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Early Puberty For Girls: A Sleep-Breathing Problem?

Posted Apr 03 2012 7:47am

You may have seen reports about the epidemic of public hair and early breast development in 6 to 7 year old girls. A recent study published in Pediatrics revealed that by age 7, 10% of white girls, 23% of black girls, 15% of Hispanic girls, and 2% of Asian girls had started developing breasts. In this week’s New York Times Magazine , a writer profiles a young girl that developed pubic hair, tall stature, big feet, and a curvaceous body at age 6.

There’s a general consensus amongst pediatricians that early puberty is a growing problem and a number of factors are blamed. The obesity epidemic is thought to play a role, since excess fat is known to produce higher levels of endogenous estrogen. The most probable suspect is thought to be due to the presence of xenoestrogens, which are artificial chemicals in our food and water supply that has estrogen-like properties. The most well-known of these is bisphenol-A (BPA). Recently, the FDA rejected a motion by environmental groups to ban BPA, which is widely found in food containers. Most baby bottle manufacturers have voluntarily stopped using BPA in their products.

Xenoestrogens and other endocrine disruptors like PBA not only act to induce early puberty, but can also alter the optimal balance of reproductive hormones in a woman’s (and man’s) body. The idea have having too much estrogen (endogenous or exogenous) in your body has been coined estrogen dominance by Dr. John Lee . An important concept to emphasize is that too much estrogen (or estrogen-like molecules) can suppress progesterone, which can have significant detrimental effects on breathing, especially in post-pubertal women. Progesterone is an upper airway muscle stimulant, and increases tongue muscle tone. Post-menopausal women have lower levels of progesterone, and lower tongue muscle tone (genioglossus muscle), but when given progesterone, muscle tone increased significantly.

This is why many women sleep better when given hormone replacement therapy after menopause. In one study, the average apnea hypopnea index (AHI, or measure of obstructive sleep apnea severity) was over 50% lower in postmenopausal women taking hormones. I sometimes wonder if the incidence of sleep apnea in women shot up after women were advised to stop taking hormones many years ago due to increased cardiovascular risks. If more women have sleep apnea, then that in itself will significantly increase rates of cardiovascular disease, including heart attacks and strokes.

If these environmental effects are happening in adult women, think about what can occur in young children. There’s even suspicion that these chemicals can cause neuro-developmental delays in infants. If you already have a sleep-breathing problem, adding xenoestrogens can only make things worse. As far as I know, I’m not sure of any studies showing that xenoestrogens can cause sleep apnea, but it can be argued that anything that prevents proper facial growth and development can increase your risk for developing obstructive sleep apnea.

What do you think about this issue? Is it a real problem that’s not being addressed by the government, or is it an an overblown concern?

 


 

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