EPIDEMIOLOGY OF ABNORMAL SEXUAL DEVELOPMENT: ENVIRONMENTAL ASPECTS
Adolfo Perez-Comas, M.D., Ph.D.
Ponce Medical School, Puerto Rico
We have evaluated over 756 patients with abnormal sexual development in the Occidental region of P.R. (Puerto Rico) in the past 11 years. Main diagnosis include Premature Thelarche, Premature Pubarche, Precocious Puberty & Gynecomastia. Other diagnoses include Iatrogenic Thelarche, Pseudoprecocious Puberty, in specific vaginitis and virginal hyperplasia of breast with high estrogen levels. Other possible related conditions include asymmetry of the breast, fibrocystic disease of the ovaries, and adult gynecomastia.
Abnormal high serum total estrogen levels (80% of patients) as well as FSH, LH, & Prolactin were observed. Bone age was accelerated in 28% of patients and 60% of females presented ovarian cysts.
The condition mimics the syndrome of “Estrogenism” observed in animal husbandry on animals treated with estrogenic growth promoting agents. Diet exclusion of meat, poultry and egg products produced a significant clinical and lab remission in 58% of patients treated.
Together with Dr. C.A. Saenz, an independent investigator who has evaluated over 800 patients, estrogen contamination of poultry and meat products from P.R. and U.S.A. were demonstrated. Dr. Saenz has also found Zeranol in 5 of 6 patients studied.
At present, we calculate that there are over 3000 affected patients in the island. This represents a serious public health problem due to the somatic and psychosocial implications of the condition, as well as its direct relation with cancer.
Adequate international legislation and fiscalization is needed to prohibit the inadequate use of these products in animal husbandry. Up to this date local and federal agencies have not taken any action to stop the distribution of these products that are freely sold over the counter in P.R.