Puberty in girls: signs, complications, symptoms, what is it? Puberty of girls. Puberty of adolescent girls

In the vast majority of girls, puberty begins at the age of 8-13 years (average 10.5 years).

Stages of puberty in girls

Stages of development of the mammary glands	Stages of pubic hair
Stage 1. Prepubertal. Only the nipples protrude above the surface of the skin	Stage 1. Prepubertal. The growth of only vellus hair is noticeable, which is not more pronounced than on the anterior wall of the abdomen, i.e. pubic hair is absent
Stage 2. Bud stage. The mammary gland and nipple protrude slightly above the surface of the skin, the areolas increase in diameter	Stage 2. Growth of lightly pigmented sparse vellus hair located only along the labia
Stage 3. Further breast enlargement	Stage 3. Hair becomes much darker, coarser, more crimped. There is a growth of sparse hair over the pubic joint
Stage 4. Areola and nipple protrude above the surface of the mammary gland in the form of a mound	Stage 4. Full pubic hair as in an adult, but the covered area is noticeably smaller than in most adults.
Stage 5. maturity stage. Only the nipple protrudes above the surface of the gland, and the areola continues the contour of the mammary gland.	Stage 5. Pubic hair, both in quality and type, corresponds to the adult period and is distributed in the form of a triangle turned apex down. Hair is also noted on the inner surface of the shins, but not along the white line of the abdomen, and does not extend above the base of the triangle of pubic hair growth.

In the prepubertal period, the level of gonadotropins and gonadal steroids is low. At the same time, under the influence of ACTH, the secretion of androgens of the adrenal glands begins to increase in girls from the age of 6-7 years, i.e. a few years before the activation of the hypothalamic-pituitary-gonadal system in puberty. This phenomenon is called adrenarche. The growth spurt observed before puberty and sometimes the appearance of axillary and pubic hair are associated with the action of adrenal androgens. Secretion of hormones of the adrenal cortex gradually increases until late puberty. Pubic hair growth is caused by androgens from the ovaries and adrenal glands, and hair growth is evaluated separately from the degree of development of other signs of puberty.

Hair in the armpits appears at about 13 years of age, and at the same time, sweat apocrine glands begin to function, which are localized in the armpits, genitals and mammary glands. Acne, acne occurs in girls at the age of 13 as a result of increased secretion of gonadal steroids.

The first sign of puberty in girls is the growth acceleration that precedes the pubertal growth spurt. The onset of puberty is usually associated with such an easily observable symptom as breast enlargement. The shape and size of the mammary glands are also determined by genetic factors and nutrition, but the characteristic stages of development of the glands are observed in all girls without exception. The diameter of the nipple practically does not change in the 1-3rd stages of development of the mammary glands (3-4 mm), but increases significantly in subsequent stages, reaching 7.4 mm in stage 4 and up to 10 mm in stage 5 as a result of increased estrogen secretion during menarche.

Under the influence of estrogens, the fundus/cervix ratio increases. The latter acquires a pear-shaped shape, while lengthening from 3 cm in the prepubertal period to 5 cm. The ovaries increase in volume from 1 ml in prepubertal to 2-10 ml. The length of the vagina from 8 cm at the beginning of puberty increases to 11 cm by menarche.

Pubertal growth acceleration occurs under multilateral endocrine control, in which the leading role is given to growth hormone and sex hormones, with a lack of which the pubertal growth spurt decreases or does not occur at all. By enhancing the secretion of growth hormone, sex hormones indirectly stimulate the synthesis of IGF-1 and, in addition, directly activate the formation of IGF-1 in cartilage. Sex hormones stimulate the maturation of chondrocytes and osteoblasts, which leads to the closure of epiphyseal growth zones. On average, during puberty, girls grow by 25 cm, and the later the puberty begins, the higher the final height (due to the longer puberty period).

From the beginning of puberty, the growth rate of the legs outstrips the growth rate of the body, but during the period of the growth spurt, these rates are equalized. The distal parts of the limbs (feet and hands) begin to grow before the growth of the proximal parts begins, so the rapid increase in shoe size is the first harbinger of the pubertal growth spurt.

From the middle of puberty, estrogens can stimulate the secretion of gonadotropins. The frequency of peaks of GnRH secretion rises to normal values, which increases the secretion of LH predominantly in comparison with FSH. This stimulates the synthesis of estrogen by the ovaries and leads to a median surge of LH secretion, which causes ovulation. However, in the first menstrual cycles, despite the median release of gonadotropins, ovulation does not always develop: up to 90% of menstrual cycles in the first year after menarche are anovulatory, and 4-5 years after menarche, up to 20% of cycles still remain anovulatory. The onset of menarche is closely correlated with a skeletal age of 13 years.

Features of the development of girls and what mothers need to remember and know

We know a lot about babies, we argue about diapers, swaddling and vaccinations, but our daughters grow up, puberty sets in, when a young maiden blooms from an angular girl in one year. What kind of puberty is this, what is its peculiarity in girls and what do mothers need to remember and know?

Puberty is a complex of physical changes in the girl's body, combined with psychological changes, they occur gradually and are manifested by the onset of menstruation. This event usually occurs between the ages of 12 and 14, but may also occur somewhat earlier or later, with a range of 10 to 15 years on average. Each girl has her own menstrual cycle, the duration of menstruation will be from 3-4 to 7 days, in the first year of menstruation they will be irregular and there is no need to be afraid of this.

What will menstruation depend on?
The reproductive function of the girl will depend on the state of health of the girl, her compliance with the rules of personal hygiene. In healthy and hardened girls who play sports, menstruation usually passes easily. But in weakened, overtired or often ill girls during menstruation, malaise, pain in the lower abdomen, headaches and aching in the lower back can be noted. A healthy girl may also have mild weakness, but this usually does not interfere with her usual lifestyle, she just needs to slow down the pace of training and classes.

Girls can lead a normal life during menstruation, they are not contraindicated in going to school or physical education, only jumping, carrying weights or cycling need to be canceled. At the time of menstruation, it is worth eating less salt and hot spices, they can increase the separation of blood during menstruation. Teach your daughter to keep a calendar of menstruation, it will be calmer for both you and her - remember, sexual life begins in adolescents without asking our permission, and if there is menstruation, pregnancy is always possible. While, unfortunately, her mother will need to think for the girl, the girls have a wind in their heads. In the calendar, let him mark the date of the beginning and end of menstruation, its duration and abundance, this will also help to note health disorders if they occur. Regular menstruation speaks of puberty - that is, the ability to conceive a child, but this is far from the maturation of a girl as a person.

About the menstrual cycle.
Tell the girl about the menstrual cycle - this knowledge will help her be more careful about her health and possible children. Menstruation is the beginning of the menstrual cycle, and not its end, as many people think. The cycle is calculated from the beginning of one menstruation to the beginning of another. They go continuously one after another due to the cyclical hormonal processes in the body, regulated by the maturing brain of a girl. On average, the cycle can be from 22 to 24 days less often longer. The menstruation itself is 3-7 days. The whole cycle can be divided into several phases in which special changes in the body occur.

First period or menstrual bleeding- this is the first day of the cycle, during it the endometrium and its vessels are rejected, leaving with bloody secretions. This is a mixture of blood, mucus and mucous membrane cells, in one cycle there is a loss of up to 30-100 ml of blood, but if it is much more, immediately go to the doctor with your daughter. The first days of menstruation are more plentiful, in the subsequent days they are scarce.

Second phase- this is follicular, during this period, under the influence of hormones, one follicle begins to mature in each cycle in one of the ovaries. Under the influence of estrogens, the inner layer of the uterus begins to grow, the follicle reaches 20-25 mm. Follicles are taken from ready-made primordia, there are about 400 thousand of them in the ovaries by the birth of a girl, about 500 will mature in her life.

Third phase- this is ovulation, it is at this time that the egg is released and it is in it that women become pregnant. This is important to know so that the girl understands the essence of protection from premature pregnancy. During ovulation, the follicle bursts and the egg enters the fallopian tube and moves along it. In the fourth stage, the egg moves through the tube, and if there is no pregnancy, the thickening and loosening of the endometrium, the death of the egg. A decrease in the level of hormones and again the transition to the first stage of the cycle - the rejection of the endometrium. If a girl becomes pregnant, her periods will stop - the absence of menstruation is the first of the signs of pregnancy, although they may be absent for other reasons.

What does menstruation depend on?
The correctness and regularity of the girl's cycle depends on her sexual and hormonal health. The main gland in menstruation is the hypothalamus, after equal time it will send a command to the pituitary gland to release hormones that affect the ovaries and the entire reproductive system of the girl. The ovary, in response to these signals, produces estrogens and progesterone, which will allow the follicle to mature and prepare for a purely theoretical conception. If any of the links in this chain fails, this leads to a disruption in the formation of menstrual function and requires the participation of a doctor. The first two years, the irregularity of the nature of menstruation is allowed, but at the age of 16-18, all monthly functions should already be clearly established, the cycle should become regular and not bring much discomfort. If this does not happen, this is an occasion to contact a teenage gynecologist.

Teenage girls today have poor nutrition, often girls of 15-18 years old are either obese or excessively thin, many live in constant stress from exams, unrequited love or problems in the family, all this unbalances hormones and nervous system. These factors are inextricably linked with sexual function and its formation.

Normal ovarian function is possible at a certain weight - this is usually a girl reaching a weight of 43-47 kg, for girls who are on a diet or malnourished, menstruation often disappears or comes much later. Very low weight women are infertile just because of the weight itself. Even if the girl had a normal weight, and she loses more than 10-15%, this can lead to amenorrhea. This happens due to disturbances in the functioning of the pituitary gland, and then it is difficult to recover - so, if you want to become grandmothers, watch your daughter's nutrition! But, without zeal, the reverse state is no less dangerous. Well-fed donuts begin to menstruate earlier than usual, forming puberty earlier. This is due to an increase in estrogen due to the deposition of excess fat, which gives an earlier maturity.

Not only the quantity is important, but also the quality of food - alcohol, fatty, salty and spicy food with excess meat leads to earlier ripening. If a girl, in pursuit of fashion, restricts herself in nutrition for any elements, is on a diet, this will affect her sexual functions, and sometimes this is irreversible. Vitamin A, zinc and iodine deficiency are especially dangerous; this is an exception to the diet of meat, fish and eggs.

Other factors.
There are also external factors that affect the onset of puberty - this is the climate and geography of residence. Earlier, girls from mountain latitudes and southerners menstruate, but girls from the plains and from the northern regions do this later. On average, the timing of the arrival of menstruation varies by no more than 6-12 months. The timing of the onset of menstruation also depends on the social wealth in the family and the quality of life, in stable times and good families, puberty in girls occurs a little earlier.

Physical activity will also affect the onset of menstruation; girls in adolescence have not very pronounced physical strength and endurance. Professional sport for them is a difficult test - it greatly affects the health of the genital area and general. Loads in sports or ballet inhibit the development of the sexual sphere, combined with growth and development delays in general. Look at the gymnasts and acrobats - they are all small and infantile at 16-17 years old. In addition, athletes during puberty may show signs of androgenization - the voice becomes coarser, the separation of sebum increases, and menstruation is disturbed. It depends on strength training and muscle pumping - this happens with swimmers and rowers, half of the female athletes with medals have very serious female problems. Therefore, think about what is more important for you to have a daughter's sports achievements and medals, or the presence of grandchildren in the family.

Another big problem is bad habits among girls. Our subculture and teenage hangouts instill in them the wrong styles of behavior - they try to smoke as early as 12-14 years old, secretly try alcohol and even start having sex far before adulthood. This leads to negative consequences - not only does health suffer in general, but the formation of menstrual function is also disrupted. Such girls with bad habits often have acne and a pale complexion, their voice coarsens - this is due to androgen hormones. They also affect the menstrual cycle - it becomes irregular and painful.

And bad habits damage eggs so much that after many years, when a girl, having played enough, stops drinking and smoking, she will have a high probability of giving birth to a sick baby from an egg damaged by nicotine and alcohol.

Naturally, adolescence is a difficult test for a girl, but she has her main assistant - her mother. Dear mothers, help your daughter to succeed as a woman, and she will help you to succeed as a grandmother in a few years!

What is considered precocious puberty

So, puberty is considered to be early if it occurs in girls before they reach 8 years old, and in boys - up to 9 years old. However, it should be noted that such norms do not apply to everyone - for example, among peoples living in countries with a hot climate, puberty of children occurs somewhat earlier. It has been observed that overweight children are more susceptible to early puberty.

There are factors that can affect the timing of the onset of puberty, including:

genetic predisposition;
features of the environment (climate);
belonging to a particular race;
socio-economic standard of living;
eating habits and characteristics;
endocrinological disorders (hypothyroidism, adrenal hyperplasia) or frequent use of hormonal drugs;
pathology of the genital organs: ovaries in girls and testicles in boys.

In some cases, puberty occurs earlier due to impaired functioning of the central nervous system. The following diseases can also contribute to the acceleration of puberty:

neoplasms of the brain (head and spinal);
inflammatory diseases of the meninges - meningitis, encephalitis;
hamartoma of the hypothalamus;
malformations of intrauterine development of the brain - hydrocephalus;
brain injury and damage;

Other diseases that are quite rare can also affect the timing of the onset of puberty. As an example, McCune-Albright-Braytsev syndrome can be mentioned here, in which skin pigmentation and bone structure are disturbed.

Experts distinguish between two main forms of precocious puberty:

True, or central, which is associated with the early activity of the hypothalamus and pituitary gland;
False, or peripheral, caused by hormones of the adrenal cortex or neoplasms of the glands of the genital area, which is the cause of increased secretion of sex hormones.

In many cases, the cause of early puberty is the premature activity of the pituitary gland.

How can you recognize early puberty?

The reproductive system of both boys and girls is formed during fetal development. Each child, by the time of birth, receives a complete set of necessary genital organs, but they “wake up” just at the time of the onset of puberty. By about the age of six in girls, and by the age of eight in boys, the adrenal glands begin to intensively produce androgens that affect changes in the child's body. This process precedes the onset of puberty.

So, on the basis of what signs can we conclude that the beginning of puberty in a child?

Boys

an increase in the size of the external genital organ, especially the testicles;
the appearance of facial hair (fluff above the upper lip), pubic hair and armpits;
intensive growth;
change and breaking of the voice;
change in sweat odor.

For girls:

breast formation;
hair growth of the pubis and armpits;
change in the shape of the body, intensive growth;
the beginning of menstruation;
the appearance of acne on the face;
change in sweat odor.

The appearance of secondary sexual characteristics in a girl

Acne is one of the signs of puberty.

How is it diagnosed

First of all, it is necessary to carefully examine the child, if the signs mentioned above are found, it is best to contact an endocrinologist who will conduct the necessary examinations and decide what cause the child's condition is and whether it needs treatment or correction.

To establish an accurate diagnosis, a special blood test is performed with a preliminary introduction to the child using an injection of a special hormone that releases gonadotropin. Depending on the result, the doctor determines the form of precocious puberty.

In addition, an X-ray examination of the child's hands is used to diagnose early puberty. The data obtained make it possible to determine the biological age of the bone tissue and its correspondence to the chronological one. When comparing the biological age with the size of the hands and wrists, one can conclude whether the child’s skeleton develops normally, whether the bones increase in size too quickly.

If there are suspicions that brain pathologies are the cause of early sexual development, children are examined using an MRI - magnetic resonance imaging. To identify possible disorders of the thyroid gland and organs of the genital area, the doctor may refer to an ultrasound scan and a blood test for the level of thyroid-stimulating hormone (TSH).

Is it necessary to treat

First of all, the main task of treating precocious puberty is to stop the intense manifestation of secondary sexual characteristics, sometimes causing psychological trauma to children. In addition, a too rapidly developing skeleton outstrips the growth of internal organs and leads to the development of bone fragility.

The choice of treatment method will depend on what causes the child's condition, and to what extent this condition is pathological. If premature puberty develops due to early activity of the pituitary and hypothalamus, then it is quite possible to slow down this process slightly by taking small doses of hormonal drugs, equalizing the child with peers. This is more of a psychological problem than a physiological one.

In the case when tumors of the brain and spinal cord are the cause of premature puberty, the doctor will consider either the possibility of conservative treatment of neoplasms, or, in extreme cases, the need to remove them. Modern medicine has high-tech methods that allow you to rid the patient of tumors without the use of a surgical scalpel, followed by rapid rehabilitation.

If the cause of premature puberty of a child lies in the disruption of the endocrine glands - the thyroid gland, adrenal glands, etc., drug therapy is carried out with the help of special steroid preparations.

Premature puberty most often causes psychological discomfort of the child.

How to prevent premature maturation

Alas, many natural factors, such as racial and genetic characteristics, cannot be eliminated. However, if your child is accustomed to a healthy lifestyle from childhood, his risk of such disorders will be significantly reduced. To do this, the baby must eat right, not abuse the intake of medicines, and especially hormonal ones. Parents should strictly control the weight of their child.

Unfortunately, there is still an erroneous opinion about how a well-groomed baby should look like - chubby arms and legs, a round tummy and bright "diathesis" cheeks. Here it is, the idol of grandparents! Parents should understand that the consequence of this "beauty" will be a disorder of the hormonal sphere of their beloved child.

It is also necessary to know that a child who goes through puberty too early is traumatized by the fact that he is not like his comrades. It is no secret that in children's groups he will be ridiculed, and in the worst cases, bullying. Parents should help the child cope with their condition, and for this it is best to contact a child psychologist or psychotherapist.

It is possible that precocious puberty in a child does not have a reason to worry, but parents should be more attentive to this factor, since it may be based on serious diseases that require immediate treatment.

How to understand that your body has already begun puberty? When does it start and what are its symptoms? What to expect from the first menstruation? In this article, you will find answers to all your questions.

Signs of puberty

One of the first signs of puberty is a sudden change in height. If earlier you added an average of 2 centimeters per year, then during puberty you can grow by 10 cm in a year! At the same time, girls grow much faster than their peers boys. This difference in height levels off at the age of 17-18. Just when girls reach puberty.

Then the proportions of your body begin to change: the length of the limbs increases compared to the length of the torso. Because of this, there is a change in the proportions of the body, which can visually make you awkward. Don't worry, it happens to everyone.

The growth of your body provokes the appearance of one of the most unpleasant signs of puberty - acne. This happens because the skin is greatly stretched due to the increase in bones in the process of growth. To avoid cracks, the body activates the sebaceous glands. As a result of their work, hair and skin become more oily. Thus, excess activity of the sebaceous glands leads to acne.

Then secondary female sex characteristics begin to form in your body. First of all, your breasts are enlarged. At the same time, hair begins to appear in the inguinal and axillary regions.

The amount of hair on your arms and legs will gradually increase, and they will become darker.

The culmination of puberty in girls is the first menstruation. It is also called the beautiful word menarche.

The changes in your appearance will not end there! The figure will begin to acquire rounded outlines that are characteristic of the female body.

In addition to external changes, hormonal changes are taking place in your body. The activation of the sebaceous glands begins, which, as you already know, leads to the appearance of acne.

When does puberty begin?

Puberty can start at 7 years old, or maybe only at 13. But the usual time for him is 10 years. This process can take 1.5–4 years. Usually, the first menstruation occurs two to three years after the girl begins to develop breasts. You must understand that the puberty of each girl is a very individual process! Some girls are already almost fully formed by the age of 12 or 13, while others enter this process much later.

The sooner you start puberty, the sooner it will end. That is, if you already have signs of puberty at the age of 9, then after a year and a half you can wait for the first menstruation, and if these signs are noted at 12-13 years old, then two to two and a half years may pass before the first menstruation.

Phases of puberty

Puberty is divided into two phases:

Presexual phase (occurs at the age of 8-9 years and lasts about 5 years); This phase begins when secondary sexual characteristics appear, the body is actively developing and growing rapidly. The presexual phase ends with the appearance of the first menstruation.

Pubertal phase (begins at 13-14 and lasts until 18 years). After the first menstruation, growth slows down. This phase ends with the completion of sexual development, when your body is completely ready to conceive and bear a child.

Factors affecting the onset of puberty

Heredity: ask your mother or other relative when she first got her period. Most likely, you should expect them at the same age.

Nationality: Girls belonging to different nationalities may begin puberty at different times. This is due to genetic information.

Weight: If you are thin, your period may start a little later than your fat girlfriend. And your normal menstrual cycle may also be different.

Psycho-emotional environment: if the conditions in your family are unfavorable and you are under constant stress, there may be a failure in the nervous regulation of maturation processes and menstruation will come later.

Presence of chronic diseases: if you are in poor health and have chronic diseases, puberty may begin later and take longer than others.

first menstruation

A few days before your first period, you may feel new and slightly uncomfortable sensations that are associated with premenstrual syndrome. Yes, yes, this is the same PMS. Its main symptoms are:

Appetite increase

Pain in the abdomen and lower back

Breast enlargement

mood swings

Tearfulness

Irritability.

Apathy and weakness

As a rule, the first menstruation is not strong. In general, it may be a few spots on your underwear that you will not immediately notice. But don't be surprised if you immediately have a copious discharge. Here you can not guess who will be lucky. But, in any case, it is the discharge of blood that is the main sign of the first menstruation.

Learn how to use the menstrual calendar.

On average, menstruation lasts 5 days. But a period of 3 to 8 days is absolutely normal. So if your period lasts only 3 days, it is absolutely normal. Moreover, you can be envied. If menstruation does not stop for more than 8 days, be sure to consult with gynecologist .

If you're worried that your period might start at any time, keep a pad in your purse just in case. Even if it happens to you during the lessons, you will be ready. And this is very reassuring. If your period takes you by surprise, don't hesitate to ask another girl for a pad. This is absolutely normal, female solidarity.

Don't forget that puberty is a very individual process. Everyone goes through it differently. So don't worry if your girlfriends are already on their period and you're still waiting. For complete peace of mind, you can consult a gynecologist.