FARGO - The perils of puberty start with the pituitary.
The brain makes a hormone that causes the pituitary gland to release two more hormones, which then produce the sex hormones that initiate physical changes.
For most girls, this process begins any time after age 8, with the average age of first menstruation at 12.7 years, says Dr. Alan Kenien with Sanford Children's Hospital.
"That hasn't changed for the last 50 years," he says of the average age of first menstruation.
But for about 5 percent of girls, the process starts earlier than expected, the pediatric endocrinologist says.
ADVERTISEMENT
Tracee Sioux's daughter, who started showing signs of early puberty at age 6, is among that 5 percent.
Since the 38-year-old Fort Collins, Colo., mother was featured in a March New York Times Magazine story on early puberty, she's become a voice for parents like her.
She advises other mothers of girls starting puberty young not to panic.
"Just because they're getting external signs (of puberty) doesn't mean that tomorrow the period's coming," she says. "It can happen gradually over a number of years."
When your daughter does start her period, she says, don't make her feel more uncomfortable by treating it like an illness.
"You don't want to have menstruation be a medical crisis no matter what age it happens because it happens to every woman on the planet," Tracee says.
She wasn't always so accepting about her daughter's early puberty. "At first, like anybody, I was panicked and wanted to fix it," she says.
She tried herbs and treatments, she restricted certain foods, she encouraged exercise. "None of it worked," she says.
ADVERTISEMENT
Then she came to the realization that it was out of her control and turned her attention toward cultivating a positive mindset.
"Now that she's older, I'm much calmer about it," Tracee says of her now-10-year-old daughter.
She refrains from complaining about her own periods and plans to mark her daughter's first period as a special occasion.
"It can be made into a really beautiful, positive experience of femininity and bonding," she says.
Tracee, author of "Love Distortion: Belle, Battered Codependent and Other Love Stories," encourages talking openly about puberty.
She says the girls in her daughter's class discuss their "stages of development" and refer to American Girl's book on puberty, "The Care & Keeping of You: The Body Book for Girls."
"Girls, in general, know about and don't fear their periods or getting breasts," she writes on her blog, "The Girl Revolution," which is "designed to help parents raise powerful daughters."
Their open attitude toward the changes in their bodies helps girls at the "early" and "late" ends of the spectrum feel less self-conscious.
ADVERTISEMENT
"Most of the fourth-graders are wearing training bras whether they need them or not. If your daughter's the one who needs it, then it's not that big of a deal because the other girls think it's cool to wear one," she says.
CAUSES AND EFFECTS
"There's a long process that goes into the evaluation of a child with early pubertal development," physician Kenien says.
He asks about medications, underlying conditions and when the child's parents started puberty.
"Oftentimes you may find that the child's parents went into puberty at an earlier than expected time," he says.
Seizures, meningitis and serious head injury can also lead to early puberty.
"Children with any kind of central nervous system problem have the potential for having early pubertal development," Kenien says.
Obesity, industrial contaminants - even familial stress - have been pegged as possible contributing factors.
ADVERTISEMENT
"Obesity tends to cause children to grow more rapidly, it causes their skeleton to mature more rapidly, and both of those things in conjunction with each other cause the central nervous system to mature more rapidly and stimulate an earlier onset of puberty," he says.
The pediatric endocrinologist says hydrocarbons (organic compounds) that are released into the water supply have been implicated because they have been shown to activate early pubertal development in other species and organisms.
"It's felt that these pollutants that are in the water supply could be one of the factors that cause early puberty in girls," he says.
Kenien says he's not aware that stress plays a role in early pubertal development, but Emily Walvoord of the Indiana University School of Medicine says it does.
"Other stressful conditions as measured by the 'Family Adversity Index,' which assesses socioeconomic status, family structure, parental education level and occupation, predict a younger age at menarche (first menstruation) as well," she writes in a controversial 2010 paper in the Journal of Adolescent Health.
If there is no identifiable underlying cause, early puberty is typically classified as "central precocious puberty."
A less common type, peripheral precocious puberty, is caused by the release of estrogen into the body because of problems with the ovaries, adrenal glands or pituitary gland.
"When there's a tumor that's producing early pubertal development, that's a whole different story," Kenien says.
ADVERTISEMENT
He says the biggest disadvantage of early pubertal development is that the child will stop growing at a very young age.
"So even though the child may be very tall during childhood, because they stopped growing at such a young age, they end up being very short at the time their growth is complete," he says.
Starting her period at a young age can be disturbing for a child, and she may have trouble understanding it.
"It's very difficult to explain that, 'Oh, this is a natural body process, it's not harmful, it's not going to hurt you in the long run,' " Kenien says.
Early puberty can also affect psychological function later in life, Walvoord says in her paper.
"Numerous studies have shown that girls with early puberty suffer from higher rates of depression and anxiety," she writes.
The process of puberty can be slowed with hormone injections, or it can be allowed to run its natural course.
"I usually leave it up to the family," Kenien says. "I give them all of the pros and cons of treatment and then let the parents decide if treatment is the right thing for their child."
ADVERTISEMENT
Fort Collins mom Tracee decided against treatment for her daughter.
"We can't control that it's happening, and we don't know why it's happening, and it's not necessarily a bad thing," she says.
