Puberty in girls can really shake things up, especially when living with type 1 diabetes. Laurie Perrin, MD a specialist in women’s health, obstetrics and gynecology in Flagstaff, Arizona graciously agreed to provide her professional wisdom on a few pertinent questions for She Sugar.
What ages do pubertal changes in girls typically occur?
I was curious about this question because we are seeing puberty in girls at much younger ages. We hear many suggestions about eating organic, hormone free, grass fed, free range, cage free, etc. Many place the blame of early pubertal changes on our diet and environment.
Dr. Perrin states to expect “pubertal changes to occur anywhere from 9-14 years of age.”
What hormones changes are responsible for erratic blood sugars during puberty (resulting in insulin resistance and higher insulin needs)?
“Mostly it’s the increase in growth hormones and IGF -1 which is responsible for changes in the bodies ability to regulate insulin and insulin resistance. It’s interesting to note that these changes in insulin resistance occur in both diabetic and non-diabetic children, both due to fluctuations in GH; as well as a reaction to the normal stressors of adolescence creating a cascade of events metabolically resulting in increased insulin requirements. The insulin resistance does seem to be greater with pubertal girls compared to boys though the exact reason for this is still unclear.”
What age do you recommend for a girls first gynecological visit?
“I believe a young woman should meet with a gyn physician for a consultation only (no exam, unless there are issues) between 12-15 yrs of age. This would be solely for the purpose of education and an acknowledgement of this being the place for a person to go to for contraception - as well as issues/questions with menstruation and sexuality. It’s important for me to stress to the adolescent especially that discussions and examinations behind closed doors are completely confidential between myself and the patient alone. A woman needs her first Pap smear by age 21.”
Are there any contraindications for the human papillomavirus (HPV) vaccine with type 1 diabetes or autoimmune disease in general?
Dr. Perrin states: “There are no contraindications found regarding the HPV vaccine and type 1 diabetes or any autoimmune disease.” This is valuable information to know if this vaccine is on your radar for a child living with type 1 diabetes.
According to the CDC, HPV is the most common sexually transmitted disease. Shockingly, the CDC goes on to say: “Anyone who is having (or has ever had) sex can get HPV. HPV is so common that nearly all sexually-active men and women get it at some point in their lives. This is true even for people who only have sex with one person in their lifetime.”
HPV is easily passed between partners, even without active symptoms of the virus. Of utmost concern is the potential HPV has for causing cancer in those hosting this virus.