Women's Health: Adolescent Years
Adolescent years are a time of transition when a girl's body starts changing from a child into an adult. Change can be scary, but it can be easier if girls know what to expect. During the adolescent transition, girls experience many different feelings as their body produces hormones that will trigger rapid growth, development of breasts and the start of menstruation. Eating well, staying active, maintaining a healthy weight and accepting the fact that change is normal, can help adolescent girls feel good and stay healthy during these changing times.
What is Puberty?
Puberty is when the female body develops its reproductive capability. Simply put, a girl will be capable of pregnancy after puberty. Every girl is unique, and puberty will start earlier for some and later for others. It usually begins earlier for girls than boys, somewhere between the ages of 8 and 13.
Girls may have a lot of different feelings as their body starts developing. Some feel ready to 'grow-up' and are excited as their body starts to take on the physical characteristics of the woman they will eventually become; others feel scared as their body starts to change. These feelings are all normal.
The brain initiates puberty by releasing gonadotropin-releasing hormone (GnRH). GnRH causes the pituitary gland (a small gland in the brain that regulates the release of hormones) to release two key puberty hormones, lutenizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones travel to the ovaries and stimulate the production of estrogen. Estrogen is another hormone that works with FSH and LH. Together they regulate the female development that enables childbearing and motherhood. Some of the changes that will happen as these hormones take action include growth, body odor, pimples and menstruation.
Girls may experience a time of rapid growth. They will become taller, heavier and may deposit some fat, especially in hips and thighs. Arms, hands, legs and feet will get bigger. The adolescent body grows faster now than at any other time, except the first year of life.
Ready or not, breasts will start to grow and develop. Some may feel some tenderness around breasts as they begin to enlarge. Now may be the time to try out a training bra; it often helps girls feel more comfortable. For girls who participate in athletics, a sports bra is a good idea. It can be aggravating to have those new breasts bouncing up and down when running, dancing or shooting hoops!
Hair is going to grow where it has never grown before. Pubic hair begins to grow between legs, in the pubic area. This hair will be soft and sparse initially, but will grow heavier and coarser over time. The hair on a girl's legs will become heavier and hair growth under arms begins. Some girls are embarrassed about all this hair and want to start shaving their legs and underarms. Talking it over with mom, an older girlfriend, aunt or teacher can be very helpful, and reassuring. It's okay to be natural and not shave legs or underarms. It is important for each girls to think about what's right for them.
Body Odor, Pimples and Other 'Joys' of Teen Years
Just because puberty is normal, doesn't mean girls are going to like all the changes that occur. The hormones that are moving their body toward adulthood cause the body to produce chemicals that make sweat smell. Girls may finally realize why there is a market for deodorant! Puberty hormones can also cause the face, back and chest to 'breakout' in pimples. Keeping skin clean can help. Also, talk to the doctor if pimples (acne) become a serious problem. Underpants may feel damp a lot during these days. Vaginal discharge (it may be clear and watery, or white and mucousy) is a normal part of female adolescence. If any itching, burning or odor occurs with this discharge, check it out with the doctor right away.
Menstruation (Starting Your Period)
Menstruation usually starts between age 9 and 16 for girls today. Starting to menstruate means that physically a girl's body is capable of becoming pregnant. The menstrual cycle (period) is a monthly cycle that begins with the production of estrogen and progesterone. These hormones are produced by the ovaries and trigger the lining of the uterus to prepare for a fertilized egg. Estrogen stimulates ovulation, the release of an egg (ovum) from ovaries. If the released egg is not fertilized by a male's sperm, it will break down. Estrogen and progesterone levels decline and the lining of the uterus sloughs off in the bleeding known as menstruation.
A typical monthly cycle lasts about 4 weeks. A girl's actual period will usually last between one and 7 days. When girls first start having periods, they are often irregular. Some girls have their first period and then don't menstruate again for a few months. Some girls have periods every 3 weeks, others have them about every 6 weeks. The average amount of menstrual fluid lost during a period is about 4 tablespoons. Some girls experience cramps (abdominal pain) during their period. A chemical called prostaglandin makes the uterus contract to expel the uterine lining (blood and tissue) during menstruation. These uterine contractions can be painful. If cramps are severe, talk with the doctor.
More About Menstruation
Starting one's period can be a wonderful, and yet terrible time. Girls may feel excited at this physical signal of their body maturing, or terrified that they aren't ready to become a woman.
It's extra hard on girls today because menstruation happens earlier. In the early 1900's, girls usually didn't start their periods until they were 15 or 16 years old. A 16 year old teen is probably a lot better equipped emotionally to handle menstruation than a 9 year old girl. It's important for girls to understand that, just because their body is developing adult characteristics, they don't have to leave childhood behind.
One of the hardest things about adolescence is that girls develop at different paces. Each girl has a unique rhythm, and biological clock. What is important is that girls don't rush into adult behaviors. Each will have the rest of their life to be a grown woman. Why not enjoy being a girl?
Mood Swings and Emotions
An adolescent girl's body is going through huge changes. They are bound to have some strong feelings during this time. As their body starts to feel more grown-up, they may find themselves thinking more about appearance, relationships and sex. Their feelings may be easily hurt and cry more often. Emotions may result in an easily lost temper and more anger, even with close friends and family members.
It's normal for girls to feel like they are on an emotional roller coaster. Remember, things will get easier as the body and brain have time to adjust to changes. It's important for each girl to find someone that they can talk with comfortably because they have a lot of questions. Besides parents, other helpful adults can include their doctor, a teacher or an older sister. Talking with friends can also be helpful.
Health Care for Teens
Routine checkups are needed during teen-age years. A regular visit with the doctor can help make sure that important things like vaccinations aren't overlooked. Most doctors recommend that a girl have a pelvic exam before she turns 18. If there are problems with periods or any unusual vaginal discharge, they should see a doctor right away for a pelvic exam and pap smear.
Why do girls need a pelvic exam?
The purpose of a pelvic exam is to be sure that growth and development is progressing normally. A routine exam of female reproductive organs (vagina, cervix, uterus, ovaries and breasts) can provide that reassurance. An appointment with a qualified gynecologist (a doctor with special training in women's health), nurse practitioner, family doctor or pediatrician, can give girls an opportunity to ask questions that they may not feel comfortable asking parents. They also need to learn how to care for their changing body. For example, learning to examine breasts now can help ensure future breast health.
Decide for Yourself
Teen years usually require some tough decisions. Girls may be faced with friends that push alcohol, cigarettes, marijuana or other illegal substances. Learning to be assertive and to value one's self are critical to resist pressure to engage in risky behavior. The decisions girls make now can have an impact that last the rest of their life. Some teens decide to become sexually active and put themselves at risk for contracting sexually transmitted disease, including HIV. If a girl is considering sexual activity, it is critical that they learn how to protect themselves. Talking to the doctor or health care provider is a good place to start. Remember, abstinence is the best way to prevent sexually transmitted disease.
One Step at a Time
Adolescent years can be a wonderful exciting time. What is important is to take each day as it comes, and try not to feel overwhelmed by all the changes. Girls, speak up, ask questions, and talk about feelings. Respect yourself and your body. Don't neglect your inside health; feelings and emotions are important. Accept yourself; you are a woman evolving. Decide now to take care of yourself. There will never be another time like this in your life, so full of promise for the road to a full, happy and healthy life!