The girls who started going through puberty at age THREE

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The girls who started going through puberty at THREE

by NATASHA COURTENAY-SMITH -

13th January 2008

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At the age of three, the worries of most little girls rarely stretch

beyond what outfit to dress their dolls in, and how to ride a bike.

But for Hayley , her third year brought a set of problems most

children her age wouldn't even have heard of, let alone been able to

comprehend - puberty.

While her baby-sized friends enjoyed the simplest of life's pleasures,

Hayley spent her time laid up on the sofa with period pains.

She also had to put up with other un-pleasantries of puberty, including

body odour, greasy hair and mood swings.

Not surprisingly, her parents, Debbie, 41, a chemist and , 45, a

project manager from Nottingham, were left both distraught and baffled

by the changes in their daughter's body, and behaviour.

Ellie Mae-Holden

[foto] Growing pains: Ellie Mae-Holden had treatment to prevent the

early onset of puberty

-!-

" I first noticed Hayley had body odour shortly after she'd turned

three, " says Debbie, who also has a 12-year-old son, Carl.

" Around the same time, she suddenly gained a lot of weight, despite not

eating any more than she usually did. I thought it was very odd, and I

mentioned it to my mother.

" When she told me that you wouldn't expect body odour until a child was

approaching their teens, I felt sick with worry. I knew something wasn't

right. Then, a few months later, I noticed pubic hair growth, and her

breasts were beginning to grow too.

" Hayley was still going to nursery, and didn't seem unwell. All she

wanted to do was make cakes and do colouring in. But and I were

very upset, and worried sick.

" Until then, Hayley had been a textbook child, hitting every

developmental milestone at exactly the right time. We couldn't work out

what was happening to her. "

A series of tests with an endocrinologist - a doctor specialising in

hormone-related disorders - revealed that Hayley's bone age was

advanced, but no firm diagnosis was reached.

Instead, her parents say they were made to feel as though they were

over-reacting. However, by the time Hayley was approaching her fourth

birthday, it was clear to Debbie that she was on the verge of menstruating.

" Hayley started suffering from terrible stomach cramps and mood swings, "

says Debbie, who in a bid to raise awareness of the condition is

appearing on ITV's Tonight programme this evening.

" She'd lie on the sofa, and tell me she felt tired and miserable. I kept

a record of when she was unwell in my diary, and I quickly realised that

her symptoms were coming in a regular monthly cycle.

" The thought that my three-year-old girl was getting her period seemed

incomprehensible, but at the same time, it was becoming obvious to me

that her mood swings and stomach cramps were to do with her time of the

month.

" The endocrinologist may have dismissed my worries, but I could just

tell that my daughter was entering puberty. "

And Debbie's instincts proved to be correct. After numerous examinations

and tests over the following 18 months, Hayley, at age six, was finally

diagnosed with precocious puberty, a condition in which puberty begins

at an unusually early age often due to abnormal production of oestrogen,

thought to affect as many as one in six children under ten.

Although her periods didn't start until she was eight, her monthly cycle

of stomach cramps and bad moods had been a warning sign that her ovaries

were maturing, and were a sign of the fluctuating hormones that define

puberty.

Her breasts also grew and Hayley, now aged 12, wears a C cup bra.

" Hayley has always taken it all in her stride, " says Debbie. " I thought

for instance that she'd be upset when at five she had to start using

deodorant. But she didn't say to anything to me about being different to

other children, and she didn't seem to be confused either.

" Instead, she told me she 'liked being like Mummy'. I bought her a book

called My Changing Body, which I used to read to her at night time to

help her understand what was happening to her, and she didn't seem

frightened or scared by any of it.

" I meanwhile, was extremely confused as to how it was possible that a

child who was only just forming sentences and learning to read and write

was developing the body of a growing adult.

" And it did get to her when she was the only girl sitting on the side of

the pool in swimming lessons because of her periods. She felt very left

out. As a result of the hormone imbalances in her body, the condition

has made her overweight and unusually tall for her age, which has meant

she has endured some bullying too.

" Things are getting better now that the other girls are catching up with

her, but Hayley still struggles to control her weight.

" And I still have sleepless nights about it. Although I've been

reassured the condition won't affect her future fertility, I find it

hard to see how it could have no impact at all. "

And Hayley is far from alone. Over the past century, the normal age at

which puberty starts in both boys and girls has dropped by about two years.

In fact, a recent study showed that British girls today start their

periods at an average age of ten years and three months, compared to 11

years nine months for their mothers and 12 years for their grandmothers.

But for a small group of children - there are no official figures -

puberty is coming even earlier.

The condition is more common in girls, but in young boys, precocious

puberty causes rapid growth spurts, acne, the growth of facial and pubic

hair and a deepening of the voice.

" In most cases, puberty would be considered precocious if it started in

a girl aged eight to ten and a little later for boys, " says Tam Fry,

spokesperson for the Child Growth Foundation. " But some of the children

we have been dealing with have been displaying signs of puberty as early

as three years old.

" It is a tremendously concerning condition - both for the parents and

for the children in question.

" There are a number of girls who have been left seriously traumatised by

going through puberty at a stage where, mentally, they are not equipped

to cope with it. And it's very hard to cope in daily life if you're an

eight-year-old girl who looks like a mature woman. "

Certainly, that was the experience of Lucia , now 20, who started

having periods at the age of six. A graphic design student from West

London, Lucia has haunting memories of receiving sexual attention from

grown men at a very young age.

" The hardest thing of all about precocious puberty was that men would

come on to me as though I was an adult. " I remember walking home from

school aged eight, and I'd often get followed by men leering at my body.

I was still in primary school and had no idea what was happening. I used

to have to phone my mother and get her to come and pick me up. It was

really frightening. "

Though she is now able to speak candidly about going through puberty so

early, it is clear that even if a child puts on a brave face, life can

be very difficult. Lucia says precocious puberty left her isolated from

her peers, and lead to frequent medical examinations which terrified her.

" I don't remember being told I had precocious puberty as such, or even

the day my periods started, " says Lucia. " All I remember is feeling

completely alone and alienated as a child. I was overweight, much taller

than everyone else - at one point I grew an inch a month - and I stood

out like a sore thumb. At the age of seven, I had the bone age of a

14-year-old and was almost five foot tall.

" But it wasn't just my height. My breasts developed too - I had to wear

a bra from the age of eight, and the other children teased me

relentlessly. I also had to cope with terrible acne, greasy hair and

huge mood swings.

" I ended up feeling very self-conscious and really uncomfortable in my

body. I suffered from terrible growing pains too, and I was far too

embarrassed to tell my peers about my periods, which left me feeling as

though I was carrying a horrible secret around with me. "

Even at secondary school - by which point her peers had started to catch

up - Lucia still felt like an outsider.

" I was still larger than the other girls, so I ended up taking on the

role of mother hen, " she says. " My peers were beginning to come to me

for advice, which helped me feel a bit better about myself.

" But even so, I still knew I was different, and I just wanted to be like

everyone else. I think of childhood and my teens as very lonely times

indeed. "

While some parents - such as Debbie, and Lucia's parents - chose to let

nature take its course and allow puberty to continue, others opt to give

their child treatment, which involves suppressing the secretions of

hormones which initiate puberty with a range of drugs and injections.

With treatment, actual puberty can be staved off until the child reaches

a more appropriate age.

That was the decision taken by Hayley Holden, 31, a full-time mum from

Padstow, Cornwall, when she discovered her daughter Ellie Mae, then just

three, was on the verge of starting her periods.

Hayley had taken Ellie Mae to the doctor, concerned she was developing

breasts. Her GP spotted the signs of precocious puberty immediately.

" I'd never even heard of precocious puberty, and although I was

concerned enough about Ellie Mae to take her to a doctor, I actually

thought I was imagining things, " says Hayley, who is separated from

Ellie Mae's father and has three other children, twins Charlie and

Chloe, 11, and Albie, 4.

" But a bone density test revealed that at just three, Ellie Mae had the

bone age of a nine-year-old, and I was told that if we didn't intervene

with medication, she was just six months away from starting her periods.

I was in bits when we got the news. I just had no idea what to think

about it. "

" I felt that full-blown puberty at the age of four would be too much for

Ellie Mae to cope with,' says Hayley.

" I know how hard it is to go through puberty, and I didn't want that for

my daughter at such a young age. I guess I wanted to protect her from

puberty for as long as possible. "

As a result of treatment, Ellie Mae's breasts have reduced in size, and

her bone age is now just a year older than her natural age. While this

gives Ellie Mae a chance of a normal childhood, her mother is still

troubled by what happened.

" The hardest thing is that we've never been given a reason as to why

this happened, and I still to this day struggle to understand how a

little girl of three could be on the verge of starting her periods,'

says Hayley.

" Other people say to me I should feel grateful that she's not terminally

ill - and of course I do - but at the same time I worry about her future.

" Ellie Mae still gets terrible monthly mood swings as well, which is

very difficult for everyone else in the house. I also worry about

whether or not she'll be able to have children, and whether she'll be at

increased risk of osteoporosis as her bones have matured so early.

Unfortunately, no one can give us any definitive answers. "

So what is the cause of precocious puberty? While experts aren't able to

give a single explanation, numerous theories exist.

One is that improved nutrition is a factor, as the onset of puberty is

believed to be linked to physical size.

Another theory is that the epidemic of childhood obesity is to blame:

heavier girls begin their periods earlier due to an increase of the

puberty-triggering hormone leptin, which is stored in fat cells.

" There is a relationship between childhood nutrition and the age that

people pass through puberty,' says Mark Bellis, Professor of Public

Health at Liverpool's s University.

" Having a calorie-rich diet in childhood, and being obese, brings the

age of puberty down. "

Modern social conditions have also been touted as a contributory factor

- with research suggesting that children from broken homes experience

earlier puberty as the stress of a family breakdown alters the balance

of growth hormones.

The arrival of a stepfather in the family home produces new and

unfamiliar pheromones, chemicals which are believed to hasten the

arrival of puberty.

" Single-parent families and divorce cause stress that can also change

the age of puberty a little, too, " says Mark Bellis.

Early puberty has even been linked to watching too much television -

Italian researchers found that children who watched three hours of TV a

day produced less of the sleep hormone melatonin, low levels of which

play an important role in the timing of puberty.

The content of today's television may also be to blame, with young

children subjected to increasingly sexualised programmes from an early

age. Research has shown that watching such images produces increased

hormones.

Another theory is that exposure to chemicals in the environment - which

mimic the effects of hormones - is causing the drop in puberty age and

disrupting the normal timing of sexual maturation.

It is not known whether the condition has any serious longterm health

implications, and early puberty has not, at this stage, been linked to

early menopause.

However, there is evidence from American studies that children who

develop early are more likely to be sexually active, smoke, and use

alcohol and drugs. Sufferers are also more likely to become obese adults

or suffer reproductive cancers.

Today, Lucia no longer stands out from her peers, but it is clear that

she still carries the legacy of precocious puberty with her, and its

potential fertility ramifications weigh heavily on her mind.

" I know I want to be a mother, and even though I've been told things

should be fine, I can't help but feel concerned that I'll enter the

menopause early, or find out I'm infertile, " she says.

" I just have to hope that the doctors are right and I will be able to

conceive. I try not to think about it too much, but the thought is

always at the back of my mind. It's a worry I carry with me every day. "

.. TEENS TOO SOON: Tonight With Trevor Mc is on ITV1 this evening,

at 8pm.

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