Srinagar: Last week, 10-year-old Fatima (name changed) visited the district hospital Pulwama with her mother who was quite panic-stricken because her daughter had started menstruating.
“She is only in Class 4. While I knew she would start menstruating one day, I didn’t expect it so soon,” the mother told the pediatrician at the OPD.
However, Fatima isn’t an isolated case. Health experts in Kashmir are observing a disturbing trend– girls in the region are attaining puberty earlier than before, with most children and their families being unprepared for this sudden change.
Puberty is a phase of life marked by the emanation of sexual hormones in a human of both genders characterized by physical and psychological changes. A significant mark of puberty in females is menarche (the first occurrence of periods) as it represents the onset of the female reproductive capacity. Menarche, however, is a late event during puberty, usually occurs 2-2.5 years after pubertal onset, and is characterized by breast enlargement and pubic hair development.
Senior Consultant and HOD Pediatrics, District Hospital Pulwama Dr. Yasir Wani told The Kashmir Monitor, he has observed a rise in the incidence of early puberty and early menstrual cycle in girls in the vulnerable age of ten to twelve years of age.
“In my clinical observations, I have seen every six out of ten girls (10-12 years of age) experiencing it,” he said.
He noted that there are many contributing factors to it. They include heredity, early menarche in the mother, obesity, and high intake of calories, proteins, and junk food.
“A common thing seen in the children residing in urban areas is early access to the internet which is also a big contributing factor to it. Secondly, eating poultry food and meat treated with hormones and antibiotics, dichlorobenzene in mothballs, Synthetic chemicals in plastics like Bisphenol A, Exposure to Pesticides, Intense stress in childhood or a child is sensitive to conflict around her, Fluoride which is added to the majority of public water supplies reduces the level of circulating melatonin and triggers the early onset of puberty resulting in early menarche,” Wani said.
He pointed out that early puberty can put females at many health risks. “The child may appear taller than her peer but it also has the drawback. The bones may stop growing before time resulting in a short height during adulthood. Early puberty can exert great psychological and physical pressure on any child. Females having more emotional inclination become more vulnerable to social stigmas related to puberty leading to low self-esteem and depression in them,” Wani said.
According to the doctor, the early menstrual cycle is usually accompanied by early menopause in the forties. “Such females can also have a high risk of Ca ovaries, Ca Breast, Endometriosis, PCOD, and metabolic diseases later in life.”
Wani said he has usually observed two types of presentations among parents. “If the parent is aware of the early signs of puberty and notices breast development, they get the child. The other set of parents come only after the child gets the menses when the child is not able to cope with the pressure of puberty,” he said.
He stressed that parents have got a very vital role to play. “Necessary psychological counseling can help both the child and parents at this time. As parents, it’s important to make sure your child is not exposed to hormonal medications containing estrogen or testosterone.”
Making sure that the child maintains a healthy weight, as per the doctor, is another way to avert early puberty. “Lifestyle modifications – like exercise, outdoor activities, and healthy diet – can also keep a check on a girl’s weight and hence delay puberty. Most importantly, always rule out the pathological causes of early puberty first and get them examined by a doctor if you notice any signs of early puberty,” he concluded.