May 2012

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What is precocious puberty? 

Precocious puberty is the beginning of sexual maturity that starts before age 8 in a girl or 9 in a boy.

A comprehensive article, Puberty Before Age 10: A New ‘Normal’?, written by Elizabeth Weil and published in the New York Times in March examines what we know today about early puberty in girls.

Weil’s article highlights the fact that although breast development begins years earlier than previously documented, the average age of girl’s first periods has remained nearly the same — dropping minimally to 12.5 from 12.8 years of age. Ms. Weil asks the question, why is puberty starting earlier but ending near the same age?

Robert Lustig of Benioff Children’s Hospital wonders if girls with early breast development are in puberty at all, arguing that puberty begins in the brain when gonadotropin-releasing hormone (Gn-RH) sets off the pituitary to signal the ovaries to produce estrogen. The Mayo Clinic explains it similarly, showing these steps on their website.

Many girls with early puberty have developing breasts and pubic hair — even as young as 4 years of age — but do not show signs that their ovaries are producing estrogen. This is sometimes referred to as partial precocious puberty. Also, some do not have another sign of true puberty, advanced bone age. During puberty, bones lengthen, cartilage shrinks and at the end of the process, plates fuse together. In Precocious Puberty, this process can cause stunted growth. Exactly where in this process a child falls can be determined with x-rays.

So, why are some girls growing breasts and/or pubic hair as young as 4 even if full puberty hasn’t commenced? If estrogen isn’t coming from their ovaries, where is it coming from? The main factors generally agreed upon to be the sources of this rogue estrogen are overweight and environmental toxins.

In Traditional Chinese Medicine, These Individual Factors Would Be Addressed In the Overall Treatment of the Presenting Problem.


Girls who are overweight have higher levels of the hormone leptin which can lead to early puberty. This starts a feedback loop of leptin –> puberty –> higher estrogen –> greater insulin resistance –> more fat tissue –> more leptin –> more estrogen, which can propel a body onwards through puberty.

How Can Traditional Chinese Medicine (TCM) Help Early Puberty Due To Overweight?

In TCM, eating more than you can process and eliminate efficiently can cause not only overweight, but a condition known as dampness. The function of the spleen and stomach is to convert food and water into energy and the rest to waste. If spleen chi is weak there can be trouble draining which results in blockages and stagnation. We can treat this by reducing problem foods and using acupuncture and herbs to drain the damp and strengthen digestion. Encouraging girls to enjoy physical activity will help burn up excess damp and keep the digestive fire lit. When the system is righted and they are enjoying healthy, clean foods, overweight will cease to be a problem.

Environmental Toxins

Unfortunately, our environment is full of endocrine disrupting chemicals that act as estrogen mimics. BPA (Bisphenol A) was used as a synthetic estrogen in the 1930s. It was used in plastic production starting in the 1950s and can now be found everywhere in things like water bottles, the lining of canned food, and sales receipts. It has been found in the bodies of 95% of adults and in remote natural landscapes. It is hypothesized that estrogen mimics are triggering early breast development.

How Can Traditional Chinese Medicine Help Early Puberty Due To Environmental Toxins?

TCM increases circulation in the body. It can boost the body’s own toxin removal and repair systems (lymphatic, digestive, circulatory) preventing further damage from toxins lingering in the body. Additionally, if a child is experiencing other systemic issues related to the the early puberty, TCM practitioners will be able to diagnose and treat these issues as a whole.

Treating “Qi Bing”, Strange or Rare Cases

In the January 1998 Journal of Chinese Medicine, Bob Flaws relates an account of a successful treatment for precocious puberty by Dr. Qiao Yong-xian.

Flaws writes that many people turn to TCM for diseases that are difficult to treat or are rare, such as MS, lupus, or Marfan’s syndrome when traditional medicine doesn’t provide enough relief or information. Because of this, TCM holds a treasure trove of case histories of difficult diseases called “Qi Bing” which translates as strange or rare diseases. In the precocious puberty case, a four year old girl came in with enlarged breasts and vaginal bleeding but no other signs of puberty. Based on this and other physical signs found in the diagnostic process, Dr. Qiao prescribed appropriate herbal medicine and saw her again in 7 days. In that time she had been diagnosed with precocious puberty at the hospital. Dr. Qiao adjusted her custom herbal formula following her condition over several visits. The patient finished the treatment and was symptom free, all within a month. Three follow up visits six months apart were made and found the patient to be in good health with no recurrence of symptoms.

Dr. Qiao acknowledged that partial precocious puberty is complex but if treated early on, the cure rate is good. However, complete precocious puberty (that has initiated in the brain) is not easy to treat. As Dr. Qiao says, “The tree has already been made into a boat.” Western doctors hesitate treating precocious puberty with hormone therapy because it is hard on young girls.They prefer parents to instead support their children emotionally and provide them with the new skills they need to cope with their body’s changes. However, as Flaws points out, “When treated with Chinese medicine based on pattern discrimination, one can also obtain a good effect but with no side effects.”



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