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Puberty and adolescenceDefinition Puberty refers to the period of sexual maturation. Puberty is when the child experiences physical, hormonal, and sexual changes and becomes capable of reproduction. It is associated with rapid growth and the appearance of secondary sexual characteristics. Adolescence is the period of transition between puberty and adulthood. Information When a healthy child is somewhere between 9 and 16 years old, he or she will enter puberty. The exact age depends on factors such as heredity and nutrition and whether the child is a boy or girl. On average, boys enter puberty 2 years later than girls. At this time, the pituitary and hypothalamus glands in the brain (endocrine glands) begin sending out new hormones that trigger the changes of puberty. Both boys and girls usually experience sudden gains in height and weight. The hormones will regulate and help determine the person's body build (whether the person tends to be tall or short, thin or heavy, and so on). The hormones also cause secondary sex characteristics and interest in sex. In girls, the ovaries begin to increase production of estrogen and other female hormones. In boys, the testicles increase production of testosterone. The sweat glands become more active. The sweat produced has a slightly different content than when the child was small (it begins to develop more of an odor). Oil glands become more active, and acne may appear. At this time the importance of personal hygiene becomes apparent and it is important for boys and girls who are beginning to mature to pay attention to regular bathing and other aspects of hygiene. The adolescent may find that an underarm deodorant or antiperspirant becomes necessary. PUBERTY IN GIRLS Puberty usually occurs in girls between ages 9 and 16 years. The start of menstrual periods (menarche) is one of the most visible signs that a girl is entering puberty. Before having the first menstrual period, the pubescent girl will normally experience:
The ovaries increase their production of estrogen and other hormones. This begins the monthly menstrual cycle. Having menstrual periods is only one part of this cycle. Girls are born with a place for babies to grow (the uterus). Next to the uterus are two small glands (the ovaries). The ovaries produce the female hormones and begin to release eggs, which have been stored in the ovaries since birth. Every month (approximately), an ovary releases one egg (ovum). This egg travels along the Fallopian tube, which connects the ovary to the uterus. In about 3 or 4 days, the egg reaches the uterus. During this time, the lining of the uterus (endometrium) begins to thicken by filling with blood and fluid. This happens so that if the egg is fertilized, it can grow in this thickened lining to produce a baby. The egg can become fertilized if unprotected sexual intercourse occurs during this fertile time. When a sperm cell (from the man) and an egg (from the woman) join, a pregnancy occurs. If the egg is not fertilized, it dissolves and the endometrium sloughs off and out of the uterus, and passes out of the body through the vagina. This is the menstrual flow. In between the menstrual periods, there may be a clear or whitish vaginal discharge. This is normal. Menstrual cycles occur over about one month (28 to 32 days). At first, the menstrual periods typically are irregular. The girl may go 2 months between periods, or may have two periods in one month. Over time, they become more regular. The girl may want to keep track of when she has a menstrual period, and how long the period lasts, on a calendar. This can help her to see what her individual pattern is, and can help her predict when she will have the next menstrual period. Generally, the different phases of the menstrual cycle are not uncomfortable and the majority of girls will not notice any problems. Cramping, when present, is usually mild. Severe menstrual cramping should be evaluated by a physician. There may, however, be other cyclic changes -- for example, just before or during a menstrual period the girl may feel moody or emotional, and her body may feel puffy or swollen (bloated). PMS (premenstrual syndrome) may begin to develop, especially as the girl gets older. In girls, maturation is usually complete by age 17. Any increases in height beyond this age are uncommon. Although full physical maturity has been reached at this time, educational and emotional maturity remain ongoing. It is important to remember that fertility (often present as early as age 12) precedes emotional maturity and pregnancy can, and often does, occur before an adolescent is equipped for parenthood. PUBERTY IN BOYS Puberty usually occurs in boys between ages 13 and 15. Unlike girls, there is no clearcut sign that tells a boy that he has entered puberty. However, boys will normally experience:
Increased body hair, voice changes and other physical changes are called the secondary sex characteristics of puberty. They are the consequence of changing hormone levels in the male body. The testes constantly manufacture sperm. While some sperm can be stored in a structure called the epididymis, the stored sperm are occasionally released as part of the normal process to make room for new sperm. This can occur automatically during sleep (known as a nocturnal emission or "wet dream") or following masturbation or sexual intercourse. Nocturnal emissions may be a common concern for young men entering puberty but they should be reassured that it is a normal part of maturation. ADOLESCENCE Adolescence refers to the time between the beginning of sexual maturation (puberty) and adulthood. It is a time of psychological maturation; becoming "adult-like" in behavior. Adolescence is roughly considered to be the period between 13 and 19 years of age. The adolescent experiences not only physical growth and change but also emotional, psychological, social, and mental change and growth. During this period, adolescents are expected to become capable of adult behavior and response. See school-age child development and adolescent development for detailed information about these changes. ADOLESCENT HEALTH CONCERNS Adolescents face several unique health concerns, such as:
These problems are very real. Help is available through multiple agencies, including schools, churches, police and other civic groups. Children should begin learning at home at a very young age about health, happiness, fulfillment, and dealing with life's difficulties and challenges. This should continue throughout the teenage years. Good examples set by parent(s), a stable and caring home life, participation of the parents during the growing-up process, and a good education may contribute more than any other resources to a happy and safe adolescence. Illustrations
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