The Hindu : `Premature thelarche major cause of secondary sexual character'

Online edition of India's National Newspaper
Wednesday, Jul 09, 2003

Southern States

Southern States - Tamil Nadu-Chennai

`Premature thelarche major cause of secondary sexual character'

By R. Sujatha

CHENNAI JULY 8. Velan (name changed) is a ten-year-old mentally disabled boy who exhibits secondary sexual character (SSC), is tall for his age and looks like a 14-year old. He is now undergoing drug therapy to correct this problem.

Premature sexual development forms around three per cent of the paediatric endocrine disorders, according to statistics available with medical practitioners. In girl children the problem may be easily identified because of external developments. Some times a small amount of oestrogen from the mother passes on to the child during pregnancy. Normally, the child's inhibitory signals prevent the production of oestrogens and the visible symptoms of abnormal development recede before the child turns three.

The child is psychologically unable to cope with its physical change and the family members who abuse the child for its altered features instead of seeking medical help, cause harm.

Two years ago, a survey by the Institute of Child Health, Egmore of the 100 reported cases of premature sexual development, revealed that the majority were due to premature thelarche upto the age of two and a half. In the past five years, the ICH has treated 50 cases of premature thelarche, a harmless, little understood condition that affects girl children. Paediatricians not attached to Government hospitals are also treating this problem, though few have been reported.

There is cause for concern when the problem persists or the child develops the SSCs after three and before normal puberty. Precocious puberty, as the condition is known, could occur due to tumour of the central nervous system, brain fever like meningitis, or a head injury. Consanguinity, tuberculosis of the central nervous system and low function of the thyroid gland also known as `congenital adreno-genital syndrome' could be the reason. A study in Brazil has attributed this problem to exposure to agricultural pesticides.

Boys who exhibit precocious puberty are hyperactive and are prone to commiting sexual assault sometimes, while girls are docile and retiring, and could become victims of sexual abuse. Paediatric endocrinologists P.G. Sundararaman and P. Venkataraman, attached to the ICH say that a hypothesis doing the rounds in the medical circles is that nutritious food and changing lifestyles and sleeping patterns, have brought down the age of normal puberty by a few years. Sometimes, playful application of oestrogens-rich creams by girls could activate oestrogens production and lead to development of SSCs. Two decades ago, the menarche in girls was 12 or even later, while boys reached puberty at 15, but paediatricians have now scaled down the age to nine in girls and 12 in boys. Any child exhibiting SSCs before 7 ½ - 8 (girls), and nine (boys), should be brought for treatment, they suggest. Drug therapy is continued until eight for girls and 10, for boys. Drugs that can treat this syndrome cost Rs. 7,000 a month. In normal children, the bones fuse around the age of 18 or 20 but children suffering sexual precocity, have a `tall' childhood and a `short' adulthood as the bones fuse at 13, stunting growth.

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