Low-Income Girls Often Feel Unprepared for Puberty

A new study finds that girls from low-income families often feel unprepared for puberty, and the transition tends to be largely negative. The findings show the need for new interventions that can support and provide information on puberty for low-income girls.

Researchers at Columbia University’s Mailman School of Public Health and the Johns Hopkins Bloomberg School of Public Health studied the puberty experiences of African-American, Caucasian, and Hispanic girls living mostly in urban areas of the Northeastern U.S. They found that the majority of low-income girls lack the information and readiness to cope with the onset of menstruation.

“Puberty is the cornerstone of reproductive development,” said Marni Sommer, Dr.P.H., M.S.N., R.N., associate professor of Sociomedical Sciences at the Mailman School of Public Health.

“Therefore, the transition through puberty is a critical period of development that provides an important opportunity to build a healthy foundation for sexual and reproductive health. Given the importance of this transition, the research is striking in its lack of quantity and quality to date.”

The investigators used Qualitative Research guidelines to review the data from peer-reviewed articles with a qualitative study design published between 2000 and 2014. They used a quality assessment form as a further check of the data.

In the last two to three decades, girls have been experiencing puberty at increasingly younger ages, with 48 percent of African-American girls experiencing signs of physical development by age eight.

“This trend may mean that increasing numbers of African-American girls are not receiving adequately timed puberty education, leaving them uninformed and ill-prepared for this transition,” said Ann Herbert, doctoral candidate at the Bloomberg School of Public Health.

Although many of the girls reported being exposed to puberty topics from at least one source — such as a mother, sister, or teacher — most felt that the information was inaccurate, insufficient, or given too late.

Girls also reported feeling disappointed in the information they received from their mothers; at the same time, many mothers said they were unable to fully address their daughters’ needs. Mothers were often uncertain about the right time to initiate conversations, uncomfortable with the topic, and uninformed about the physiology of menstruation. The timing of puberty also influenced girls’ puberty experiences.

The researchers noted that despite a strong focus on adolescent sexual health outcomes, such as sexually transmitted infections and teen pregnancy, clinicians and public health practitioners in the U.S. have yet to focus on the issues of puberty onset and menstruation as a window of opportunity to improve adolescent reproductive health. In addition, the current body of research leaves out many topics entirely.

“For example, missing are the voices of adolescents with non-conforming gender role and sexual orientation,” Herbert said.

Previous studies have shown that, regardless of race, higher-income girls are better informed about puberty and are more prepared for and have more positive attitudes toward menstruation. This strongly suggests that socioeconomic disparities are directly related to preparation for puberty.

“Findings from the current review suggest that low-income girls today expressed a sentiment similar to girls studied in the 1980s and 1990s — a feeling that they were largely unprepared for puberty and menarche,” said Herbert.

“Our review makes it clear that there is a need for new more robust interventions to support and provide information about puberty for low-income girls, something we are considering for the coming years,” said Sommer.

The findings are published online in the Journal of Adolescent Health.

Source: Columbia University Mailman School of Public Health