Early Menstruation and Birth Control

Menstruation normally begins between the ages of eight and fourteen, with the average age being around twelve. When it begins before the age of eight, it is known as precocious puberty. There are two types of precocious puberty, central precocious puberty and peripheral puberty. Both, however, cause early menstruation.

Types of Precocious Puberty

• Central precocious puberty is when the processes which are responsible for puberty simply begin too soon. There is usually no particular reason why this happens when it does happen, and except for the fact that everything just starts earlier than it normally would, things proceed as they should.

  Sometimes, however, central precocious puberty can be caused by certain conditions. These include, but are not limited to, hypothyroidism, a brain tumor, brain injury caused by head trauma or an infection such as meningitis.

  Peripheral precocious puberty, however, occurs without any action from the processes which cause puberty. Rather, it occurs as a result of the release of estrogen or testosterone into the body, most often caused by problems with the adrenal glands, the pituitary gland, or the ovaries.

  Tumors on the above-listed glands or on the ovaries can cause peripheral precocious puberty. In addition, ovarian cysts can also cause this condition.

McCune-Albright Syndrome

• A more rare condition that causes peripheral precocious is McCune-Albright syndrome, causing disorders in the bones, skin, and endocrine tissues. Endocrine tissues are those which produce hormones. This disease is characterized by the formation of fibrous tissue in the bones as well as light-brown patches of skin on the body.

  Girls who suffer from this disease will usually enter puberty, which includes early menstruation, earlier than they should. Menstrual bleeding has been seen at age two, long before any signs of puberty and/or sexual maturity should be occurring. This is believed to be caused by an overproduction of estrogen caused by the presence of a cyst on one of the ovaries.

Type of Birth Control Pill and Effects

• Early menstruation can be treated by the prescribing of a birth control pill that contains cyproterone. This ingredient prevents testosterone from acting in the way it should and also blocks androgen receptors. Androgen cannot bind to these receptors; therefore testosterone levels are reduced due to the suppressing of the luteinizing hormone.

Considerations

• Besides causing early menstruation, precocious puberty can lead to an early growth spurt. However, once puberty ends, growth ceases also; therefore, there is a chance your child could not grow to full height. Treatment of precocious puberty, however, will slow the growth process, and it will begin again when true puberty begins.

  If an underlying condition such as a tumor or disease is causing early menstruation, the tumor will be removed, or the disease will be treated. As soon as the problem is corrected, precocious puberty will stop, and at the intended, regular puberty will begin.

Warnings

• When cyproterone is given in high doses, liver toxicity can occur. The lower the dose can be, however, the less likely this is to happen. However, the doctor will monitor your child's liver functions carefully, in order to determine if this is happening or not.

  Cyproterone can also cause mood changes, specifically toward depression, although some children who were suffering from depression reported improvement in those symptoms. Children who are exhibiting signs of depression, however, should be watched closely, and the doctor should be kept aware of the condition.