Girls who start menstruation early may be short – Paediatric endocrinologists

Parents experience significant anxiety due to the proliferation of myths and misconceptions regarding the growth in height of girls who start menstruating early.

Paediatricians state that most girls will stop growing in height approximately 2.5 years after they start menstruating, despite the fact that girls start puberty at different times and that genetics mostly determines growth patterns.

A girl usually experiences her biggest growth spurt right before the onset of her menstrual cycle, according to the child health specialists.

They say that although a girl may grow a little after she begins her menstrual cycle, her main growth spurt ends before her first period.

Menarche, or the beginning of the menstrual cycle, typically occurs at the age of twelve. Since it signifies the beginning of a girl's pubertal development, child health experts refer to this event as a milestone in girls' development.

According to the paediatric endocrinologists, a girl typically gets her first period two years after breast development starts.

They clarified that she might experience an earlier menstrual cycle if breast development occurs earlier, and a later menstrual cycle if breast development occurs later.

According to the UN Children's Fund, menstruation is a normal and healthy aspect of life for the majority of women, who typically experience it for seven years out of their lives.

According to UNICEF, ignorance about menstruation causes damaging misconceptions and discrimination, which can cause girls to miss out on normal childhood experiences and activities.

“Stigma, taboos, and myths prevent adolescent girls — and boys — from the opportunity to learn about menstruation and develop healthy habits.

“The first period can be met with either celebration, fear, or concern. For every girl, this signifies an important transition to womanhood – a time when they would benefit from the support of family and friends”, the international organisation states.
Speaking, the paediatric endocrinologists emphasised that menarche is a complicated phenomenon influenced by both genetic and environmental factors and that each girl experiences the early menstrual phase differently.

According to Abiola Oduwole, a professor of paediatric endocrinology at the University of Lagos' College of Medicine, early menstruation may stunt a girl's growth.

At the Lagos University Teaching Hospital in Idi-Araba, the head of the paediatrics department stated, "Every girl child will go through puberty usually between the age of 10 and 11." A few who are slightly younger than nine years old are still typical.

Your body now starts to transform as you approach puberty and gets ready to become an adult. Accordingly, if you begin growing breasts now, there will be some underarm hair and some in the private parts, by another two and half years, you will start to see your period.
The hormones released during your menstrual cycle will also have an impact on the growth plates in your joints. It is here that we become taller. These growth plates, known as epiphyses, will eventually stop and contract.

The closing of the epiphyses is a typical bodily reaction, according to the consulting paediatric endocrinologist.

The cartilaginous layers at the end of long bones that are responsible for growth are called epiphyses.

Your joints will stiffen up and you won't be able to grow taller for 1.5 years after you first notice your menstruation. Therefore, the earlier you start your period, regardless of your height at the time, you will only grow a few inches, and your epiphyses will close in 1.5 years. You will not be able to grow more.

“That is why some girls who see their periods between the ages of 14 and 15 grow much taller because they still have two years more to grow after seeing their menses.

“But if you have a child with precocious puberty – that is earlier than it should be, and the child starts seeing her menses at the age of five; by the time the child is seven, the epiphyses will close. And a child that the epiphyses close by seven will be short.
Children who experience menstruation at a young age will therefore not grow tall. That's what actually occurs, she clarified.

Precocious puberty, sometimes referred to as premature puberty, is a condition where a child's body starts to change into an adult's too soon, according to the Mayo Clinic.

According to this, precocious puberty typically sets in before the ages of eight for girls and nine for boys.

Oduwole added that in addition to genetic factors, environmental factors that can cause early menstruation include high body mass index, increased subcutaneous fat, and sugar-sweetened beverages.

However, she pointed out that by lowering fructose consumption—which is present in high concentrations in beverages with added sugar—health education can help prevent early menarche.
The don counselled parents against giving their kids foods that make them more likely to become obese.

Speaking about some of the reasons behind early puberty, Dr. Elizabeth Oyenusi, a paediatric endocrinologist at the Lagos University Teaching Hospital, advised that girls who develop breasts early in life should be assessed by paediatricians.

The expert, who serves as the President of the African Society for Paediatric and Adolescent Endocrinology, informed our correspondent that a girl's development of breasts before the age of eight—which is the age at which menstruation typically occurs—is not typical.

"Any pubertal development," which she defined as breast, pubic, or axillary hair development in a girl before the age of eight, is abnormal, she stated. Puberty is coming on early.

Therefore, aside from the growth of breasts, the development of pubic hair, the development of axillary hair, and also having adult body odour and body shape, are some of the things you can see. It is not normal.

“The things that can cause it are varied. There is one called idiopathic, you may not be able to find any cause. That one most times may run in families.”

Oyenusi, a senior lecturer in the Department of Paediatrics, Faculty of Clinical Sciences, University of Lagos, also listed some other causes of early puberty, which she said are more dangerous.
"Things like having an adrenal gland tumour, an ovarian tumour, or a brain tumour can all cause a child to start developing earlier than normal," she continued.

Therefore, you must consult a physician, specifically a paediatric endocrinologist, if a child experiences breast cancer or any other pubertal development before the age of eight.

When you check them out when they are about seven years old, it sometimes turns out that they are simply starting earlier and there isn't another issue.

"But that means you have to look into the child because there are a lot of other issues that, if you don't solve, can lead to that."

Additionally, she made note of the possibility that early puberty could expose kids to psychological distress and also impact their growth by making them have a small height in adulthood.

Experts say early puberty will cause a child’s body and moods to change much sooner than that of friends and classmates, adding that this may make a child feel self-conscious and embarrassed or be teased by other children.
In addition to tumours, Oyenusi mentioned a few other hereditary illnesses that could cause children to enter puberty too early, including enzyme deficiencies and hormone imbalances.

"If we see a child that has precocious puberty and we investigate, if there is a life-threatening cause, it has to be treated," Oyenusi said when discussing management and treatment options for early puberty.

However, we stop puberty by giving them drugs that block the progression of puberty if the cause is simply that they are starting too early and are unable to handle the changes.

She counselled parents to make sure their kids receive evaluations and treatment if they enter puberty too early.

The authors of a 2023 paper titled "Analysis of risk factors of precocious puberty in children" that was published in BMC Paediatrics stated that research has shown that the incidence of precocious puberty in children is rising annually.

Open-access journal BMC Paediatrics publishes peer-reviewed research articles on all facets of neonatal, paediatric, and adolescent health care.

"Children who experience premature puberty may have shorter adult height due to an early onset of bone maturity and increased hormone secretion that affects their psychology, height, nervous system tumours, etc., seriously endangering children's physical and mental health," the study said.