Post pandemic, experts see an increase in early menstruation

Mumbai Mahi Arora’s daughter, Monica, is just eight years old

Mumbai Mahi Arora’s daughter, Monica, is just eight years old. Earlier this week, Arora was shocked when she found that her daughter had started menstruating. “Monica is only in Class 3. While I knew she would start menstruating one day, I didn’t expect it so soon,” she said.

Recognising the need to educate young girls and their families on menstruation and menstrual hygiene, BJ Wadia Hospital for Children has started a unique awareness and screening campaign every Sunday (AFP)

However, Monica isn’t an isolated case. City doctors said that they are witnessing girls as young as six and seven attain puberty, with most children and their families being unprepared for this sudden change. Recognising the need to educate young girls and their families on menstruation and menstrual hygiene, BJ Wadia Hospital for Children has started a unique awareness and screening campaign every Sunday.

Dr Sudha Rao, head of the paediatric medicine department, BJ Wadia Hospital for Children said that post-pandemic, they have seen a 50% rise in early puberty cases in girls.

“Seeing the sudden rise, we thought of this outreach programme to look at the community-based increase in the incidence of early puberty in girls in the vulnerable age of between six to nine years. We’ll be screening girls for such changes and providing them with concise care in the form of testing and treatment. Moreover, the treatment will depend on the type of precocious puberty and the cause,” she said.

The camps started last Sunday and will continue for the next few Sundays followed by opening an OPD for the same.

Dr Rao said that they have been getting panicky parents seeking help on how to deal with the situation. “Parents are not even aware of the signs of early puberty and panic. They approach us when it is too late and the child has got menses. Six of the 10 girls we see are brought to us after they have got their first menses,” she said.

Dr Rao, who has seen a girl as young as 8-year-old get menses said that at such young age, the girl is prone to more abuse. “It is a social concern too as the child is not aware of the good touch and bad touch. Both parents and child need awareness,” she said.

Dr Prashant Patil, a paediatric endocrinologist at NH SRCC Hospital, said that they have seen a manifold rise in early puberty. “The frequency in which they are coming is humungous. We are seeing a four to five times rise compared to the pre-Covid era. Every day I see four to five new cases. There are two types of presentations. 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 said that unfortunately, they see more parents getting the child after getting the menses. “It is unfortunate because once the girl gets the menses, the height of the child gets compromised. They also do not know how to handle the periods. We help them to achieve the psycho-social maturity to handle periods,” said Dr Patil.

Dr Aspi Irani, senior consultant, paediatric endocrinology, Nanavati Max Super Speciality Hospital, said that the chief risk of early puberty besides the psychological impact on the child is the reduction of the final adult height. “With the onset of puberty, the bones fuse early so the child may initially appear taller than peers but will stop growing earlier than the peers and hence remain stunted as an adult. For this (and many more) reasons, prevention/early detection of paediatric obesity is essential. If a parent notices breast development before 8, they should approach a doctor soon,” he said.

The Wadia Hospital, which also has the country’s oldest paediatric endocrinology department, is also trying to find reasons behind the dipping age of puberty and collaborating with National Institute for Research in Reproductive and Child Health (NIRRH).

“There are many hypotheses to the dip in the puberty age including heavy use of sanitisers and the chemicals in it creating the problem, sudden weight gain in the lockdown. But, there can be environmental factors too or some biomarkers. We are doing additional blood tests free of cost with NIRRH and trying to find the cause,” said Dr Rao, a practising paediatric endocrinologist.