A recent study that analysed data from more than 71,000 females in the United States published in JAMA Network Open revealed that the average age at menarche, a menstruator's first period decreased from 12.5 years from those born in 1950-1969 to 11.9 years for those born in 2000-2005. The research also found that menarche may happen earlier than the age of 11 in some cases. Dr Ash Sujit G, consultant gynaecologist and obstetrician at PD Hinduja Hospital and Medical Research Centre in Mumbai notes that while the average age for menarche has become 6 months earlier in the US since the 1960s, the average age in India remains between 12.77 years to 13.49 years. "That said, around 10-15% of girls are getting their periods at age 7 or younger. There has been an obvious shift in the age of menarche, with as many as 30% of them getting thelarche (breast growth) and pubarche (hair growth around the pubic and axillary area) by the age of 8," he notes. This is a trend mostly seen in developing nations. The initial years mostly have irregular cycles and hormonal imbalance around early menarche, which can add to longer and heavier periods along with pain, weakness, iron and vitamin deficiencies, loss of school days, and overall poor health for the kid, notes Dr Ash Sujit G. But Why Is This Happening?"Several environmental and lifestyle factors contribute to this change. One of the key contributors is excessive body weight or obesity which is associated with a sedentary lifestyle as excessive body fat triggers the production of estrogen which further accelerates puberty," notes Dr Avir Sarkar, Assistant Professor, Department of Obstetrics and Gynaecology NIIM. Pollution, Sedentary Lifestyle And StressChildhood obesity and stress are the two most important reasons. High androgen levels, note the experts and more fat tissue, and eventually more estrogen conversion can cause changes in hormonal patterns. Also, pollutants in plastics, cosmetics, food products, and the environment (phthalates, bisphenol) have been linked to endocrine disruption and interfere with hormones. There has been a significant influence of lifestyle patterns and habits, such a high-calorie diet, and lack of exercise, over the menarcheal age, and this is where the area of concern and change lies, notes Dr Ash Sujit G. What Happens Then?" Girls with early menstruation have higher chances of premature sexualization or struggle with the social and emotional challenges of puberty before they are ready. Earlier menstruation can be associated with an increased risk of certain health issues such as breast cancer, ovarian cancer, and metabolic disorders in the long term. Menstruation before time doesn't always signal underlying issues but awareness and proper care can lower the significant health risks," explains Dr Sarkar. Dr Ash Sujit G also point out that as per one study, early menarche can increase the risk of breast cancer by up to 20%. "Social and emotional problems due to body dysmorphia (shorter height, early development of breasts), lack of self-esteem and depression can add to the burden too."What Can Be Done?Experts point out that awareness about menarche and how it begins is essential. "There should be unhinged talks about this as a support group, including teachers, parents, healthcare providers, along with the kid. This will help overcome the psychological barrier and fears related to menstruation and menstrual hygiene. Diet and lifestyle play an important role in this," notes Dr Ash Sujit G.