Girls: What
We Know, What We Need to Know," examines everything from obesity and
inactivity to family stress, sexual imagery in media sources and
accidental exposures of girls to chemicals that can change the timing
of sexual maturation.

Steingraber concludes that early puberty could best be understood as
an "ecological disorder," resulting from a variety of environmental
hits.

"The evidence suggests that children's hormonal systems are being
altered by various stimuli, and that early puberty is the
coincidental, non-adaptive outcome," she writes.

Steingraber's report is being released amid growing national interest
in how the environment contributes to disease, particularly cancer.

California is at the forefront of the research movement. Among the
ongoing efforts:

** The California Environmental Contaminant Biomonitoring Program, a
five-year, state-funded project, will measure chemical exposures in
blood and urine samples from more than 2,000 Californians.

** The Bay Area Breast Cancer and the Environment Research Center, a
federally funded project run by scientists at Kaiser Permanente and
the University of California, San Francisco, is studying predictors of
early puberty through monitoring of environmental exposures in more
than 400 Bay Area girls over several years.

For years, parents, doctors and teachers have recognized the trend in
early puberty among girls, with little information to explain it.

Dr. Charles Wibbelsman, a pediatrician with Kaiser Permanente in San
Francisco and a member of the American Academy of Pediatrics committee
on adolescents, said he now routinely sees girls as young as 8 with
breast development and girls as young as 9 who have started their
periods. He said the phenomenon is most striking in African American
girls.

"We don't think of third-graders as using tampons or wearing bras," he
said. In fact, he said, pediatricians are having to adjust the way
they do regular check-ups because the older approaches don't jibe with
reality.

Steingraber acknowledges that some of the shift in girls' puberty is
evolutionary, a reflection of better infectious disease control and
improved nutrition, conditions that allow mammals to reproduce.

But since the mid-20th century, she said, other factors seem to have
"hijacked the system" that dictates the onset of puberty.

Rising childhood obesity rates clearly play a role, she said, noting
that chubbier girls tend to reach puberty earlier than thinner girls.
Levels of leptin, a hormone produced by body fat, is one trigger for
puberty, and leptin levels are higher in blacks than in other groups.

But obesity cannot alone be blamed for the shifts, she said.
Steingraber's paper explored many other factors that likely play a
role, including exposure to common household chemicals. And she cited
findings that link early puberty with premature birth and low birth
weight, formula feeding of infants and excessive television viewing
and media use.

"My job was to put together a huge jigsaw puzzle," she said.

Steingraber also reported associations of early puberty with emotional
and social problems. "The world is not a good place for early maturing
girls," she said. "They are at higher risk of depression, early
alcohol abuse, substance abuse, early first sexual encounter and
unintended pregnancies."

The reasons for this may be related to the way these children are
treated or because of the way puberty affects a child's judgment, she
said.

"It's possible that developing an adult-style brain at age 10 instead
of 14 makes you make decisions about your life that are not really in
your best interest," she said.

Priya Batra, a women's health psychologist at Kaiser Permanente in
Sacramento, said she's seen the effects on girls who "look like sexual
beings before they are ready to be sexual beings," and counseled
mothers worried about their daughters entering puberty too early.

"It's a stressful culture, and we have a lot of demands on children,"
she said. "It's hard when we add this other layer of early puberty."


-- 
"Fool's gold exists because there is real gold." -Rumi
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