The early onset of puberty in girls has been linked with better bone health in older women, but it is also associated with a host of negative outcomes including teenage pregnancy and serious ill health in mid-life. With girls over the last few decades starting their periods earlier and earlier, this is a real cause for concern. A better understanding is needed of who is affected and how if this trend is to be reversed and the long-term health of girls and women is to be secured. Researchers at the ESRC International Centre for Lifecourse Studies at UCL have investigated whether a girl’s socioeconomic background or ethnicity are associated with early puberty and have looked in detail at more commonly supposed links with weight and stress. Yvonne Kelly explains more.
Sexual activity whilst still young, teenage pregnancy, mental health problems, heart disease and breast cancer later in life are just some of the things linked to early puberty in girls. Over the last few decades, girls have started their periods earlier and earlier (in 2016 at around age 11, according to the NHS).
This research is the first to look over time at whether and how a girl’s social and economic circumstances and her ethnicity might be linked to the early onset of puberty. We suspected that any link that did emerge would, most likely, be explained away by other factors such as being overweight or suffering from stress.
Using information on 5,839 girls from the Millennium Cohort Study, which has been tracking the lives of nearly 20,000 children born at or around the start of the century, it was possible to know, at age 11 whether they had started their period or not.
Details of their birth weight, ethnicity, family income when they were aged 5 and height and weight when they were 7 were also available. This rich information gathered across 11 years of the girls’ lives really enabled us to put together a detailed picture over time of how these factors come together to influence the early onset of puberty.
The girls’ mothers completed questionnaires any social or emotional problems their daughter might be facing, and their own mental health.
Puberty facts and figures
Nearly one in ten of the girls, a total of 550, had started their period at age 11, with girls from the poorest families twice as likely as their most well-off peers to have done so (14.1 per cent v 6.8 per cent). Those from the second poorest group were also nearly twice as likely to have started their period.
Indian, Bangladeshi and Black African girls were most likely to have started their period at age 11, with Indian girls three and a half times more likely than their White counterparts to have done so.
On average, girls who were heavier at age 7 and suffered stress in early childhood were more likely to have begun menstruating. Those who had started their periods early also tended to have mothers with higher stress levels, were from single parent families, and tended to have had some social and emotional difficulties themselves.
However, even when we took all these things into account, girls from the poorest and second poorest groups were still one and a half times more likely to have started their periods early.
As far as ethnicity was concerned, income, excess body weight and stress accounted for part or all of the differences in most cases. Interestingly, though with most Indian girls coming from more advantaged backgrounds than their White peers, the likelihood of them having started their period was not explained after we took all the above factors into account.
Our findings highlight the different lived experiences of ethnic minority groups in the UK: for example Indians are relatively advantaged whereas Pakistanis tend to be materially disadvantaged, Bangladeshis and Black Africans are materially and psychosocially disadvantaged and have a tendency to be overweight compared with the majority ethnic group. They also demonstrate the complex and potentially opposing factors at play for the onset of puberty.
All that considered, we can say with considerable confidence that socioeconomic and ethnic disparities are indeed apparent in the UK. Given the short and long term implications for early puberty on women’s health and well being, improving our understanding of these underlying processes could help identify opportunities for interventions with benefits right across the lifecourse, not just for the girls in our study, but for future generations.
It was also encouraging to note that in the decade or so covered by the data we used, there appears to have been no further decline in the average age that girls begin puberty.
Early puberty in 11-year-old girls: Millennium Cohort Study findings is research by Yvonne Kelly, Afshin Zilanawala, Amanda Sacker, Robert Hiatt andRussell Viner and is published in Archives of Disease in Childhood.
Photo credit: Afla