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| Basic Information |
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| Description |
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Puberty is the time of hormone changes in both sexes. It begins
nearly 2 years earlier in females than males. In females, it usually
takes place anywhere between the ages of 8 to 14 and may last
for 2 to 3 years. At puberty, the hypothalamus and the pituitary
glands produce hormones that stimulate the ovaries to increase
production of female sex hormones (estrogen hormones). This causes
the reproductive organs to mature in both size and function, allowing
reproduction to become possible. Adolescence is the period of
transition from childhood to adulthood and is generally considered
to last from the beginning of puberty to age 18 or 20
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| Characteristics |
Physical changes include:
- Breast budding. It is usually the first sign (at around age
11). The breasts often grow at uneven rates, which is completely
normal, and the difference usually disappears by the time full
maturity is reached
- Growth of pubic hair (in some females, this is the first
sign of puberty)
- Growth of hair under the arms starts about 1 year after the
pubic hair appears
- A significant growth spurt and increase in weight. During
adolescence, body weight may double due to increased fat, and
height increases by 15 to 20%. Some girls attain their adult
physique by age 13; others do not do so until age 18
- Widening of the pelvis; fat deposits on the hips; enlargement
of the uterus
- Development of sweat glands under the arm and in the groin
- Menstruation occurs at an average age of 12 1/2 years. Girls
who are overweight tend to start menstruating earlier than the
average. Menstruation may be delayed in girls who are malnourished,
involved in strenuous sports or other physical activities (e.g.,
dancing) or have a chronic health disorder. Menstrual periods
can be irregular for the first 1 to 2 years
- Other aspects of puberty include an increased appetite, changes
in the sleepwalk cycle, and temperament fluctuations. Intense
emotions and mood swings are typical (which are probably attributable
to hormone changes)
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| Expected Outcome |
- The age at the time of puberty is variable and the onset
can be especially troublesome in girls. There are physical,
mental and emotional changes that make adolescence a particularly
difficult time
- Early puberty and development toward physical maturity is
normally not a cause for concern
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| Possible Complications |
- Delayed puberty. The age varies, but may be first considered
if a girl has no signs of sexual development by age 13. Usually
no extensive medical workup to look for causes is recommended
until after age 16 is reached
- Severe acne
- Eating disorders (anorexia nervosa or bulimia nervosa)
- Emotional disorders
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| Treatment/Post Procedure Care |
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| General Measures |
- A parent should prepare a prepuberty child for the experience.
If unsure about how to communicate, seek help from educational
reference material on parenting, the family doctor, or other
resources in the community
- As a daughter goes through puberty and adolescence, parents
should try to keep the lines of communication open and keep
discussions nonjudgmental and honest. There is no easy answer
to the adolescent's complex problems dealing with family, friends,
society and the additional life stresses on teenagers
- Tampons or sanitary pads are acceptable for use during menstrual
periods. With good hygiene, there should be no problems with
menstrual odor
- A girl's first pelvic examination should be at age 16 to
18 (if not done previously) to ensure normal reproductive anatomy
and for Pap smear testing
- Seek professional help if an adolescent girl appears to have
an eating disorder (anorexia nervosa or bulimia nervosa)
- Additional information is available from the American Academy
of Pediatrics, Department of Publications, P.O. Box 927, Elk
Grove Village, IL 60007; web site
www.aap.org
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| Medication |
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If there is a problem with cramps during menstrual periods,
a mild nonprescription pain medicine may be used
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| Other |
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Adolescent girls should be encouraged to eat well, maintain
a normal weight, and to develop a routine exercise program (taking
into consideration the peer pressure and the multiple, difficult
changes going on during this time)
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| Notify Your Healthcare Provider If |
- You have concerns about your daughter's physical or sexual
development
- Any unusual vaginal bleeding or discharge occurs, or there
is excessive pain during menstruation
- Your daughter develops any psychological or behavioral problems
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