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What is puberty? When does puberty occur? What determines when puberty begins? What are the physical changes of puberty? What other changes in the body occur during puberty? What are the medical concerns associated with normal puberty? What are medical conditions associated with early, or late, puberty? Are you, like most parents, not comfortable talking to your kids about sex? Do you feel awkward and isolated about it? When do kids start becoming curious about sex? What sort of "sexual" behavior do young kids exhibit? Is it OK to use nicknames for private parts? When Should Puberty Start? What are the first signs of puberty in boys and girls? Does sexual development have a typical pattern? Does sexual development always follow the same pattern? What is early puberty? What causes it? What is delayed puberty? What causes it? Do early and late puberty run in families? How will my doctor know what is causing the change in puberty pattern? Are early and late puberty treated? What can I do to help my child? www.qureshiuniversity.com/pubertyquiz.html |
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What is puberty? Puberty is the time at which a growing boy or girl begins the process of sexual maturation. Puberty involves a series of physical stages or steps that lead to the achievement of fertility and the development of the so-called secondary sex characteristics, the physical features associated with adult males and females (such as the growth of pubic hair). While puberty involves a series of biological, or physical, transformations, the process can also have an effect on the psychosocial and emotional development of the adolescent. When does puberty occur? The onset of puberty varies among individuals. Puberty usually occurs in girls between the ages of 10 and 14, while in boys it generally occurs later, between the ages of 12 and 16. In some African American girls, puberty begins earlier, at about age 9, meaning that puberty occurs from ages 9 to 14. Adolescent girls reach puberty today at earlier ages than were ever recorded previously. Nutritional and other environmental influences may be responsible for this change. For example, the average age of the onset of menstrual periods in girls was 15 in 1900. By the 1990s, this average had dropped to 12 and a half years of age. What determines when puberty begins? The timing of the onset of puberty is not completely understood and is likely determined by a number of factors. One theory proposes that reaching a critical weight or body composition may play a role in the onset of puberty. It has been proposed that the increase in childhood obesity may be related to the overall earlier onset of puberty in the general population in recent years. Leptin, a hormone produced by fat cells (adipocytes) in the body, has been suggested as a possible mediator of the timing of puberty. In studies, animals deficient in leptin did not undergo puberty, but puberty began when leptin was administered to the animals. Further, girls with higher concentrations of the hormone leptin are known to have an increased percentage of body fat and an earlier onset of puberty than girls with lower levels of leptin. The concentration of leptin in the blood is known to increase just before puberty in both boys and girls. Leptin likely is one of multiple influences on the hypothalamus, an area of the brain that releases a hormone known as gonadotropin-releasing hormone (GnRH), which in turn signals the pituitary gland to release leutinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH secretion by the pituitary is responsible for sexual development. A gene has been identified that appears to be critical for the normal development of puberty. The gene, known as GPR54, encodes a protein that appears to have an effect on the secretion of GnRH by the hypothalamus. What are the physical changes of puberty? The sexual development of puberty has a typical pattern in both boys and girls, with a generally predictable sequence of changes. In most girls, the first sign of puberty is the beginning of breast development, which occurs at an average age of approximately 11 years. In girls, the growth of pubic hair typically begins next, followed by the growth of hair in the armpits. A minority of girls, however, begin to develop pubic hair prior to breast development. The onset of menstruation (having periods) usually happens last and usually occurs around two and a half years after the onset of puberty. A regular pattern of ovulation, corresponding to achievement of fertility, usually develops rapidly once a girl begins having menstrual periods. However, girls who have a later onset of menstruation (after age 13) tend to have lower rates of regular ovulation in the years following the onset of menstruation. Studies have shown that one-half of adolescent girls who first begin to menstruate after age 13 will not ovulate regularly over the next four and a half years. In boys, an increase in the size of the testicles is the first change observed at the onset of puberty. Enlargement of the testicles begins at an approximate average age of 11 and a half years in boys and lasts for about six months. After enlargement of the testicles, the penis also increases in size. Enlargement of the testicles and penis almost always occurs before the development of pubic hair. The next stage is the growth of pubic hair and hair in the armpits. Next, the voice becomes deeper and muscles increase in size. The last step is usually the development of facial hair. Fertility is achieved in males near the onset of puberty, when a surge in testosterone triggers the production of sperm. The sequence of changes in puberty has been characterized by physicians and is referred to as sexual maturity rating (SMR) or Tanner stages, named after a physician who published a description of the sequence of physical changes in puberty in 1969. Tanner stages are determined by the development of the secondary sex characteristics and encompass changes in the size and appearance of the external genitalia, the development of pubic hair, and breast development in girls. Tanner stages allow doctors to classify the extent of development of sex characteristics into five distinct steps ranging from stage 1 (prepubertal) to stage 5 (mature adult type). What other changes in the body occur during puberty? The "growth spurt" A rapid increase in height, referred to as a growth spurt, usually accompanies puberty. About 17%-18% of adult height is attained during puberty. Although the increase in height affects both the trunk and the limbs, growth in the limbs usually happens first. The growth spurt characteristically occurs earlier in girls than in boys, with girls having the growth spurt approximately two years prior to boys, on average. In girls, the growth spurt typically precedes the onset of menstruation by about six months. Bone growth and mineralization Puberty is accompanied by growth of bones and increases in bone density in both boys and girls. In girls, bone mineralization peaks around the time of the onset of menstrual periods, after the time of peak height velocity (growth spurt). Studies have shown that bone width increases first, followed by bone mineral content, and lastly by bone density. Because of the lag between bone growth and achievement of full bone density, adolescents may be at increased risk for fractures during this time. Weight changes Changes in weight and body composition occur in both boys and girls. Adolescent girls develop a greater proportion of body fat than boys, with redistribution of the fat toward the upper and lower portions of the body, leading to a curvier appearance. While boys also have an increase in the growth of body fat, their muscle growth is faster. By the end of puberty, boys have a muscle mass about one and a half times greater than that of comparably sized girls. Other changes Maturation of the cardiovascular systems and lungs results in an increased working capacity of these organs, associated with an overall increase in endurance and strength. These changes are more pronounced in boys than in girls. What are the medical concerns associated with normal puberty? While puberty is a normal condition and not an illness, many medical conditions and illnesses may first appear during puberty. Some conditions potentially associated with puberty include: * Acne: Acne is an inflammation of the sebaceous glands and hair follicles of the skin, which is most pronounced on the face. The hormonal changes in puberty lead to the development of acne in many adolescent boys and girls. * Gynecomastia: Gynecomastia is the term used to describe enlargement of the male breasts. The hormonal changes of puberty can cause a transient gynecomastia in normal boys that typically lasts for six to 18 months. Pubertal gynecomastia occurs at an average age of 13 in boys and affects up to one-half of normal adolescent boys. * Anemia: The normal pubertal progression in males is associated with increases in the ferritin (iron) and hemoglobin concentrations in the blood, but this increase is not observed in females. Adolescent girls tend to consume less iron-containing foods than boys, and this, combined with blood losses through menstrual bleeding, may place adolescent girls at risk for anemia. * Sexually transmitted diseases (STDs): If teens become sexually active at puberty, they are at risk for _________ and other sexually transmitted infections. * Scoliosis: Because of rapid growth during puberty, scoliosis (abnormal curvature of the spine) can be worsened. * Vision changes: Near-sightedness (myopia) has a high incidence during puberty because of growth in the axial diameter of the eye. * Musculoskeletal injuries: Adolescents may be particularly prone to musculoskeletal injuries during the growth spurt and during growth of muscle mass. Since bone growth usually precedes full bone mineralization, adolescents are at risk for fractures. Also, since the growth in the limbs usually occurs prior to growth in the trunk, some joints may be left with a limited range of motion that increases the risk for sprains and strains. * Dysfunctional uterine bleeding: Girls who have recently begun menstruating may have irregular, prolonged, or heavy menstrual bleeding. Anovulation (not ovulating) is the most common reason for abnormal menstrual bleeding in adolescent girls. What are medical conditions associated with early, or late, puberty? Precocious puberty Precocious puberty is the medical term for puberty that occurs earlier than usual. While medical professionals are not in full agreement about the age ranges for the definition of precocious puberty, many doctors believe that a medical evaluation for precocious puberty should be performed if breast or pubic hair development occurs prior to age 7 in Caucasian girls and prior to age 6 in African American girls. Boys who show signs of developing secondary sex characteristics prior to age 9 are also considered to have precocious puberty. Precocious puberty can be associated with psychological difficulties that may impact a child's emotional development. Precocious puberty is much more common in girls than in boys. Many girls experience precocious puberty in the absence of any disease or condition. In boys, however, precocious puberty is more likely to be associated with an underlying medical problem. While in many cases the exact cause of precocious puberty cannot be determined, a small number of cases are related to abnormalities of the ovaries or testes, thyroid gland abnormalities or other hormone problems, genetic conditions, tumors or infections of the brain, and injury to the brain. Precocious puberty may be treated by treating the underlying condition that is responsible for the condition, or by lowering the high levels of sex hormones with medications (known as GnRH agonists) that block the production of sex hormones to stop sexual development from progressing. Delayed puberty Delayed puberty is the late onset of puberty. Puberty is usually considered to be delayed when there has been no increase in testicular volume by 14 years of age in boys and no breast development by 13 and a half years of age in girls. Sometimes, delayed puberty tends to "run in families" and normal adolescent development proceeds normally after the delay. This is sometimes called a constitutional delay and is responsible for the vast majority of cases of delayed puberty. Constitutional delay that affects both growth and achievement of puberty is much more common in boys than in girls. Chronic medical conditions, such as diabetes or cystic fibrosis, may also cause the delayed onset of puberty. Genetic conditions, problems with the pituitary or thyroid glands, problems with the ovaries or testes, and malnutrition are other causes of delayed puberty. Many girls who exercise strenuously have very little body fat and also experience a delay in the onset of puberty, since a certain amount of body fat appears to be required for the initiation of puberty. Girls who are competitive athletes may have a delay in the onset of menstruation of up to one year or more when compared with nonathletes. Puberty At A Glance * Puberty is the time of sexual maturation and achievement of fertility. * The time when puberty begins varies greatly among individuals; however, puberty usually occurs in girls between the ages of 10 and 14 and between the ages of 12 and 16 in boys. * Body fat and/or body composition may play a role in regulating the onset of puberty. * Puberty is associated with development of secondary sex characteristics and rapid growth. * Some medical conditions may worsen or first become apparent at puberty. * Precocious puberty is puberty that occurs earlier than usual. It is more common in girls than in boys. When do kids start becoming curious about sex? Children are human beings and therefore sexual beings. It's hard for parents to acknowledge this, just as it's hard for kids to think of their parents as sexually active. But even infants have curiosity about their own bodies, which is healthy and normal. What sort of "sexual" behavior do young kids exhibit? Toddlers will often touch themselves when they are naked, such as in the bathtub or while being diapered. At this stage of development, they have no modesty. Their parents' reaction will tell them whether their actions are acceptable. Toddlers should not be scolded or made to feel ashamed of being interested in their bodies. It is natural for children to be interested in their own bodies. Some parents may choose to casually ignore self-touching. Others may want to acknowledge that, while they know it feels good, it is a private matter. Parents can make it clear that they expect the child to keep that activity private. Parents should only be concerned about masturbation if a child seems preoccupied with it to the exclusion of other activities. Victims of sexual abuse sometimes become preoccupied with self-stimulation. Is it OK to use nicknames for private parts? By the time a child is 3 years of age, parents may choose to use the correct anatomical words. They may sound clinical, but there is no reason why the proper label shouldn't be used when the child is capable of saying it. These words penis, vagina, etc. should be stated matter-of-factly, with no implied silliness. That way, the child learns to use them in a direct manner, without embarrassment. In fact, this is what most parents do. A Gallup Poll showed that 67% of parents use actual names to refer to male and female body parts. The American College of Obstetricians and Gynecologists (ACOG) recommends that girls first see a gynecologist when they're between the ages of 13 and 15. Not all girls will need a pelvic exam during this initial visit, though. Many gynecologists will just do a regular health exam and talk to a girl about her development. This is a great way for your daughter to develop a relationship with her gynecologist, so that she is comfortable sharing personal information in the future. While all teenage girls should see a gynecologist, it is especially important if your daughter has been sexually active (or is planning to be) or has problems with her period. For more information, check out these articles: Your Daughter's First Gynecological Exam Medical Care and Your 13- to 18-Year-Old STDs Understanding Puberty Puberty is the time in life when a young person starts to become sexually mature. In girls, puberty usually starts around 11 years of age, but it may start as early as 6 or 7 years of age. In boys, puberty begins around 12 years as age, but may start as early as 9 years of age. Puberty is a process that goes on for several years. Most girls are physically mature by about 14 years of age. Boys mature at about 15 or 16. What are the first signs of puberty in boys and girls? The first sign of puberty in most girls is breast development. The first sign of puberty in most boys is an increase in the size of the testicles. Does sexual development have a typical pattern? Yes. In girls, breasts develop first. Then, hair starts growing in the pubic area. Next, hair starts growing in the armpits. In girls, acne usually starts around 13 years of age. Menstruation (the period) usually happens last. In boys, the testicles and the penis get bigger first. Then hair grows in the pubic area and the armpits. A small amount of breast tissue might develop at this time. The voice becomes deeper. Muscles grow. Last, acne and facial hair show up. Does sexual development always follow the same pattern? No. Some children can have different patterns. Some girls develop breasts at a very young age but have no other signs of sexual development. A few children have pubic and armpit hair long before they show other signs of sexual growth. These changes in pattern usually don't mean the child has a problem, but it's a good idea to visit your doctor to find out for sure. What is early puberty? What causes it? Early puberty is sometimes called precocious or premature puberty. In most cases, early puberty is just a variation of normal puberty. In a few cases, there may be a medical reason for early puberty. You may want to visit your doctor if a young girl develops breasts and pubic hair before 7 or 8 years of age. You may want to visit your doctor if a young boy has an increase in testicle or penis size before 9 years of age. What is delayed puberty? What causes it? Sometimes (but not always) a medical reason causes delayed puberty. For example, malnutrition (not eating enough of the right kinds of food) can cause delayed puberty. Puberty may be late in girls who have the following signs: * No development of breast tissue by age 14 * No periods for 5 years or more after the first appearance of breast tissue. Puberty may be late in boys who have the following signs: * No testicle development by age 14 * Development of the male organs isn't complete by 5 years after they first start to develop. Do early and late puberty run in families? Both early and late puberty can run in families. There can be other causes, too. How will my doctor know what is causing the change in puberty pattern? Your doctor will talk to you and your child. Then your child will have a physical exam. The doctor might suspect a cause for the puberty variation and order some tests. Sometimes the cause can't be found even after several tests. These are some tests your doctor might order for your child: * Blood tests to check hormone levels * An X-ray of the wrist to see if bone growth is normal * A CT or MRI scan (special pictures) of the head to look for a tumor or brain injury * Chromosome (gene) studies Are early and late puberty treated? In most children, no cause is found. It's just a variation of normal puberty. No treatment is needed. In some children, a medical cause is found and treated. For example, if the reason for late puberty is lack of hormones, hormone medication can help. What can I do to help my child? The way children see their own body has a lot to do with their self-esteem. It's important to let children know they're OK the way they are and that you love them that way. You can let your child know that he or she is normal (when the tests are normal). You can tell your child that you'll help him or her with any problems (if the tests show a problem). If you need help or if you think your child may need counseling, talk to your family doctor. http://kidshealth.org/parent/emotions/feelings/sex.html?tracking=P_RelatedArticle |