Early puberty in girls. Recommendations of a pediatric gynecologist. Girls' first hair: puberty

Puberty for girls begins and ends earlier than for boys (10-15 years and 12-19 years, respectively). In parallel with the acceleration of the rate of general physical development (acceleration), in the modern world there is a slowdown in the rate of puberty. And yet, puberty and the ability to bear children develop much earlier than the mental and material capabilities to raise and provide for your child. This is the main danger of early onset of sexual activity: the psychological and mental unpreparedness of a teenager, his illiteracy, lack of independence, incl. and material. Therefore, there are no general recommended timing for the optimal start of sexual activity: everything depends on the degree of psychological maturity of a person, on his responsibility, on his literacy. Therefore, puberty means only what it means, and in no case does it mean that a person has become an adult, or that he can have children, or that he has finally grown up and can take alcohol and drugs, because... they can no longer harm him. Puberty only means the end of childhood and the entry into a new period of life - adolescence.

Primary sexual characteristics: are formed in the prenatal period, are present in the newborn, and depend on genetic sex. These include the external and internal genitalia. A person has them throughout his life.

Secondary sexual characteristics: appear during puberty and disappear after menopause. Depends on hormonal levels. These include: pubic and armpit hair, in men - face, chest, legs, etc.; developed mammary glands; changes in the skeleton, body shape, distribution of fat and muscle tissue; voice changes; differences in character, temperament, psychological and mental characteristics; menstruation in girls and ejaculation in boys; sexual abilities.

In childhood and old age, a person has only primary sexual characteristics, supported by a minimal level of adrenal sex hormones.

1. Accelerate growth

Before puberty (puberty), there is a sharp growth spurt (growth rate of about 10 cm per year). In girls it begins earlier, the pace is less pronounced, and ends earlier. Therefore, girls first overtake boys who have not yet entered puberty, and then they stop growing forever, and the boys leave them far behind. Different bones grow at different speeds, hence the change in body proportions, angularity: the hands and feet grow faster, the bones of the facial skull (lengthening of the face), and lastly the torso. Therefore, teenagers appear thin, with long, awkward arms and legs, and with a horse-like face.

In parallel with the growth of the skeleton, muscle growth and development occurs. The function always lags behind the structure that is responsible for it, muscle growth does not keep pace with the growth of the skeleton (stick arms), and the growth of nerve endings and blood vessels does not keep up with muscle growth, hence the lack of coordination of movements and clumsiness of adolescents.

The lower degree of muscle development in girls does not mean that they do not need strong muscles. There are certain muscles that a woman needs primarily - these are the abdominal muscles, pelvic floor and pectoral muscles, which provide the shape of the chest and abdomen and help in sexual activity and during childbirth.

2. Thelarche - maturation and growth of mammary glands

Starts at age 10, along with accelerated growth. The mammary glands reach the penultimate stage of development by the age of 16, and the last - during the feeding of the child. Therefore, you should not worry about the insufficient size of the gland - it is still growing. Immature, small breasts do not require a bra, quite the contrary. Under no circumstances should the bra squeeze, rub, interfere, or be felt at all. A bra is not a sign of femininity, so there is no need to wear one unless necessary.

Breast growth begins with the growth of the nipple and areola. The color of the nipple can be anything from light pink to dark brown, it depends only on the total amount of pigment in the body (color of skin, hair, eyes) and nothing else, does not affect the function or sensitivity of the gland.

Dark hair may appear around the nipple. If they are rare, this is a variant of the norm (especially in eastern, southern women with dark hair and skin). If their number begins to bother you, it is better to consult a gynecologist-endocrinologist, especially if this is accompanied by hair growth on the face, abdomen, and thighs.

Veins may be visible under the skin of the breasts, especially in girls with fair skin - this is normal.

Before your period, your breasts may swell and hurt. Depending on the severity of these symptoms, you can choose remedies that alleviate them. In mild cases, you can get by with infusions of herbs and vitamins; in more severe cases, accompanied by other complaints of premenstrual syndrome, consultation with a gynecologist-endocrinologist is necessary.

3. Pubarhe - pubic hair growth

Starts at 10-11 years old. The last stage is reached by 15-16 years. Hair color, stiffness, and curl depend only on genetic characteristics and do not affect sexual function.

In girls, pubic hair occurs in the shape of a triangle with a clear horizontal upper border. Individual hairs going to the navel do not mean anything, but noticeable hair growth in the midline of the abdomen, approaching diamond-shaped, is a reason to contact a gynecologist-endocrinologist. Hair growth should not extend far to the inner thighs. Female sex hormones inhibit the spread of hair, while male hormones stimulate it.

Around the age of 13, hair growth begins in the armpits and the front surface of the lower leg. In modern women, in general, the level of female sex hormones is reduced and the level of male hormones is increased. Therefore, hair on the legs is no longer a rarity, but a variant of the norm. This hair growth should not extend to the back and inner thighs, otherwise it is a sign of increased levels of androgens (male sex hormones), especially in combination with hair on the chest, abdomen, and face.

How to deal with increased hair growth?

Do not shave your legs under any circumstances! Shaving only makes hair thicker and stiffer (just ask men). We specially trim, cut, and “refresh” the hair on the head so that it becomes thicker and grows faster - the mechanism is the same. In addition, shaving is accompanied by cuts that hurt, become inflamed, bleed, and most importantly, shaved legs are visible a kilometer away. Even in winter, do not allow yourself this quick and easy procedure - in summer you will have rough, blue-tinged feet with black spots. If you don't believe me, look at the chin of a clean-shaven brunette over 30 years old.

Legs can only be epilated. In this case, the hair is completely removed, from the root, so the new one grows slower, each time becoming thinner and lighter. However, it is, of course, much more painful, longer and more expensive than shaving.

Depilatory creams have an effect similar to shaving, because they only dissolve the outer part of the hair without affecting the root. In addition, they can cause chemical burns or allergies. The next day the same stubble grows.

Mechanical epilators pull hairs out by the roots. The effect lasts 1-2 weeks. The procedure is painful and requires patience. Wax strips do this immediately, with one jerk.

The best method of hair removal is electrical or laser removal of hair follicles. This is irreversible hair removal. It should be carried out only in highly qualified institutions, otherwise you can get scars.

It is advisable to epilate only the legs! It is better to shave or remove hair under the armpits and along the bikini line with a depilatory cream (carefully maintaining hygiene, as there is a danger of infection of the sweat glands, which could lead to surgery). It is better to bleach facial hair with hydrogen peroxide or remove it with wax in a beauty salon.

Epilation does not eliminate the cause of hair growth! Contact a gynecologist-endocrinologist, there are special drugs, androgen antagonists. They reduce the severity of hair growth, oily skin, and the number of acne. They can only be used as prescribed by a doctor, because... they are hormonal.

4. Skin changes

Due to the active growth of the skeleton, the skin does not have time to grow and begins to stretch. To avoid damage and cracks in stretched skin, the sebaceous glands begin to work actively, secreting lubricant. These glands are located at the base of the hair, which is why the hair also becomes oilier. The only way to combat excess sebum is careful hygiene. Hair should be washed every day, with special shampoos for oily hair, suitable for frequent use. Places of increased acne formation (clogged sebaceous glands, inflamed due to infection) - back, chest, neck - must be washed with soap or shower products. Your goal is to degrease the skin, but not dry it completely, because dry skin is many times worse than oily skin; irreversible wrinkles form on it very quickly.

Do not wash your face with soap. There are special lotions for washing. The main thing is to take care of your skin. Most have a mixed type: oily on the forehead, nose and chin, dry on the cheeks. You will use different care products for different areas of your face. Dry skin requires rich nourishing creams, especially before going outside, especially in direct sun or frost.

Under no circumstances should you squeeze out acne or even touch it with your hands! You push the infection, which is limited to one place, deep into the skin, into the blood vessels. There is a so-called on the face. "triangle of death", there are veins communicating with the veins of the brain. If an infection gets into them, inflammation of the membranes or the brain itself can develop - meningoencephalitis. In addition, by squeezing out acne, you stimulate the proliferation of connective tissue cells, and the wound becomes overgrown with a scar. The only way to fight is cleanliness. Do not touch your face with your hands unnecessarily, do not use low-quality cosmetics, and do not try to cover acne with foundation, because... it will clog the pores even more and cause even more inflammation. Wash your face more often, eat less sweets and fatty foods, because... These products stimulate sebum production.

During a growth spurt, the skin can stretch so much that stretch marks may appear on the thighs, abdomen, and mammary glands - purple stripes that turn white over time. If there are few of them, this is a variant of the norm.

5. Fat metabolism

The body shape begins to become feminine: short stature; shorter legs in relation to the body than men; narrow rounded shoulders, rounded wide hips; developed mammary glands; large buttocks; characteristic distribution of fat: belly, thighs. This happens because muscle tissue in girls develops much more slowly and less pronouncedly than in men, and adipose tissue, being the target of sex hormones, develops in those parts of the body where maximum protection of internal organs is necessary (in men this protection is performed by muscles, in women strong abdominal muscles would interfere with bearing a child). Overeating, low physical activity, a sedentary lifestyle, and a passion for sweets lead to impaired fat metabolism, and, consequently, to impaired puberty, because estrogen exchange and androgen synthesis occur in adipose tissue.

6. Menarche - the appearance of the first menstruation

Age 12-15 years. Deviations from this interval, especially strong ones, are a reason to contact a gynecologist.

With the onset of puberty, a girl’s external and internal genital organs begin to actively grow and mature under the influence of hormones secreted by the endocrine glands. The gonads are subordinate to the regulatory endocrine gland - the pituitary gland, located in the brain. The synthesis of pituitary hormones leads to the appearance of external signs of puberty. Growth hormone influences the growth and ossification of cartilage; ACTH stimulates the adrenal glands, whose hormones (including androgens) are responsible for pubic and armpit hair growth, changes in metabolism, and adaptation to a stressful situation. Prolactin stimulates the maturation and growth of mammary glands. Gonadotropic hormones promote the growth and maturation of the sex glands - gonads.

The ovary begins to synthesize female sex hormones - estrogens. The target organs of estrogen are all tissues and organs. First of all, the growth and development of the external and internal genital organs (genitals) occurs. The vaginal mucosa matures, becomes folded, its epithelium begins to peel off, mucous discharge appears in small quantities - this is the norm. If their color, consistency, or smell changes, you should contact a gynecologist without hesitation. Almost all women have one or another chronic infection of the genital tract, which is transmitted through household means (through towels, soap, in the pool, toilet, etc.). At an early stage they are all cured, at a chronic stage - almost never! Do not allow yourself to develop chronic infections!

The external and internal genital organs grow and reach adult sizes. The mucous membrane of the uterus begins to undergo cyclic changes, because... The release of hormones from the pituitary gland, and therefore from the ovaries, occurs cyclically. This is the main difference between the functioning of the reproductive systems in men and women: in men everything happens constantly, throughout life, and in women it happens cyclically, with an abrupt beginning and end of the activity of the gonads. The duration of the established menstrual cycle is 21-35 days. The cycle is established, at most, a year after menarche. The duration of menstruation is 3-7 days, the volume of blood lost is 30-50 ml (no more than 80 ml). Pay attention to these numbers; deviation from them, as a rule, means some kind of malfunction in the reproductive system and requires contacting a gynecologist.

At the beginning of the cycle, FSH is released from the pituitary gland, causing the maturation of oocytes in the ovary. Growing follicles secrete estrogens. Within 5 days, the dominant follicle is selected, the best of all that have entered into growth. The rest die, it grows until it reaches a diameter of 20 mm. Such a follicle synthesizes the maximum level of estrogen. They affect the pituitary gland, causing a decrease in FSH and a surge in LH. Under the influence of LH, ovulation occurs - the rupture of the follicle membrane and the release of the oocyte into the abdominal cavity, where it is captured by the fallopian tube. In the fallopian tube, the oocyte develops into an egg. Fertilization can occur here. If it does not occur, the egg passes through the uterine cavity in transit and exits into the external environment through the vagina. At this time, the uterine mucosa was preparing to receive the fertilized egg and ensure the development of the embryo. This happened under the influence of a special hormone progesterone, secreted by the corpus luteum - the gland left after ovulation. The development of the corpus luteum is ensured by LH of the hyplphysis. It is progesterone - the hubbub of pregnancy - that causes changes throughout the body, preparing it for pregnancy. If it is deficient, the so-called premenstrual syndrome: swelling of the mammary glands, fluid retention, swelling, changes in weight, mood, attention, pain in the lower abdomen. At the end of the cycle, 14 days after ovulation, the level of all pituitary hormones drops sharply, the corpus luteum atrophies, the level of progesterone and estrogen decreases, a minimal hormonal background is formed with a predominance of androgens (acne, mood changes), insufficient to retain the uterine mucosa, which has grown to adoption of the embryo. The mucous membrane is rejected and comes out along with the egg - menstruation. Immediately, FSH is released, and a new cycle begins - the growth of new follicles and the choice of the dominant one.

An established menstrual cycle means the girl is physically ready for pregnancy. With menarche, it is necessary to think about contraception in case of initiation of sexual activity, because... You can get pregnant even with an unsteady, irregular cycle, on any day.

To start menstruation, the so-called critical body mass (at least 50 kg) and a certain percentage (at least 35) of adipose tissue mass from the total body weight (estrogens depot). Therefore, girls who exhaust themselves with a diet risk losing or severely disrupting their reproductive function.

Menstruation is usually painless or moderately painful. In girls, they can be very painful due to a small hole in the hymen, which interferes with the release of menstrual flow (sometimes this hole may be absent altogether, then cyclic pain appears, intensifying from cycle to cycle due to the accumulation of blood, without discharge. This condition requires dissection hymen). Soreness can be caused by general immaturity of the body, small size of the genital organs, hormonal insufficiency, psychological characteristics, concomitant inflammatory process, strong muscle contractions of the walls of the uterus. Depending on the cause, no-spa or besalol, suppositories with belladonna, heating pads, hot baths (antispasmodics) can help with pain; aspirin, indomethacin, methindole or ketonal (anti-inflammatory); hormonal agents. It is better if the remedy is prescribed by a doctor, at the same time specifying the cause of painful menstruation.

Normally, a small amount of blood is lost during menstruation, which is even useful, because... the blood is constantly renewed, which stimulates the immune system. With increased blood loss, high nervous and physical stress, malnutrition, and hypovitaminosis, a gradual loss of iron occurs. The girl turns pale, has blue circles under her eyes, severe weakness and fatigue. These are signs of anemia, which occurs in almost all women, and especially in young women. It is necessary to take multivitamins with a high iron content.

Hygienic measures during menstruation do not differ from usual ones. The daily routine should not change. Everything is allowed. If pain or profuseness interferes with normal performance, you should consult a doctor.

Girls can use tampons. The hole in the hymen is usually large enough for a small tampon to pass through. The tampon should not be in the vagina for more than 4 hours. Tampons should not be left in overnight. The tampon needs to be changed earlier if it becomes soaked faster. You need to choose the smallest suitable tampon (if 4 hours after removal the tampon is semi-dry, then the smaller size is suitable for you). It is better to combine a tampon and a pad, and at night or when you don’t go out anywhere, use only a pad. Use products from well-known companies, beware of fakes!

A woman should keep a menstrual calendar, noting in it the characteristics of the discharge, its duration, and abundance. These calendars help the gynecologist make a diagnosis upon treatment.

Menstruation is the main criterion for reproductive health. Watch yourself! Don’t hide the incomprehensible, don’t think that some deviation will go away on its own - it doesn’t happen. There is a pediatric gynecologist who deals with virgins. Don't listen to your friends' advice, don't trust cheap brochures! Only a qualified gynecologist can help a woman with the assistance of herself!

7. Puberty is also accompanied by an increase in sexual activity, which is provided by androgens. In girls this is expressed to a lesser extent and later than in boys, but later in women sexuality is much more developed. In connection with this problem, the girl needs knowledge! Anything that is not harmful to health is possible. The only thing that is better to wait for now is sex life.

The growth of mammary glands, pubic and armpit hair before the age of eight is caused by premature puberty. If these signs appear, you should consult a doctor to avoid serious gynecological problems in the future.

Last consultation

Allah asks:

The girl turned 8 years old in August and began to notice that her breasts were swollen. We went in September and did an ultrasound of the mammary glands and an ultrasound of the thyroid gland, everyone said well, the thyroid gland corresponds to age, and the mammary glands said the formation of the gland and ducts, after that in November we went to the endocrinologist, there was no free time at the doctor. She looked and said that in appearance, both in height and in principle in weight, she was normal, maybe she was just early, especially now many children are early, so even if it turns out that she is really developing, we will not treat it. She gave us appointments to take hormone tests and undergo an ultrasound. In December I had a crazy work schedule, so I decided to do this in January after the holidays. Yes, and she was so reassuring. So we took the tests, but when we took the tests, she was kicking and screaming, we could barely hold her together with the three of us. Well, thank God they passed, phew. And here are the bad tests. And they did an ultrasound of the pelvis and said everything was fine, only there were follicles in the right ovary a little more than in the left, ultrasound of the kidneys and adrenal glands, everything was fine there, only the right kidney was a little drooping, but with the kidneys at 4 years old we were in the hospital for examination, our right one was a little twisted , the doctor said with age it will fall into place, maybe it will drop a little, and that’s what happened. And the ultrasound of the abdominal cavity says everything is fine, only the gall bladder is twisted, this is what we have had since we were little. In general, she is cheerful and active, but she drinks a lot of water, pees, and loves to eat especially sweets. It’s like saying that she somehow feels bad, no. I also wrote on one forum where the doctors all write that an MRI is necessary because prolactin is elevated. I can’t imagine how to do an MRI on her, the blood was donated by mistake. The only thing is that one oncologist wrote that no MRI is needed, it’s not a tumor, the clinic is not the same. And what should I do? I’ve been sitting at work all day today, my head hurts, I’m thinking all the time, wondering what to do. Tell me what to do? One doctor says you need to do an MRI, the second says you don’t need to do it, just retake the tests in a month and look at the diagnostics, because according to them the result is despite the fact that the numbers are such prolactin is normal. Thinking about what to do, she turned to someone else, after looking at all the tests and ultrasound, she says you have hypoplasia of the thyroid gland. I'm in shock... I'm sitting crying, I don't know what to do.

Answers:

Good afternoon, you did not send the results of the thyroid ultrasound. However, if prolactin is elevated, it is indeed recommended to perform an MRI of the pituitary gland. During this examination, you will be allowed to be near your daughter and hold her hand so that she is not afraid. Also, you need to find a specialist who will analyze the results of your examinations, scattering among different specialists, it will be difficult for you to understand what your actions should be.

Aliya asks:

Hello! The doctor diagnosed my child (girl, 8 years 10 months) with partial early puberty. Based on ultrasound and tests, I gave the following conclusion. (I don’t describe all the medical indicators) The girl’s height is now 150, from the age of 7 the development of the mammary glands, light hair growth according to the female type. Now an encrinologist and head. calving clinics are sounding the alarm that I need to take diferilin, otherwise I might go on my period and my growth will stop. When we visited the gynecologist, the doctor said that this is inevitable, don’t do anything, don’t give any injections, now some children already have early sexual development, I went to a homepath, took the prescribed pills, she also said there will be early individual development, don’t give injections. And at the site they are sounding the alarm, it’s time to take diferilin. The tests are normal, there are no deviations to be nervous, there is accelerated growth and development is ahead of peers. I’m worried, my eldest girl died from anaphylactic shock, they couldn’t save her. Tell us about diferilin?

Answers Krasulya Elena Stanislavovna:

Hello! If you are recommended diferelin, then your diagnosis should be Premature puberty (PPS) of central origin, complete or incomplete form. Since only the central form (damage at the level of the pituitary gland) can be treated with this drug. It should also be clarified and indicated what happened to the pituitary gland (benign tumor, hyperfunction, or, for example, some syndrome that is accompanied by dysfunction of the pituitary gland). Here is an excerpt from the official document:
"LABORATORY RESEARCH
Determination of FSH, LH, prolactin, TSH, estradiol, testosterone, 17-OP, DHEAS, cortisol, free T4 and T3. A single determination of LH and FSH levels is not very informative in the diagnosis of PPS.
Carrying out tests that stimulate and suppress the production of steroid hormones.
-A test with a synthetic analogue of GnRH is carried out in the morning after a full sleep. The initial values ​​of LH and FSH are determined twice - 15 minutes and immediately before the administration of GnRH. Basal concentration is calculated as the arithmetic mean of 2 measurements. A daily GnRH analogue (triptorelin) is administered rapidly as a single intravenous dose of 25–50 mcg/m2 (usually 100 mcg), followed by venous blood sampling at baseline, 30, 45, 60, and 90 minutes. Compare the initial concentration with any three highest stimulated values. The maximum increase in LH concentration is determined, as a rule, 30 minutes after administration of the drug, FSH - after 60–90 minutes. An increase in the content of LH and FSH by more than 10 times from the initial or additional values ​​characteristic of the puberty period, i.e. exceeding 5–10 IU/l, indicates the development of complete gonadotropin-dependent PPS. An increase in FSH concentration while maintaining minimal LH concentrations in response to a test with triptorelin in patients with premature thelarche indicates a low likelihood of developing gonadotropin-dependent PPS. In children with other partial forms of PPS, the levels of LH and FSH after the test are equal to those in children under 8 years of age."
In short, you had to have tests done, but they are done only in hospitals, and not in every city.
X-ray of the hand should show that the bone age is exceeded by more than 2 years, or the growth zones are closed (it is too late to treat short stature). Electroencephalography and echoencephalography should reveal at least some abnormalities. MRI of the brain in T2-weighted mode is indicated for all girls with the development of mammary glands before 8 years of age and the appearance of pubertal hair before 6 years of age.
I understand that everything is fine with you. No menstruation yet, sparse hair growth, female type. Most likely you have an Idiopathic (sporadic or familial) variant of the disease. Puberty begins at a time close to physiological, and an early surge in the growth and development of the mammary glands is observed. Pubertal values ​​of LH, FSH, estradiol or pubertal response to GnRH stimulation in the absence of organic and functional pathology of the central nervous system.
I most likely would not prescribe such a drug. He is far from harmless. Its use is justified; the benefits far outweigh the risks. When If the mother is 1.9 in height, and the daughter is 1.5, then maybe you should worry...
Also... You didn't indicate the child's weight, and this is important. All information about the drug is available on the Internet. Make a decision.

Tatiana asks:

My daughter is 5 years old. The endocrinologist examines us for PPR. Preliminary results are disappointing: follicles are maturing in the ovaries, cortisol is elevated. While we are talking about the examination. The doctor recommends examination by a neurologist. It suggests that this disease may be caused by hypertension syndrome. Is it possible to treat this disease by eliminating intracranial pressure, or can it only be treated by suppressing the production of hormones by the adrenal glands?

Answers Shevchenko Venera Nadirovna:

Hello Tatiana! Your daughter needs to be examined in a pediatric endocrinology department. Without receiving the results of a complete examination, it is difficult to recommend anything or make predictions. In addition to a neurologist, you need “bone age”, ultrasound of the adrenal glands, a complete hormonal examination (you indicated only cortisol, and not only the absolute amount of each hormone is important, but also their ratio). You did not indicate how PPR manifests itself: breast growth and/or pubic hair growth. The scope of the examination depends on this. Have you been seen by a gynecologist? If the laboratory of your clinic is available, it is better to take a smear from the vestibule of the vagina for a “hormonal mirror”, the result of which can indirectly indicate the estrogen saturation of your daughter’s body. If there are no other reasons other than increased intracranial pressure or impaired blood supply to the brain, a eurologist will actually be involved in the treatment. If there is no effect after 6 months, you must return to the endocrinologist and gynecologist. An increase in the level of cortisol alone does not indicate increased production of hormones by the adrenal glands. By the way, cortisol increases sharply if the child was very afraid of the blood sampling procedure. Other adrenal hormones need to be assessed. I advise you to be patient and undergo further examination. If you have any questions, please provide the results of all examinations and we will try to figure it out. Although it is easier for a doctor to interpret examination data in combination with an external examination of the girl. Be healthy!

Tonya asks:

Hello, I'm 15 years old. I'm dating a guy and I want to start having sex. What is the best way to choose protective equipment? and the main question is how can parents find out about this? Is the doctor obligated to keep this secret? thank you very much in advance.

Answers Karapetyan Eliz Martinovna:

Hello, Tonya! It is very good that you took care of the issues of contraception before starting sexual activity. Modern medicine has a large arsenal of contraceptives. All types of contraception are described in detail in the article Methods of modern contraception (protection against unwanted pregnancy). Doctors recommend the use of a condom for young, healthy girls who are beginning to become sexually active. If you have hormonal disorders, your doctor may recommend tablet contraceptives, which will not only protect you from pregnancy, but will also have a therapeutic effect. So be sure to consult a gynecologist - after 14 years of age, girls can visit him on their own, without their mother. Don't be afraid that the information you share with your doctor will reach your parents. This is a medical secret and keeping it is the responsibility of every doctor. Do not be ill!

Lena asks:

Hello dear consultants! Daughter is 5 years old. At the age of 4, after taking antibiotics due to itching due to candidiasis, she discovered masturbation. We tried everything: not paying attention and scolding and scolding and explaining that it’s not nice and you can’t behave like that. But the child says, “I like it, it’s ticklish there.” Is this a sign of precociousness? Where to go is a question for a pediatric gynecologist (there is no such thing in the city) or a neurologist. If this is not a pathology, then I don’t really want to advertise this, but what if it’s worth sounding the alarm?

Answers Shevchenko Venera Nadirovna:

Hello, Lena! In every major city, and especially in the capital of the country, there is a Center for Pediatric Gynecology. If your local pediatrician does not know the address of the Center, contact the deputy chief physician for outpatient services. Masturbation occurs against a background of prolonged itching, so it is important to undergo a full examination by specialists. I advise you to be examined for dysbacteriosis, because it creates dryness of the mucous membrane of the external genital organs, and hence itching of the vulva. Against the background of dysbiosis, a regular smear is normal; it is better to take a more detailed smear test (smear for dysbiosis). Itching can be caused by allergies, poor diet, helminthic infestations, changes in the composition of urine, and more. When ruling out all possible causes of itching or when treating identified problems, it is better to visit a psychologist without your daughter, who will tell you how to behave correctly with a child who has been diagnosed with masturbation. It is considered a violation of behavior if a girl masturbates in front of people. I wish you patience and be healthy!

Julia asks:

I am almost 18 years old when I was a child, about 4-5 years old, I remember that the first hair appeared on my pubic area, not fluff, but hard hair, and one breast was a little larger than the other, I grew in height very quickly, ( Could this be pre-mature puberty?) My mother and I didn’t go to the gynecologist then, now I have a lot of different problems and questions about gynecology, but I can’t go to the gynecologist with my mother, since I have a boyfriend and if I go with Mom, she will probably find out that we had sex and she will hardly understand it. please advise something

Answers Shevchenko Venera Nadirovna:

Hello Julia! The appearance of mammary glands or pubic/armpit hair before the age of 8 is called precocious puberty. So you are right in your assumptions. Regarding a visit to the gynecologist. At your age, you have the right to maintain medical confidentiality about the intimate side of your life, i.e. about the beginning of sexual activity.
Therefore, your fear is unjustified. In addition, when talking with a gynecologist, you can discuss not only health problems, but also questions about family planning, i.e. method of contraception. Among the highly effective, modern, micro-dosed hormonal contraceptives, there are those that have medicinal properties for correcting hormonal status, which forms against the background of premature pubic hair. Those. you catch two birds with one stone - you get high protection against unplanned pregnancy and correct your hormonal status. Be healthy!

Elena asks:

A 1.7-year-old girl with breast swelling since birth was diagnosed with PPP thelarche. The tests are normal, and the bone age is 4 years. What threatens the future?

Answers Medical consultant of the portal “health-ua.org”:

Hello, Elena!
The isosexual type of precocious puberty in girls can manifest itself in one or another clinical variant. One of them is the cerebral form. The main reasons for this situation are considered to be functional or organic - in this case, such disorders appear as a result of the peculiarities of intrauterine development of the fetus, the course of the intranatal period (immediate birth of a child - birth injuries, “oxygen starvation” of the brain, etc.), as well as diseases of the child in the first year of life with the involvement of the central nervous system (encephalitis, meningitis - infectious and inflammatory processes in the brain and its membranes).
Much less frequently, brain neoplasms (tumor processes) can serve as factors for the cerebral form of premature sexual development. Therefore, it is the latter that determine the particular severity of the prognosis. However, if such circumstances are excluded, after examination by a pediatric neurologist/neurosurgeon, as well as special paraclinical research methods recommended by them, you only need to remember regular examinations by a neurologist, endocrinologist, gynecologist to assess the child’s development over time.
Treatment of the underlying disease in the cerebral form of this disease is carried out by a neurologist/endocrinologist, and, if necessary, a neurosurgeon.
The incomplete form of the cerebral type of premature puberty (thelarche), in general, is manifested by a “extended” primary phase of puberty in time.
The age of menarche (first menstruation) in such cases, as a rule, occurs at 10-11 years.
Features of the hormonal background of sex hormones also determine the growth characteristics of the child (height up to 150-152 cm). Be healthy!

Tatiana asks:

Two months ago, my daughter developed a lump in her breast around the nipple, we went to a pediatric gynecologist in Akhdet and took tests for the hormones prolactin-115.9 (normal 40-355)
Estrodiol-0.08 (norm 0.029)
Lg-0.16 (norm 0.9-14.4)
Fsg-6.15 (norm 1.1-9.5)
Blood sugar 4.1 (normal 3.9-6.4)
The doctor said that hormones are normal at 7 years old, this is a variant of the norm, they prescribed me to drink potato juice. After a month, the thickening went away, leaving a slightly enlarged nipple. Now a lump has appeared in the other breast, slightly painful on palpation, we went back to the doctor and was prescribed to transfer prolactin using another method and drink potato juice. The doctor says that after 7 years it is normal for growth sake and therefore does not require hormonal treatment. But what confuses me is that menstruation may come soon and the child may stop growing; height at the moment is 126 cm, weight 23 kg, there have been no jumps in height and weight. Maybe it’s necessary before examination or treatment, but the doctor doesn’t prescribe it, I’m afraid to miss the moment.

Answers Rumyantseva Tatyana Stepanovna:

Hello!
Everything you describe is truly a variant of the norm. Each person is an individual and each person develops differently.
Remember yourself at 10-12 years old... Many of your classmates were already familiar with menstruation and wore bras..... In physical education lessons, some girls stood in front, and others at the back of the line...... Where do you live? What you eat? When did your period start? When is your mom's??? Yes, it’s possible that your girl’s period will begin earlier than that of her peers – and this happens.
The growth and development of our children is influenced by many factors, even just such a factor as living in a large metropolis. Don't worry about your baby's growth. The onset of puberty will not lead to a stop in growth, but on the contrary will give an impetus to its acceleration.
From the examination, I would advise you to undergo an ultrasound of the pelvic organs. An ultrasound will clearly show all the processes that occur there. You can do this, say, once every six months.
You will still need to monitor your baby closely. Drink freshly squeezed juices - carrot, apple and potato - make a mixture of them - believe me, it is not only tasty, but also very healthy!
Try to make your child more of a child and less of an adult, I mean conversations, movies, games, books, even clothes - everything has an impact.
If you see that the process of growing up continues, you will need to tell the girl about menstruation in a simple and clear way so that she is not afraid of spotting. And if menstruation does happen, we’ll talk about hygiene these days. Of course, doing this at 10-12 years old is somewhat easier than, say, at 9-10 years old. But I believe you will succeed!

Julia asks:

Hello. We have a problem. My seven-year-old daughter began to grow hair under her arms and on her pubic area, her voice began to change, acne appeared on her face, and she began to somehow stretch out in height. Tell me, what could this be and who is the best person to contact?

Answers Rosokha Ekaterina Miroslavovna:

Hello. The clinical picture you describe may be a manifestation of a disease such as premature sexual development. This pathology occurs as a result of disruption of the adrenal cortex, which, in turn, leads to excess production of male sex hormones. The disease is clinically manifested by the early appearance of male pattern hair, acne, enlargement of the clitoris, change in voice, male physique, and accelerated growth. With timely diagnosis and initiation of treatment, it is usually possible to reduce the level of male sex hormones in the blood and normalize the process of sexual development. Therefore, you need to immediately contact a gynecologist-endocrinologist who can carry out the necessary treatment and prescribe adequate treatment in a timely manner.

Ksenia Seryogin asks:

Hello, please help me figure this out. My daughter is almost 1 year and 9 months old, from early childhood she was diagnosed with swollen mammary glands, after I stopped breastfeeding they began to decline, now they are almost not pulped at all. But our endocrinologist sent us for tests:
1) hormones - LH 0.10 mIU/ml; FSH-3.28mIU/ml; Prolactin-7.48ng/ml; Estradiol-5.0 pg/ml; TSH-2.03 µIU/ml, so no one really told me whether it was normal or not;
2) Ultrasound of the hand with the wrist joint - showed us the age of 4.5 years;
3) Ultrasound of the pelvis - the uterus and ovaries from 3.5-4.5 years and the ovaries in the stage of formation (as the ultrasound specialist told us, this only happens at 7 years);
4) MRI of the pituitary gland - it showed nothing, they said neither a cyst nor a tumor was visible.
My question: is there really no alternative to treatment or only Defirilin? It is very scary to treat hormones with hormones. I’m already exhausted, she’s not even 2 years old yet, and all the doctors are scary. If it's not difficult, explain her tests to me. Thank you in advance.

Answers Krasulya Elena Stanislavovna:

Hello, Ksenia!
Your hormonal tests are normal. Diferilin is prescribed only for gonadotropin-dependent PPS and after a test with GnRH (if there is any doubt, it must be carried out, this is done in specialized hospitals in large regional centers).
But most likely you have Gonadotropin-independent PPS (isosexual) premature thelarche. Breast enlargement is most common in girls under 3 and over 6 years of age. As a rule, there is no pigmentation of the nipple areola, sexual hair growth and signs of estrogenization. The physical development and size of the internal genital organs corresponds to age.
The advance in maturation of the skeletal system does not exceed 1.5–2 years and does not progress further. In girls with isolated premature thelarche, in 60–70% of cases, follicles are found in the ovaries, sometimes reaching a diameter of 0.5–1.5 cm. In the hormonal status, deviations from the normative indicators for age of LH and FSH are most often absent. When tested with GnRH, girls with premature thelarche show an increased level of FSH response compared to healthy peers. The LH response is prepubertal.
Typically, the mammary glands spontaneously decrease to normal size within a year, but in some cases they remain enlarged until puberty.
Instability of gonadotropic regulation can lead to progression of sexual development in 10% of patients.
No specific treatment is required - only observation, healthy eating, regimen, vitamins.

Tatiana asks:

The girl is 6 years old, over the past year she has grown sharply and gained weight, sweating has appeared, and her character has deteriorated. She either becomes aggressive for no reason or falls into a state of melancholy. What is happening to the child, can it start like this? sexual development Is this normal at her age?

Answers Medical consultant of the portal “health-ua.org”:

Hello Tatiana!
The timing of the onset of sexual development varies from person to person, and this is especially pronounced in the case of family predisposition (constitutional, genetic factors). Thus, with the constitutional form of premature sexual development, the appearance of secondary sexual characteristics is noted - the formation of mammary glands, hair growth in the axillary areas and the pubic area - as well as menstrual-like discharge at the age of up to 7 years. All external manifestations of sexual development are initially accompanied by massive hormonal surges, “restructuring” of the neuroendocrine regulation of the child’s body as a whole (hypothalamic-pituitary centers, limbic-reticular structures), so not only physical changes, but also psychological ones are natural.
However, in order to confirm the individual physiological nature of precocious puberty, it is necessary to exclude other conditions that, accompanied by externally considered changes, may be caused by pathological disorders on the part of the structures regulating these processes.
So, taking into account the described signs, it is necessary, first of all, to confirm the “well-being” of the hypothalamic centers.
The hypothalamus is the main center for regulating the autonomic functions of the body, and the appearance of hyperhidrosis (sweating) and a sharp increase in body weight may indicate changes in the activity of this particular nervous structure, as well as the pituitary gland. Therefore, you should definitely consult a pediatric endocrinologist or neurologist.
Be healthy!

Margot asks:

Tell me, what age is considered the most favorable for starting sexual activity?

Answers Karapetyan Eliz Martinovna:

Good afternoon At 18-20 years of age, the hymen is elastic, highly extensible, and its rupture is accompanied by slight bleeding. With age, the hymen begins to lose its elasticity and thickens. 80% of the elasticity of the hymen is lost by the age of thirty. By the way, every woman’s hymen has its own characteristics. Size, type, shape, thickness, as well as the supply of blood vessels - everything is strictly individual. This leads to the fact that all women experience defloration differently. Usually there is some bleeding and pain during defloration, but there are no rules without exceptions. According to statistics, approximately 10% of women experience no bleeding or pain during their first sexual intercourse. Be healthy!

Olya asks:

My girl is 4 years old, dark long hairs have appeared under her arms, this is premature sexual development?

Answers Medical consultant of the portal “health-ua.org”:

Hello, Olya!
It is considered possible to talk about premature sexual development in a child when secondary sexual characteristics (growth of mammary glands, appearance of hair growth in typical areas, appearance of menstrual-like discharge) appear in a child under 7 years of age.
In turn, premature sexual development can be of a hetero- or isosexual type. The causes of the latter form may be cerebral, constitutional or ovarian factors. In the cerebral form of disorders of sexual development, as a rule, there are indications of functional or organic disorders of the central nervous structures (the hypothalamic-pituitary system with the natural involvement of the ovaries in the process).
This form of disorders of sexual development can be complete (when both secondary sexual characteristics and the onset of menstruation are observed) and incomplete - when hair growth appears in areas typical of the female body according to a characteristic type or development of the mammary glands in the absence of menstrual function.
The ovarian form of precocious puberty is associated with the development of hormone-producing ovarian tumors or follicular cysts.
In the constitutional form, as a rule, the age of the first menstruation in a girl (at 8-9 years) is of diagnostic importance.
Therefore, taking into account all of the above, you should immediately seek advice from a pediatric endocrinologist. Take care of your health!

Marina asks:

Good afternoon My daughter is 15 years old. Already at the age of 6, hairs began to appear on the pubis and under the arms. I then consulted a gynecologist-endocrinologist about this. At that time, the doctor determined a slight inflammation, but no treatment was prescribed for early development. First menstruation at age 11. Menstruation is irregular, with breaks of 1-2 months. Hair growth is still higher than normal: there is some on the face, thighs, butt, and a little on the chest. Six months ago (my daughter was 14 years old), during a medical examination at school, the gynecologist gave a referral for tests and an ultrasound due to irregular menstruation and complaints about hair growth. An ultrasound was performed in pediatric gynecology (slight enlargement of the ovaries, free fluid to the left of the uterus 25-10 mm) Tests: testosterone 1.0 (normal 0.01-0.5), free testosterone 9.3 (normal 0.1- 4.1), DEHA-s 4.5 (norm 0.9 - 3.6). Having this data, we came for a consultation with a gynecologist. We received referrals: ultrasound of the adrenal glands (result was normal), analysis of secretions (minor inflammation - currently treated), general clinical blood and urine tests (normal), to a neurologist, psychotherapist, ophthalmologist, pediatrician. The ophthalmologist (vascular condition) did not find any pathology. The neurologist sent for an EEG, since in childhood (up to 1 year) the child was treated for left-sided hemiparesis. EEG result: computer-topographic analysis of a resting EEG in a disorganized pattern represented by alpha activity of medium amplitude with sharply smoothed zonal differences reveals significant diffuse changes with moderate interhemispheric asymmetry in the temporal leads in the alpha and theta frequency ranges. The use of active methods of physiological control causes signs of activation of the median structures with the appearance of bilateral bursts of sharp waves, and a decrease in the threshold of paroxysmal readiness.

All surveys were carried out in October-November. After this, the gynecologist prescribed treatment with traumeel, viburkol, mulimen, veroshpiron, lymphomyosot, lactofiltrum, and vitamins. Based on the EEG results, the neurologist also prescribed treatment, but softened it due to the large number of medications taken.
After a month of this treatment, new tests were done: progesterone 0.8 (below normal), LH 2.8 (fol. phase 2.0-12.0), FSH 8.7 (normal). The doctor prescribed hormonal treatment, canceling the previous course. Since December, my daughter has been drinking Klimen. January tests: testosterone 0.5 (normal 0.01-0.8), free testosterone 10.9 (normal 0.1-4.1). They did an ultrasound again: limited. the fluid area is 27-8 mm, OD is slightly increased, OS is not increased. Doctor's decision: continue "Climen" with T monitoring. March tests: LH 5.9 (normal), FSH 9.2 (normal), testosterone 0.9 (normal 0.01-0.8), T free. 3.6 (norm 0.1-4.1) DEHA -s 4.3 (norm 0.9-3.6). Ultrasound in March: the ovaries are not enlarged, there is no fluid. May tests: Testosterone 1.2 (normal 0.01-0.8), free Testosterone 15.4 (normal 0.1-4.1), DEHA-c 4.7 (normal 0.9-3.6) .
We have been drinking Clymene for the 6th cycle already. Menstruation occurs on time. The hair growth has not disappeared, but the hair on the body has softened and decreased somewhat. However, the tests are very far from normal. At the same time (I don’t know if there is a connection), a neurologist at the district hospital said that the encephalogram (the one in October) was simply terrible.
Please excuse this huge description. But, having received the latest tests today, I am simply at a loss. We treat for 6 months. What should I do, continue treatment as before or contact someone else in Donetsk? Thank you in advance for your response.

Answers Gavrilova Irina Vsevolodovna:

Dear Marina!
According to the information you provided (somewhat chaotic), the child has polycystic ovary syndrome (unfortunately, you did not provide information about the level of LH and FSH before starting treatment).
What you write about the ultrasound does not contain sufficient information - what is important is the size of the uterus, (the ratio of width and anterior-posterior size), the thickness of the endometrium, the volume of the ovaries, the condition of the follicular apparatus, the location of the follicles in relation to the ovarian capsule. A fairly complete examination has been ordered; treatment by a neurologist is necessary. Gynecological diseases in adolescence most often develop against the background of various diseases of other organs and systems.
It is advisable for your girl to be treated by a gynecologist-endocrinologist or a pediatric gynecologist with experience in treating endocrine gynecological pathologies. It may be advisable to conduct diagnostic tests with hormones, change the drug, test for C-peptide (you do not write if you are overweight or have acne). Treatment of your daughter requires a systematic approach and must be long-term. The selection of prescribed drugs requires an individual approach. As far as I know, there are enough qualified specialists in this field in Donetsk, there is a specialized department of pediatric gynecology (you have someone to turn to) and a full-fledged consultation with a doctor will never be replaced by a correspondence consultation on the Internet.

Tanya asks:

Hello! The doctor diagnosed my child (girl, 1 year 3 months) with partial early puberty. Based on ultrasound and tests, he gave the following conclusion: True premature sexual development, incomplete form, isosexual type, thelarche. Examination:
1) PRP195mIU/l is normal
2) Ee49.8 pg/ml norm up to 30,
3) T 0.18 nmol/l is normal,
4) LH 1.99 mIU/ml norm 1.57
5) FSH 5.27 mIU/ml, normal 2.54
2) Colpocytology - CPI 0%, superficial 5%, intermediate 10%, parabolic 65%, basal 20%.
Ultrasound OMT UL 20*15*21mm
OLD 19*12
OLS 20*10
The sizes of higher education programs correspond to 3-7 years.
We were prescribed to drink melatonin, one tablet a day at 18:00. We don’t drink. Please tell us whether we should drink it or not? The instructions don’t write anything about this, it says that the drug can be taken from 12 in other sources from 16 years old. Now we drink instead of tablets, potato juice 3 times a day, a dessert spoon.
Enlargement of the mammary gland has been observed since the birth of the child. We consulted a pediatrician, he says everything is normal, this happens, the gynecologist has the same opinion. Please tell us what we should do, treat or not treat, how serious is all this? The doctor says that if we don’t treat the child, all the signs will appear sexual development. Also in a child at 2 months. there was increased muscle tone. Subepidimal cysts, but everything went away, an ultrasound was done a year later, everything was normal. At birth, the child weighed 4250 g. height 57 cm. Now 11 kg, height 79 cm.
. Thank you very much for your answer.

Answers Buyalo Valentina Vitalievna:

Tanya, this is a very serious question to answer without seeing the child. In order to take the pills (we use Androcur and Diferelin or one of the two, depending on the indications), you could undergo further examination and look at the dynamics of the tests, find out (necessarily) your bone age. How quickly did the mammary glands enlarge or were they simply enlarged from birth as you write, the size of the VPO (I would like to estimate it myself), how the pregnancy and childbirth went, etc. Consult an endocrinologist (you can conduct a test to detect the presence of PPR), again with a pediatric gynecologist - You can take a referral to our clinic, Kiev, Stretenskaya Street 7/9, KDP "Okhmatdet". Take your time with melatonin.

Ekaterina asks:

Hello. My daughter is 5 years old. At the age of 3, in 2012, she was diagnosed with PPD of central origin. Idiapotic form. height 109. weight 21.5 bone age 7 years. hormone indicators: - LH 2.76 IU/l, prolactin-1300 mIU/l, TSH-3.15 mIU/l, free T4- 15.00 pmol/l, FSH-8.60 IU/l, estradiol -126.08 pmol/ l..Dimensions of the uterus for 9 years. The follicles in both ovaries are 4-5 mm in size. MRI - MRI revealed no changes in the brain and pituitary gland. No formations were found in the pelvis. DECAPEPTYL DEPOT 1.875 was prescribed once every 28 days. After 1 year of receiving the drug (2013), bone age 7.5 years, height 119, weight 25.5 kg Lg, FSH, TSH, T4 free, prolactin is normal, Estradiol is 115.3 pmol/l. The follicular apparatus is not traced.. The dose was increased to 3.75 once every 28 days. After 9 months of treatment, the indicators are as follows: bone age 8.5 years LH, FSH, TSH, free T4 are normal, Estradiol - 126.0 pmol/l, (at 27 after the injection); 18.6 pmol/l (on the 21st day after the injection) 25.pmol/l (on the 7th day after the injection) Prolactin 646.0 mIU/l, Pelvic ultrasound - follicles of 2.5-3 mm appeared in both ovaries. Height 126, weight 28 kg. We underwent a repeat MRI examination - MRI revealed no changes in the brain and pituitary gland, no additional formations were found in the pelvis. The size of the uterus corresponds to 7 years. Tested with Synacthen depot
17-OP before the test 3.26 nmol/l, Cortisol 360.70 nmol/l, after injection of Synacthen depot after 6 hours 17-OP - 8.75 nmol/l, Cortisol - 1671.00 nmol/l, after 24 hours 17- OD 10.81 nmol/l, Cortisol - 1536 nmol/l. Based on the test results, there is no data for non-classical VDKN. We had an appointment with 4 specialists, their opinions differed:
1- bone age 8.5 years. Treatment Decapeptil depot 1 time for 28 days. Look for pituitary adenoma.
2-bone age 10 years, replacing the drug with diferelin once every 28 days. Prognosis of final height 148 cm
3- bone age 8.5-9 years. treatment with decapeptil depot 1 time every 21 days. 4- bone age 12 years. treatment: replacement of the drug with diferilin once every 28 days. Please tell me what is the reason for the increase in bone age and why the level of estradiol does not fall. Do we have the time and opportunity to correct the current situation.

Answers Rumyantseva Tatyana Stepanovna:

Hello! The picture you described fits into the PPR. This is a very serious problem - which is not easy to treat, because treatment with hormones is almost always difficult to predict. It is very important to determine the cause of PPR, and then decide on treatment. The growth of bone age depends on the level of estrogen in the blood - the higher the level, the older the age. But, if the level is high, then at an early age growth will stop and perhaps the height will remain at the level of 145-155 cm. If, during treatment with estrogen blockers, the ossification of bone tissue is stopped until the age of 8-10 years, then after stopping the drugs, the formation of M\ is possible functions are normal. The estradiol level does not fall because perhaps the dose of the drug was chosen incorrectly - it is small. Or its production is higher than the expected value and therefore its production is not suppressed. Treatment should be long-term and constant until the age of 8-10 years or more. I don’t know what city you live in - but definitely the treatment of such a problem should be at the clinic level and not just at the local doctor. Take your doctor’s recommendations seriously and follow all requirements - this will ensure positive dynamics in your treatment. As a doctor and as a mother and grandmother, I sincerely wish you success and health for your girl! Don't lose hope! The one who walks will master the road!

Why are many of your daughter’s age already interested in the opposite sex, wear “adult” underwear, are concerned about their appearance, but your girl still plays with dolls? The reason lies in the puberty of girls, the timing of which is purely individual.

Irritability, touchiness, frequent mood swings, isolation are temporary difficulties that every teenage girl has to go through. Some parents believe that girls' puberty and adolescence occur simultaneously, around the age of 11-13 years. In fact, a girl begins to turn into a girl starting from the age of 8-9. By the age of 17, a girl’s puberty stage is usually completed.

Puberty of girls. How does this manifest itself?

“You have a girl,” the midwife delivering the baby said joyfully. It is thanks to the primary sexual characteristics - external as well as internal genital organs - that the gender of the child can be determined. Subsequently, the manifestation of secondary sexual characteristics, which directly depend on the predominance of certain hormones, indicates the onset of puberty in the girl.

Puberty in girls: rapid growth.

A sure sign of the initial stage of puberty in a girl is rapid growth. To the surprise of parents, a daughter can gain up to 10 cm in height in a year, surpassing her peers, whose sexual development begins several years later.

Due to the rapid and disproportionate growth of bones and lagging muscles in development, the girl’s figure has angular outlines, her arms and legs appear thin and long, and her face appears elongated. Nerve endings and blood vessels lag behind the growth of bones, as a result of which the teenage girl is clumsy like a “bull in a china shop.”

In addition to intensive skeletal growth, puberty in girls is characterized by increased activity of the sebaceous glands. In this situation, the sebaceous glands perform a protective function, preventing damage, stretching and drying out of the skin. Since the sebaceous glands are “involved” in work throughout the body, the hair on the head and facial skin become oilier, causing the girl a lot of inconvenience. In the absence of proper skin care, acne appears - a faithful companion of teenagers.

IMPORTANT! External changes that occur during a girl’s sexual development can cause shyness, mistrust, and complexes. During this period, it is important to explain to a teenage girl the significance of her transformation. Ignoring the fact that your daughter is growing up is stupid, especially when she needs parental support.

Puberty of girls: enlargement of the mammary glands.

At puberty in a girl, the beginning of the development of the mammary glands, or “thelarche” in other words, occurs in parallel with the acceleration of growth. Breast enlargement in a young girl begins with the areola and nipple area, after which the entire gland begins to develop. Breast growth continues until the age of 16. The final size of the breast is determined only after breastfeeding ends.

The presence of several dark hairs on a girl’s chest is considered normal. The presence of a large amount of hair on the mammary glands is a sign of hormonal disorders and requires contacting a gynecologist-endocrinologist.

IMPORTANT! The color of the peripapillary area (halos) and nipple varies from light pink to rich brown, and depends solely on the level of pigment - melanin. The color of the nipple does not in any way affect the sensitivity or function of the mammary gland.

Puberty of girls: pubarche.

At the age of 10-11 years, the first coarse hairs appear in the pubic area. In girls, hair in this area grows in the shape of an inverted triangle, without creeping onto the inner surface of the thigh. With an excess of male sex hormones, hair grows not only on the pubis, but also on the hips and lower abdomen, which is the reason for consultation with a gynecologist-endocrinologist. Pubic hair growth during puberty in girls is called pubarche.

Puberty of girls: first menstruation (menarche).

An integral part of a girl's puberty is the first menstruation, which occurs on average at the age of 11-15 years. For Eastern and African peoples, menarche at the age of 10-12 years is also considered the norm. Within a year after the first menstruation, the ovulatory cycle is restored, becoming regular.

Important conditions for the onset of the first menstruation are normal body weight (at least 50 kg), as well as a sufficient mass of adipose tissue (35% or more), which is a depot of estrogens - female sex hormones.

IMPORTANT! The appearance of the first menstruation before the age of 11 indicates a girl’s premature sexual development. Late first menstruation (after 16 years) is a sign of delayed sexual development.

Rounded hips, enlarged mammary glands, pubic hair, fat deposits in the abdomen, waist and buttocks, the onset of the first menstruation - all this indicates the beginning of the female body’s preparation for bearing a fetus. Do not forget that the first menstruation is not an indicator of puberty, but only indicates the possibility of pregnancy.

The influence of obesity on the sexual development of adolescent girls.

Puberty in girls has its own characteristics, in particular those related to fat metabolism in the body. Puberty in girls is characterized by a slowdown in the growth of muscle tissue and the deposition of muscle tissue in these areas as compensation. For example, if the abdominal muscles of girls are as developed as those of boys, bearing a child will become impossible, since the tension of the abdominal muscles will prevent the growth of the uterus.

Puberty in girls is often accompanied by an increase in appetite, which leads to weight gain. A sedentary lifestyle, the predominance of carbohydrate foods in the diet, and overeating can lead to the development of nutritional obesity, which, in turn, disrupts hormonal levels.

According to research conducted by experts from the United States, obesity is one of the main causes of premature puberty in girls. Obesity promotes the production of female reproductive organs, which accelerate the process of puberty in girls. With regard to the problem of excess weight among boys, the situation is exactly the opposite. Obesity slows down the sexual and physical development of boys, disrupting the production of androgens - male sex hormones.

Towards the end of the girl's puberty, puberty begins, which is characterized by sexual activity due to increased sexual desire. Dramatic changes in a girl’s body should prompt her parents to hold an appropriate conversation about the beginning of sexual activity. By imposing a ban on the topic of intimate relationships, you can achieve only one thing - mistrust on the part of a teenage girl. It’s better to talk to your daughter about an exciting topic, warning her about the possible adverse consequences of early sexual relations. Sooner or later, what parents are so afraid of will happen, and it is better if the young girl is armed with the necessary knowledge about protection from unwanted pregnancy and sexually transmitted diseases.

The process of puberty is influenced by many factors. Early and increased hair growth in girls is not the norm and indicates serious disorders of the endocrine system.

What hormone affects hair growth?

During development in adolescents, the appearance of secondary sexual characteristics is observed: pubic hair growth in girls, development of hair in the armpits, development of mammary glands, and the presence of menstruation. In boys, pubic hair growth, prominence of the thyroid cartilage and changes in voice timbre. Hair growth in the armpits of boys is also noticeable.

The sex hormone testosterone stimulates hair growth. The formation of hair growth in boys is controlled by androgens produced in the testicles. Hair growth in girls is controlled by androgens produced by the adrenal glands and ovaries.

In girls, the role of androgens is not so great. The influence of androgens on a girl’s body manifests itself in pathological conditions - with excessive production of androgens. Increased levels of hormones cause excess hair growth. Low levels of the hormone lead to a prolongation of puberty and, accordingly, delayed hair growth in adolescents.

Hair growth in girls

In girls, hair growth is formed according to the female type: moderate hair growth in the armpit area, and on the pubis - in the form of a triangle. The hair on the limbs is inconspicuous and not coarse.

Pubic hair growth in girls is completed by the age of 16, going through several stages. Hair color and curl depend on genetic characteristics. At the age of 13, armpit hair appears.

Rice. Hair growth in girls (photos of types of pubic hair growth in girls)

Early hair growth in girls

In girls, puberty is considered premature before the age of 8 years. A cause for concern is swelling of the mammary gland and pigmentation of the nipple. The girl should be under the supervision of an endocrinologist, since this may be followed by an increase in the level of sex hormones and early hair growth in girls.

Precocious sexual development is associated with activation of the hypothalamus or pituitary gland. This leads to increased secretion of gonadotropins, which stimulate ovarian activity. Such conditions often develop with diseases and tumors of the central nervous system.

With tumors of the adrenal glands, early hair growth is also observed in girls. These are quite serious symptoms, which, among other things, can be considered a sign of polycystic ovary syndrome.

Increased hair growth in girls

Disorders of the endocrine system (hyperandrogenism) cause increased hair growth in girls in the pubic area and axilla, so you need to consult an endocrinologist to identify the causes of this condition. Increased hair growth in girls is associated with Cushing's syndrome and polycystic ovary syndrome, adrenal hyperplasia or tumor.

Rice. Hair growth in girls (photo of increased hair growth due to adrenal hyperplasia)

Increased hair growth is often accompanied by increased oily skin and the appearance of acne. Only a specialist after an examination can recommend androgen antagonist drugs that will reduce hair growth in girls.

Hyperandrogenism not only causes increased hair growth in girls, but is also accompanied by a number of complications in the woman in the future: menstrual irregularities, miscarriage, infertility, breast cancer.

Hair growth in boys

An important sign of puberty is pubic hair growth. Pubic hair first grows according to the female pattern, and hair growth begins at 12-13 years of age. Adolescent hair growth in boys aged 13-14 years is also characterized by the appearance of a delicate fluff above the upper lip. At the age of 14, hair in the armpits becomes noticeable. Complete hair growth in the cavities occurs by the age of 17. At the same time, facial hair appears: the fluff above the lip turns into a mustache, then a beard begins to grow. By the age of 16-17, male-type pubic hair growth ends and hair growth is noted throughout the body. Hair growth in boys has a direct connection with testosterone production.

Obstetrician-gynecologist

The sexual development of girls is a very difficult and delicate issue, which should be discussed with the child with extreme caution. Today we will talk about how to do this correctly, without abstruse phrases and unwanted silences.

The time has finally come when you are faced with a wonderful, albeit difficult age.

If you are a mother, then it is difficult for you to realize that your baby is getting older and now the thoughts in her head can suddenly become multi-colored butterflies or glossy black. At this age, my mother’s girl tries to defend her character, thinking that she can handle everything herself.

Meanwhile, she does not have time to keep track of the changes in her body, which undoubtedly worry her. And you, as the closest person, have been entrusted with the responsibility to tell, help, and direct in the right direction all the energy that is overwhelming your child.

If you are a young girl, you have already had many questions regarding everything related to the adult life of a woman. But these questions could have been put off earlier, since it was far away, maybe not very interesting, in no way connected with that life when you were a carefree girl.

Sex education for girls is a complex and time-consuming process that must be approached with caution. Not only mom, but also dad should take part in the process.

Let's start with the changes in the girl. Precisely in a girl, because perestroika does not begin when secondary sexual characteristics appear, but much earlier. On average, puberty lasts 10-12 years. During this time, the girl changes noticeably before the eyes of others.

Prepuberty is a period that begins at 7-8 years of age and ends with the arrival of the first menstruation. Usually this (menstruation) happens 1-3 years after the appearance of secondary sexual characteristics. Already from such an early age, you can notice changes in the child’s body. Hormones begin their activity, although not cyclically. But hormone releases occur constantly. In this connection, the transformation of a girl into a girl occurs.

Signs of puberty in girls

The first changes take place in the girl’s body - the hips are rounded, the growth of the pelvic bones begins. Mammary glands appear. You can already notice areas of hair growth on the pubis and armpits.

As a rule, a girl begins to grow sharply before the onset of menstruation.

All these signs may develop inconsistently. Now let’s look at each sign and the pathologies associated with it. There are several stages in the development of secondary sexual characteristics.

A few years before the onset of the first menstruation, a girl’s growth begins to grow sharply. Presumably, this happens 2-3 years before the onset of menstruation.

At this time, growth spurts can reach up to 10 centimeters per year.

Often during this period the child is awkward, since the bones do not grow evenly; first the hands and feet become larger, then the tubular bones and only then the torso.

Clumsiness in movements may also be observed, this is due to the fact that nerve fibers and muscles do not always keep pace with the growth of skeletal bones.

Skin

The skin develops according to the skeleton and muscles, for this purpose the secretion of the glands is increased in order to have good stretching, as a result of which the teenager suffers from rashes, which in science are called “acne”, “acne” or pimples. Hair also becomes oilier at the roots, so now you need to wash your hair more often.

Subcutaneous fatty tissue also develops. There is increased deposition of fat in the hips and abdomen. The shoulders are also rounded and the waist appears.

Telarche - development of the mammary gland. Typically, breast growth begins in girls at 10-11 years old, 1.5-2 years before the onset of menstruation. According to WHO, the appearance of signs of breast growth after 8 years is considered normal. The nipples become sensitive and can change color, depending on the amount of pigment in the body.

There is also an increase in the size of the nipple itself. Hair growth is possible around the areola of the nipple - this happens in women of Eastern and Caucasian origin and is not a pathology. The color, shape, and size of the breast depend on genetic factors and the amount of subcutaneous adipose tissue.

There are several degrees of breast development.

• Ma0- the gland is not developed, the nipple is not pigmented.
• Ma1- gland tissue is palpated in the area of ​​the areola and is painful.
• Ma2- the mammary gland is enlarged, the nipple and areola are raised.
• Ma3- the mammary gland takes the shape of a cone whose base is located between the III and VI ribs. The nipple does not stand out separately from the areola.
• Ma4- the gland has a hemispherical shape, the nipple is separated from the areola and is pigmented.

The mammary gland completes its development and grows to its maximum only after childbirth and breastfeeding. And the final stage of mammary gland development is observed at about 15 years. The mammary gland itself may be painful during the growth period and before menstruation.

Hair growth

Pubarche - hair growth of the pubic area - begins at 10-12 years of age. Growing pubic hair forms a triangle, the base of which is located on the lower line of the abdomen. There may be isolated hairs rising towards the navel. But if the hair densely covers the entire area, forming a diamond, you should contact a gynecologist-endocrinologist.

By the age of 13-15, hair appears in the armpits and on the legs. The hardness, color and shape of hair is individual and depends on genetic predisposition.

Armpit hair:

• Ah0- no hair growth.
• Ah1- hair growth with single straight hairs.
• Ah2- the appearance of hair in the middle of the armpit.
• Ah3- hair growth throughout the axillary area.

Pubic hair growth:

• Pb0- no hair growth.
• Pb1- hair growth with single straight hairs.
• Pb2- the appearance of hair in the center.
• Pb3- hair growth of the entire pubic area along a horizontal line.

You need to learn how to properly maintain the smoothness of your legs, bikini area and armpits. Each girl chooses an individual method for achieving her goal. But do not rush into removal, because the first hair is softer, thinner and less noticeable. Over time or under the influence of external factors, they become tough.

Menarche - the beginning of menstrual flow, the first menstruation. This happens to everyone at different ages, and menarche also depends on genetics. As a rule, the first bleeding occurs from 12 to 14 years. After the start of the first menstruation, the girl's growth slows down, but other signs of puberty continue to develop.

Many girls' periods are not cyclical at the very beginning. For some, it takes some time - from six months to two years. In case of non-cyclical discharge, you should consult a doctor in the future.

During menstruation, the mammary glands may be tense and somewhat painful. Also, many girls and women experience aching pain in the lower abdomen before and during bleeding, and some experience discomfort in the stomach or intestines. All this can accompany mensis (menstruation) normally.

Before the critical days, the mood may change; more often the girl feels irritated, overwhelmed, and tearful. But all this passes during the first days of menstruation. Despite the irregularity of the cycle, a girl can become pregnant, and it is important to convey this to an immature person.

Deviations from the norm

As everyone knows, where there is a norm, there is also a pathology. Today, cases such as premature puberty in girls (PPD) are increasingly observed. And here it is important that the mother carefully approaches changes in the child’s body.

They speak of PPD if the girl herself is under 8 years of age at the appearance of her first sexual signs. At this age, a child cannot always adequately approach the innovations of his body.

Types of PPR

Precocious puberty in girls is divided into into several types.

1. True type. It occurs when the functioning of the endocrine glands - the hypothalamus and pituitary gland - is disrupted, which, in turn, stimulate the functioning of the ovaries.

• Full form. When all secondary signs begin to develop before the age of 7-8 years, growth slows down due to the closure of growth zones in the bones, and menstrual flow appears.
• Incomplete form. Here secondary signs appear, but the periods themselves come much later - at 10-11 years.

2. False type. It is characterized by a disorder in the ovary itself - the random production of sex hormones occurs, and therefore the order of appearance of secondary sexual characteristics in the child is disrupted. And there is irregular spotting, which can begin without the full development and formation of the mammary gland or hair growth.

3. Hereditary type. As a rule, if a girl has women in her pedigree (especially if it is her mother) whose maturation began earlier than the designated dates, then the child himself will turn into a girl earlier than his peers. In this case, the order of appearance of sexual characteristics will not be disrupted.

Causes of PPR

Causes of early puberty in girls can be:

• brain cysts;
• previous bacterial or viral infection;
• cerebral circulatory disorders;
• congenital anomalies (hydroencephaly);
• exposure (high exposure to radiation);
• poisoning by poisons (lead);
• consequences of brain injuries.

If you notice any changes in your princess that can be attributed to PPR, or there is a growth spurt before the age of 7, it is better to contact a gynecologist, endocrinologist and undergo an examination. Early sexual development is a process that requires mandatory supervision by a specialist.

Delayed puberty

Another problem for mothers and their girls is delayed pubertal development in girls (DSD).

Signs of delay:

• absence of onset of menstruation before age 16;
• lack of sufficient growth of the mammary glands before the age of 13;
• scanty hair growth by the age of 14;
• insufficient growth or abnormal development of the genital organs;
• lack of correspondence of height and weight to age.

Also, delayed development of maturity is a condition when a girl’s sexual development is only half complete. That is, the mammary glands have developed, there is partial hair growth, and then everything slowed down for more than a year and a half.

Causes of mental retardation

1. Congenital disorders of the brain.
2. Brain cysts and tumors.
3. Poisoning by poisons.
4. Heredity.
5. Exposure of the body to radiation or radiation therapy.
6. Removal of ovaries.
7. Strong physical activity.
8. Severe stress or malnutrition (exhaustion).
9. Complications after bacterial or viral infections, etc.

If you are concerned about your girl’s health, consult a doctor, he will conduct an examination and be able to make the correct diagnosis. It is easier and more effective to treat any condition of the body at the very beginning, when the pathology has not caused irreversible consequences. Everything needs to be done on time!

Another important moment in a girl’s development is growing up and becoming a girl, a woman from the inside.

Sexual development of girls should be given special attention from birth. Even from the cradle, a girl should feel like an important link in creating family comfort, since the atmosphere in the family mainly depends on her. In addition, the girl will face pregnancy, childbirth, and caring for a newborn in the future.

The child must prepare for the upcoming difficulties, and this is not bad when little girls push their dolls in strollers and already begin to experience maternal feelings and a sense of responsibility. When a girl tries to be like her mother and knows what awaits her, she enjoys all the changes and is not afraid to move forward.

If a girl is not talked to about the topic of transforming a girl into a girl, and then into a woman, all changes in her body are unpleasant for her, and the onset of menstruation generally frightens her. You need to explain everything to your princess as she grows into adulthood, step by step. It is important that next to the girl there is an older comrade in the person of a mother, friend, aunt, etc.

During adolescence, it is sometimes very difficult for teenagers to understand themselves, their mood can change dramatically, and the feeling of irritability and tearfulness does not allow them to calmly perceive changes. You should never ridicule or reproach a child during this period.

With the onset of adolescence, or rather, with its end, it is time to discuss the sexual side of her life with the girl. The girl's behavior changes - she often looks at the opposite sex, experiences attractions, and is overcome by erotic fantasies. A teenager must understand everything and learn not to be ashamed of it. Sex education for girls is an important task that falls on parents.

In addition to the perception itself, it is necessary to convey to your child information about the possibility of becoming pregnant and contracting infections through sexual contact. You should also tell her about the negative effects of early sexual debut. Teenagers at this age often experiment, including in this area, and violent actions are possible.

Teach your child the rules of personal hygiene, purity of sexual relations and their protection, tell them about the frequency of showering during menstruation - all this is the task of a good parent. Having matured, the child encounters new conditions of his body. For example, thrush occurs - a fairly common disease that needs to be cured in time.

Often a teenager, feeling his imperfection, withdraws into himself and suffers for a long time from symptoms that can bring severe discomfort. It is worth paying attention to the appearance of acne, it is important to tell your child how to deal with them correctly, because we all know the tendency of children to squeeze everything out. This can lead to unpleasant consequences: scarring of the skin, blood poisoning.

Sex education is often the subject of much controversy. But there are certain rules that are best adhered to - they will allow you to transition into puberty as smoothly as possible and preserve the girl’s health.

It is worth paying attention to the nutrition of a teenager; girls themselves often skip meals on purpose in order, as they think, to be more beautiful. A girl should eat well to avoid delays in the development of sexual characteristics and the onset of menstruation.

Under no circumstances should you treat a teenager like an adult. A person in adolescence already knows a lot, has his own point of view, but he is just starting on the path of growing up; your advice is important to him, although sometimes he does not show it. Control is never superfluous.

Masturbation is very important in the development of sexuality. There is nothing unhealthy or shameful about this behavior. This is how the child learns to relieve stress by fantasizing, imagining imaginary actions. Contrary to the thoughts imposed by the Bible and Soviet education about masturbation as something dirty and unacceptable for a self-respecting woman, today its benefits have been proven, of course, if you don’t “go too far.”

As a conclusion

The main goals of parents, especially mothers, during puberty, are:

• teach the girl to accept herself as she is;
• convey all knowledge regarding the technique of sexual relations, contraception and methods of protection against sexually transmitted infections;
• show all the beauty of a woman, mother, wife;
• determine the boundaries of decent behavior with the opposite sex;
• teach how to cope with some ailments associated with premenstrual syndrome, thrush, etc.;
• surround your child with love and care, especially when he needs it.

Of course, just like a child, you also grow up. Do not forget that the child has never been an adult, and you, adults, have already experienced all the hardships of this difficult period. How your child perceives everything depends largely on you.

We know a lot about babies, we argue about diapers, swaddling and vaccinations, but our daughters are growing up, the period of puberty begins, when a young maiden blossoms 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 about?

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

What will menstruation depend on?
The reproductive function of a girl will depend on the girl’s health and her compliance with personal hygiene rules. In healthy and seasoned girls who play sports, periods usually pass easily. But weakened, overtired or frequently ill girls may experience malaise, pain in the lower abdomen, headaches and aching in the lower back during menstruation. A healthy girl may also have slight weakness, but this usually does not interfere with her normal lifestyle, she just needs to slow down the pace of training and activities.

Girls can lead a normal life during their periods; they are not contraindicated from going to school or doing physical education; they only need to stop jumping, carrying heavy objects, or cycling. During menstruation, you should eat less salt and hot spices; they can increase the flow of blood during menstruation. Teach your daughter to keep a menstruation calendar, it will be calmer for both you and her - remember, sexual activity begins in teenagers without asking our permission, and if you have periods, pregnancy is always possible. While, unfortunately, her mother will have to think for the girl, the girls have wind in their heads. In a calendar, let him mark the start and end date of menstruation, its duration and abundance, this will also help to note health problems if they arise. Regular menstruation indicates 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 in matters of 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 the next. They follow each other continuously due to the cyclical nature of hormonal processes in the body, regulated by the girl’s maturing brain. On average, the cycle can be from 22 to 24 days, less often longer. Menstruation itself lasts 3-7 days. The entire cycle can be divided into several phases during which special changes in the body occur.

First period or menstrual bleeding– this is the first day of the cycle, during which the endometrium and its vessels are rejected, coming out with bloody discharge. This is a mixture of blood, mucus and mucous membrane cells; in one cycle, up to 30-100 ml of blood is lost, but if it is much more, immediately go with your daughter to the doctor. The first days of menstruation are more abundant, in the subsequent days they are scanty.

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 estrogen, the inner layer of the uterus begins to grow, the follicle reaches 20-25 mm. Follicles are taken from ready-made buds; by the time a girl is born, there are about 400 thousand of them in the ovaries; about 500 will mature during her life.

Third phase- this is ovulation, it is at this time that the egg is released and it is during this time that women become pregnant. It is important to know this so that the girl understands the essence of protection against 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 endometrium thickens and loosens, and the egg dies. A decrease in hormone levels and again a transition to the first stage of the cycle - endometrial rejection. If a girl becomes pregnant, her menstruation will stop - the absence of menstruation is the first sign of pregnancy, although they may be absent for other reasons.

What does menstruation depend on?
The correctness and regularity of a girl’s cycle depends on her sexual and hormonal health. The main gland in menstruation is the hypothalamus; after an equal amount of 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 a malfunction occurs at any of the links in this chain, this leads to disruption in the development of menstrual function and requires the participation of a doctor. For the first two years, irregular menstruation is allowed, but by the age of 16-18, all menstrual functions should be clearly established, the cycle should become regular and not cause much discomfort. If this does not happen, this is a reason to contact a teenage gynecologist.

Teenage girls today have poor nutrition, often girls 15-18 years old are either obese or excessively thin, many live in constant stress from exams, unrequited love or family problems, all this unbalances hormones and the 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 when a girl reaches a weight of 43-47 kg; in girls who are on a diet or exhausted, menstruation often disappears or occurs much later. Very low weight women are infertile due to their weight alone. Even if a 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 diet! But without diligence, the opposite state is no less dangerous. Fat chicks 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 leads to earlier maturity.

Not only the quantity, but also the quality of food is important - alcohol, fatty, salty and spicy foods with excess meat lead to earlier ripening. If a girl, in pursuit of fashion, limits herself to some elements of nutrition or goes on a diet, this will affect her sexual functions, and sometimes this can be irreversible. Deficiency of vitamin A, zinc and iodine is especially dangerous; this is the exclusion of meat, fish and eggs from the diet.

Other factors.
There are also external factors that influence the onset of puberty - climate and geography of residence. Girls from mountainous latitudes and southerners menstruate earlier, but girls from lowland latitudes and northern regions menstruate 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 influence the onset of menstruation; girls in adolescence do not have very pronounced physical strength and endurance. Professional sport is a difficult test for them - it greatly affects the health of the sexual sphere and general health. Stress in sports or ballet inhibits the development of the sexual sphere and is combined with delays in growth and development in general. Look at the gymnasts and acrobats - they are all small and childish at 16-17 years old. In addition, female athletes during puberty may show signs of androgenization - the voice becomes rougher, the secretion of sebum increases, and menstruation is disrupted. This depends on strength training and muscle development - this happens among swimmers and rowers; half of the female athletes with medals have very serious problems as women. Therefore, think about what is more important to you: your daughter’s sporting achievements and medals, or the presence of grandchildren in the family.

Another significant problem is bad habits among girls. Our subculture and teenage parties instill in them the wrong styles of behavior - they try smoking as early as 12-14 years old, try alcohol secretly from their mothers, and even begin sexual activity long 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 are more likely to develop acne and a pale complexion, and their voice becomes rougher - this is due to androgen hormones. They also affect the menstrual cycle - it becomes irregular and painful.

And bad habits also damage eggs so much that many years later, 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 a main assistant - her mother. Dear mothers, help your daughter succeed as a woman, and in a few years she will help you succeed as a grandmother!

It seems like just yesterday your baby was trying to hold her head up, smile, crawl, talk, walk…. And today you notice strange changes in her. What's happening to her? Don't be alarmed by the changes taking place - your baby has most likely smoothly entered puberty in girls. And it doesn’t matter that she may be only 8 years old and still just a child. Already now she is actively preparing to become a woman, a mother. And right now you, parents, must help your daughter get through a difficult period in her life. And for this, you need to have an idea of ​​what puberty in a girl means and how it occurs normally.

• How does puberty differ between girls and boys?

Puberty of girls and boys is completely different; they are completely different processes. Puberty begins at different times, is perceived by children in completely different ways, and proceeds differently. For example, earlier puberty in girls is a fairly common occurrence, while in boys it is rather an exception to the rule. However, the premature puberty of girls should not be a cause for concern for parents at all - this is normal.

Puberty in girls and boys generally takes about five years. The timing of the onset of puberty, as already mentioned, is very individual and may well fluctuate greatly, both in one direction and the other. In cases where parents notice significant fluctuations - puberty in girls or boys is too early, or, conversely, too much delay - it makes sense to consult a pediatrician. The doctor is able to assess the most adequate state of the physical development of your son or daughter, and refer you for additional examinations, if necessary, in order to reliably determine the reasons for the deviation of the child’s sexual development from the norm.

However, serious hormonal problems are very rare. Almost always, the cause of such temporary deviations is a hereditary trait. The fact is that if at one time at least one parent also had some deviations in either direction, this increases by 50% the possibility of the same deviations in the child. This is especially evident in relation to the growth of children - if both parents are short, one should not expect the teenager to experience an intense growth spurt.

Modern medicine has established some frameworks within which the start of puberty should fit, both girls and boys. Puberty begins earlier for girls at the age of 8, and only at the age of 10 for boys; the deadline for puberty to begin for a girl is 12 years old, for a boy - 14 years old. If parents have any doubts about the sexual development of the child, they should seek advice from a pediatrician or endocrinologist. And remember: under no circumstances should you express your doubts or fears in the presence of your son or daughter - you risk causing the child quite serious psychological trauma, which you will have to struggle with for a long time in the future. Do not forget that the adolescent psyche is a delicate “instrument”, very, very vulnerable.

Actually, this is all that puberty has in common between girls and boys. Everything else is a complete difference that parents should be aware of.

• Sex education for girls

The first thing I would like to say is that sex education for girls should begin at a very young age, literally from birth. After all, instilling hygiene in a child is also sex education for girls. Each parent probably wants their daughter to grow up to be a soft, sensitive, caring woman who loves her children. This is what sex education for girls is all about at an early age.

You shouldn’t be a prude with your child, tell “fairy tales” about gender differences in childhood, and talk nonsense about storks and cabbages when answering the question “Where do children come from?” The main thing that is required from parents in the event of “uncomfortable” questions or situations is natural behavior, a willingness to answer everything comprehensively, and the ability to explain everything without fear or shame. Regardless of the child’s age, whether he is four, seven or fifteen years old, your answers must be truthful in content, objective and scientific. Be truthful with your child, but age appropriate, and answer clearly, concisely and to the point.

A child’s assimilation of his own gender role, his character, and the development of his sexuality largely depend on the family, which is able to harmoniously combine the social and biological principles of the future woman’s personality.

If you took the issues of sex education responsibly from the very beginning, then during puberty in girls you will not have any special problems; this difficult time will pass for your child and for you without any psychological trauma or misunderstandings in relationships. You can read more about what sex education for girls is in the article: “Sex education for children. Principles of sex education for boys and girls.”

• Puberty in girls

Puberty of a girl is a very intensive growth of the child, which lasts about two years, and precedes the onset of puberty of the girl. A girl's puberty begins with her first menstruation.

As already mentioned, it is impossible to name the exact age when puberty begins in girls. The average age at which girls begin sex education is approximately 11 years old, therefore, the first menstrual cycle should occur around 13 years old, that is, puberty will occur in two years. However, in recent decades there has been a trend towards “rejuvenation” of puberty - earlier puberty in girls increasingly begins at the age of 8-9 years. It happens, especially if the mother’s puberty was late, the girl’s puberty can begin at the age of 13, and the first menstruation, accordingly, at the age of 15.

There are cases, occasionally, but still, that a girl’s puberty starts at the age of 7 or 15. In this case, parents have cause for concern; such deviations are pathological in nature and require special medical correction. If this occurs, premature or excessively early puberty in girls, it is necessary to consult a doctor.

When the deviations are not so drastic, they should not frighten parents. Minor deviations do not signal any hormonal disruptions in the child’s body or malfunctions of the hormonal glands. Most likely, this is just a hereditary predisposition. If you yourself don’t remember when your puberty began and how it went, ask your parents - they will probably be able to dispel your doubts. And, of course, under no circumstances should you give your child any hormonal medications - this can simply cause irreparable harm to the girl’s health and even lead to infertility in the future. Such drugs should be prescribed exclusively by the attending physician.

• Signs of puberty in girls

Height. Puberty in girls is accompanied by the following characteristic signs, each of which manifests itself in its own life period and begins with growth:

• At 7-8 years of age, the baby grew approximately 7 centimeters over the course of a year.
• By the age of 9, nature begins to sharply slow down the growth process, and it is only about two centimeters. This will continue throughout the tenth year of life - not exceeding 1 - 3 centimeters of increase in height per year.
• During the 11th year, a powerful growth spurt usually occurs - over the next couple of years, the average increase in height per year will be about 10 centimeters. In addition, her weight will begin to grow rapidly - the usual 2 kilograms per year will be replaced by approximately 6 kilograms of weight gain. However, this will not be noticeable outwardly, except that the girl may simply develop a “brutal” appetite, due to the body’s need for a large amount of nutrients to ensure such a rapid growth spurt.

Mammary gland. A girl's puberty is accompanied by significant changes in her body. At its very beginning, an enlargement of the mammary glands is noted, which occurs as follows: the first changes concern the areola and nipple, which slightly enlarge and protrude forward. A little later, the mammary gland itself begins to change. During the first year after the onset of puberty in girls, the mammary gland takes on the shape of a cone. About a year before the first menstruation begins, the girl's breasts will take on a more familiar, rounded shape.

Hair growth and body changes. When a girl begins puberty, vegetation appears in the perineal area and armpits. The figure changes, acquiring more feminine outlines: gradually the girl’s hips begin to widen, and her waist becomes visible. In addition, during puberty, girls' hair and skin structure changes dramatically, which is affected by certain hormones.

First menstruation. Around the age of 13, a girl’s first menstruation occurs. However, the formation of the menstrual cycle is a very long process that can last up to one year. Before the menstrual cycle is established, menstruation may be extremely irregular and vary in length - but no more than 5 days of menstrual bleeding. Such irregularity is a completely normal phenomenon, which should not cause any concern for parents. When the first menstruation occurs, the girl’s growth seriously slows down; in general, she will subsequently gain no more than 5 centimeters in height.

The mother of a girl should pay especially close attention during menstruation. Regardless of how old a girl’s first menstruation began - at 11 or 15, this event always turns out to be stressful for her. One can only imagine how serious the stress will be if the girl knows absolutely nothing about what is happening to her? As psychological practice shows, a girl may begin to panic, and she will not even tell her mother about what is happening to her and her body.

That is why the mother is absolutely obliged in a timely manner, before the first menstruation occurs, to prepare the girl psychologically for the upcoming physiological changes, teach her how to use the necessary hygiene items, and tell her the rules of behavior during menstruation. Of course, a girl can learn about everything from other sources, for example, from her friends. However, in this case, do not be surprised if she shares the news that she has become a girl, and other events in her life, with a friend, and not with you. Also, you should not react too violently to the onset of menstruation in a girl, and especially not publicly inform relatives and friends about it - this can seriously confuse the girl, provoke the appearance of complexes, and the fear of telling you something in the future.

Clumsiness. It is during a rapid growth spurt that the same “clumsiness” familiar to many appears in a teenage girl. Parents should not worry about this - such disproportion of the body is completely normal and does not indicate any pathology. The “ugly duckling” period will soon end irrevocably, and your little princess will turn into a real beauty. Be sure to talk to the girl about this, she also needs to understand this, explain what is causing this change, and that it will end soon.

• Psychological difficulties during puberty in girls

During puberty in girls, the skeleton grows most intensively, but unevenly. The fact is that bones grow at different speeds, absolutely not synchronously - first the bones of the hands and feet grow, then the bones of the arms, and the skull of the face. And only at the very last stage does the body “catch up” with them. This explains the fact that teenage girls often have too long legs and arms, and a slightly elongated face. In addition to all this, the rate of muscle growth is often significantly lower than the rate of bone growth, as a result, a certain clumsiness and angularity of the teenager’s movements.

Signs of puberty are usually pronounced in girls, and if premature puberty occurs in girls, problems of a psychological nature occur. A girl may feel embarrassed by the changes taking place, especially if her peers have not yet begun to experience them. If this issue is quite painful for your daughter, try talking to the teacher, the class teacher, who will make sure that the girl does not become the subject of ridicule at school. It would not hurt to seek advice from a child psychologist; he will explain to the child in a tactful manner and with knowledge of the psychological characteristics of children and adolescents that all changes are absolutely natural and normal.

Remember : How a girl perceives the changes that occur in her body depends to a large extent on how good and close her relationship is with her mother. Try to communicate with your daughter as often and as much as possible, answer all her questions, even if they seem ridiculous and stupid. Believe me, your daughter’s trust will more than pay off, and it will be much easier for you to survive the difficult adolescence.

Equally, psychological problems can be associated with a girl’s late puberty. If she begins to understand that at the age of 13-14 she practically does not experience the same changes that her friends and classmates experience, then she may begin to experience discomfort and worry. A girl may begin to feel extremely awkward in the company of her peers, and develop a strong inferiority complex, feeling worse than everyone else.

In this situation, only constant confidential communication with the daughter can help; she needs to explain everything and periodically remind her that this is normal, and the girl’s puberty is simply inevitable. Mom can use herself as an example, even if she has to slightly embellish the reality. In especially difficult cases, if the daughter does not make contact and the mother cannot cope, we advise you to contact a child psychologist. Do not ignore the problem, because such psychological traumas are quite strong, and an acquired inferiority complex can poison a girl’s existence for the rest of her life.

The sexual development of girls may well have different variations, and not only with age. Sometimes the appearance of hair can vary significantly in its sequence. Usually, breast growth and development occurs first, then pubic hair appears, and armpit hair appears last. However, in some cases, hairs appear in the armpits first, but other signs are not yet noticeable. Sometimes hair appears on the genitals first, and then all other signs.

Also, doctors noticed one pattern - the earlier a girl’s puberty began, the faster it proceeds, and, conversely, the later a girl’s puberty began, the longer the process takes. For example, in a girl who started puberty at the age of 9, its duration is no more than one and a half years, while its onset in a 14-year-old girl will last about two and a half years.

Therefore, support your princess, be that as it may, because the most important period in her life is happening now. She is about to turn from a girl into a girl, and then into a woman, and soon she will take on your role - the role of a mother.

Under puberty This refers to the 2-year period of intense growth that precedes puberty. Puberty in girls begins with the first.

First of all, it is necessary to remember that puberty does not occur at the same age for everyone. For most girls, it begins at age 11, and the first menstrual cycle occurs two years later - at age 13. But for quite a few girls, puberty begins at age 9. It happens that it comes only at the age of 13. In exceptional cases, girls begin puberty at 7 or only at 15 years of age.

Later or earlier puberty does not mean improper functioning of the endocrine glands. This only means that they work on different schedules. This is an individual schedule, probably a hereditary trait. If parents experience puberty later than others, their children usually experience it later as well.

Let's follow the girl's puberty, which begins at 11 years old. At 7-8 years old she grew by 5-6 cm per year. By the age of 9, the growth rate had decreased by 2 cm, as if nature had hit the brakes. But suddenly, by age 11, the brakes are released. In the next 2 years, the girl will rapidly grow upward at a speed of 8-10 cm per year. She will gain weight by 4-8 kg per year instead of 2-3.5 kg, as in previous years, but she will not gain weight. She becomes “wolfish” to keep up with such rapid growth.

Other changes occur in the girl’s body. At the beginning of puberty, girls' mammary glands enlarge. First, the isola is enlarged and protrudes slightly. Then the entire mammary gland takes the appropriate shape. In the first year or one and a half years, the girl’s mammary gland has a conical shape. But closer to the beginning of the menstrual cycle, it becomes more rounded. Soon after the mammary gland begins to take shape, they grow in the area. Later, hair grows under the arms as well. The hips expand. The structure is changing.

At age 13, girls usually begin menstruating. By this time, her body becomes that of an adult woman. Since that time, its growth has slowed down significantly. In the year following her menstrual cycle, a girl will probably grow 4 cm, but in the next year she will only grow 2 cm. Many girls have irregular periods and not every month in the first year or two. This does not mean any pathology.

If puberty begins in an 8-9 year old girl, she will naturally feel awkward and embarrassed among her classmates who see her quickly growing up and becoming a woman. But not every girl cares about this. It all depends on the degree of her peace of mind and on her desire and readiness to turn into a woman. If a girl has a good relationship with her mother and wants to be like her, then she will be pleased with her rapid growth, despite the fact that she is ahead of her peers. But if a girl is unhappy with being female or afraid of becoming an adult, she will be frightened and upset by the signs of early puberty.

A girl whose puberty is delayed is also worried. It happens that even at the age of 13 she did not show a single sign of puberty, while her other girls grew up a lot. She herself is still in the slow growth stage that precedes puberty. The girl feels like an underdeveloped little person. She thinks she is worse than others. Such a girl needs to be reassured and assured that her puberty will begin as surely as the rising and setting of the sun. If it started late in the mother or other relatives, the girl needs to be told about it.

In addition to age, there are other variations in sexual development. In some girls, hair in the genital area grows before the mammary glands develop. And very rarely, armpit hair is the very first sign (and not the last, as in most cases). It usually takes 2 years from the time the first sign of puberty appears until the first menstruation. If puberty begins at an earlier age, then it usually proceeds faster - less than 1.5 years. For those girls whose puberty begins later in life, it usually lasts more than 2 years before the first menstruation begins.

By puberty, I mean the two-year period of intense growth that precedes puberty. Puberty in girls begins with the first menstrual cycle. Boys do not have such a pronounced event, so I start talking about puberty with girls.
The first thing to remember is that puberty does not occur at the same age for everyone. For most girls, it begins at age 11 and the first menstrual cycle occurs two years later - at age 13. But for quite a few girls, puberty begins at age 9. It happens that it begins only at the age of 13. In exceptional cases, girls begin puberty as early as 7 years old or only at 15 years old. Later or earlier puberty does not mean improper functioning of the endocrine glands. This only means that they work on different schedules. This individual schedule is probably a hereditary trait; if parents experience puberty later than others, then their children usually experience it later as well.
Let's follow the girl's puberty, which begins at 11 years old. At 7-8 years old she grew by 5-6 cm per year. By the age of 9, the growth rate had decreased to 4 cm per year, as if nature had hit the brakes. But suddenly, by age 11, the brakes are released. In the next two years, the girl will rapidly grow upward at a speed of 8-10 cm per year. She will gain 4.5-9 kg per year instead of 2-3.5 kg as in previous years, but she will not become fatter. Her appetite becomes ravenous to keep up with such exuberant growth. Other changes are also taking place. At the beginning of puberty, a girl's mammary glands will enlarge. First, the isola is enlarged and protrudes slightly. Then the entire mammary gland takes the appropriate shape. In the first year or one and a half years, the girl’s mammary gland has a conical shape. But closer to the beginning of the menstrual cycle, it becomes more rounded. Soon after the mammary gland begins to develop, hair grows in the genital area. Later, hair grows under the arms as well. The hips expand. The structure of the skin changes.
At age 13, girls usually begin menstruating. By this time, her body becomes that of an adult woman. She's almost that height and weight. which stays for a long time. Since that time, its growth has slowed down. In the year following her menstrual cycle, a girl will probably grow 4 cm, but in the next year she will only grow 2 cm. Many girls have irregular periods and not every month in the first year or two. This does not mean any pathology.

549. Puberty begins in different ways.

For many girls, puberty begins much earlier, while for others it begins much later. If it begins in an 8-9 year old girl, she will naturally feel awkward and embarrassed among her friends in the class, who see how quickly she is growing and taking shape into a woman. But not every girl cares about this. It all depends on the degree of her peace of mind and on her desire and readiness to turn into a woman. If a girl has a good relationship with her mother and wants to be like her, then she will be pleased with her rapid growth, despite the fact that she is ahead of her peers. But if a girl is unhappy about being female (for example, because she is jealous of her brother) or she is afraid of becoming an adult, she will be frightened and upset by the signs of early puberty.
A girl whose puberty is delayed is also worried. It happens that at the age of 13 a girl has not shown a single sign of puberty, while before her eyes the other girls have grown a lot. She herself is still in the slow growth stage that precedes puberty. The girl feels like an underdeveloped little person. She thinks she is worse than others. Such a girl needs to be reassured and assured that her sexual development will begin as surely as the rising and setting of the sun. If the mother or other relatives started puberty late, the girl needs to be told about it.
In addition to age, there are other variations in the onset of sexual development. In some girls, hair in the genital area grows before the mammary glands develop. And very rarely, armpit hair is the very first sign (and not the last, as in most cases). It usually takes 2 years from the time the first sign of puberty appears until the first menstruation. If puberty begins at an earlier age, it usually occurs faster - less than 1.5 years. For those girls whose pubertal development begins later in life, it usually lasts longer than 2 years before the first menstruation begins. Sometimes one breast develops earlier than the other. This is a common occurrence and does not mean anything. That chest. which developed earlier will remain enlarged compared to the second throughout the entire period of puberty.

550. Puberty of boys.

It begins on average 2 years later than in girls. If girls begin puberty on average at 11 years old, then for boys it starts at 13 years old. It can begin as early as age 11, or in rare cases even earlier, but can linger until age 15, and in very few boys, longer. The boy begins to grow at double the speed. His genitals develop intensively and hair grows around them. Later, hair begins to grow under the arms and on the face. The voice breaks and becomes lower.
Over a two-year period, the boy's body almost completes the transformation into a man. Over the next 2 years, his growth will slowly increase by 5-6 cm and then practically stop. A boy, like a girl, may go through a period of physical and emotional awkwardness as he tries to learn to manage his new body and new feelings. Just like his voice, sometimes high and sometimes low, he himself is both a boy and a man, but no longer one or the other.
It is appropriate here to talk about the difficulties of relationships between boys and girls at school during puberty and adulthood. Boys and girls of the same age study in the same class, but between the ages of 11 and 15, girls are almost 2 years older than a boy of the same age.
She is ahead of the boy in development, she is taller, she has more “adult” interests. She wants to go to dances and accept advances, but he is still a little savage who considers it shameful to pay attention to girls. During this period, when organizing extracurricular activities, it is better to combine different age groups to make it more interesting for children.
A boy whose puberty is delayed, who is still smaller in stature while his companions are growing into men, is even more in need of consolation than a girl who is delayed in puberty. Height, build and strength play a huge role in the eyes of children of this age. But in some families, instead of reassuring the boy that over time he will grow by 24-27 cm, the parents take the boy to the doctor, begging for a course of special treatment. This further convinces the boy that there is indeed something wrong with him. It is wiser and safer to allow a normal boy to develop in accordance with his individual, innate “plan”.

551. Skin diseases in a teenager.

Puberty changes the structure of the skin. Pores become larger and produce more oil. Blackheads form from the accumulation of oil, dust and dirt. Blackheads further enlarge the pores, making it easier for bacteria to penetrate the skin and cause a minor infection or pimple. Teenagers are prone to shyness. They are bothered by the slightest defect in their appearance. They feel embarrassed about pimples, constantly touching them with their hands and squeezing them out. This causes bacteria to spread to nearby areas of the skin and to fingers, which the child touches and introduces bacteria into new acne, causing new pimples. Squeezing pimples often makes them bigger and deeper, which can leave a scar. Some teenagers interested in gender issues imagine that their acne is caused by immodest thoughts or masturbation.
Almost all parents accept their children's acne as a necessary evil, believing that only time will cure it. This is the wrong approach. Modern medications can provide improvement in most cases. The child, of course, needs to be shown to the attending physician or a skin specialist, who will take all measures to improve the teenager (which in turn will improve the mood) and to prevent the scars that acne sometimes leaves.
There are also general measures that are considered very useful. Vigorous exercise, fresh air and direct sunlight improve the complexion of many people. Excessive consumption of chocolate, sweets and other high-calorie sweets contributes to the formation of acne. It is reasonable to exclude these foods from the teenager’s diet, at least during this trial period. Typically, the skin is thoroughly but lightly cleaned with a hot, soapy sponge, followed by rinsing with hot and cold water. It is very important to explain to your child why he should not touch his face with his hands or squeeze out pimples.
Teens also experience increased armpit sweat and odor. Some children and even parents do not notice this, but the smell will be unpleasant to classmates, which will cause hostility towards the child himself. All teenagers should thoroughly wash their armpits with soap every day and regularly use special anti-sweat products.

*Psychological changes*

552. Shyness and touchiness.

As a result of all the physiological and emotional changes, the teenager’s attention turns to himself. He becomes more sensitive and shy. He gets upset over the slightest defect, exaggerating its significance (a girl with freckles may think that they disfigure her). A small feature of the structure of his body or the functioning of his body immediately convinces the boy that he is not like everyone else, that he is worse than others. A teenager changes so quickly that it is difficult for him to figure out what he is. His movements become angular because he cannot yet control his new body as easily as before; similarly, at first it is difficult for him to manage his new feelings. The teenager is easily offended by comments. At some moments he feels like an adult, wise from life experience and wants others to treat him accordingly. But the next minute he feels like a child and feels the need for protection and maternal affection. He may be worried about increased sexual desires. He still doesn’t have a very clear idea of ​​where they come from and how to act. Boys and especially girls fall in love with different people. For example, a boy may admire his teacher, a girl may fall madly in love with her teacher or a literary heroine. This is because for many years, girls and boys stuck to the company of their own sex and considered members of the opposite sex to be their natural enemies. This is an old antagonism and barriers are being overcome very slowly. When a teenager first dares to entertain tender thoughts about a person of the opposite sex, it usually turns out to be a movie star. After some time, boys and girls studying in the same school begin to dream about each other, but even then it will still be a long time before the shy ones find the courage to express their affection in person.

553. The demand for freedom often means fear of it.

Almost all teenagers complain that their parents restrict their freedom. It is natural for a rapidly maturing teenager to insist on his rights and dignity, befitting his stage of development. He has to remind his parents that he is no longer a child. But parents should not literally understand every child’s demand and give in without talking. The fact is that the teenager is frightened by his rapid growth. He is completely unsure of his ability to be as knowledgeable, skillful, sophisticated and charming as he would like to be. But he never admits his doubts to himself, much less to his parents. The teenager is afraid of his freedom and at the same time protests against parental care.

554. Teenagers need guidance.

Teachers, psychiatrists and other professionals who have worked with teenagers say that some of them admit that they wish their parents were a little stricter with them, just like the parents of some of their friends, and taught them what is right and what is wrong. . This does not mean that parents should become judges of their children. Parents should talk to teachers and other teens' parents to find out the customs and rules of the area where they live. They should certainly discuss these rules with the child. But in the end, they must decide for themselves what they think is right and insist on their own, although this is quite difficult. If the parents' decision is reasonable, the teenager accepts it and is grateful deep down. On the one hand, parents have the right to say: “We know better,” but, on the other hand, they must feel and show deep trust in their child, in his judgment and his morals. What keeps a child on the right path is mainly his healthy upbringing and the confidence that his parents trust him, not the rules they teach him. But a teenager needs both rules and the knowledge that his parents pay enough attention to him to teach him these rules that fill the gaps in his life experience.

555. Rivalry with parents.

The tension that sometimes arises between teenagers and their parents is partly due to natural rivalry. The teenager realizes that it is his turn to conquer the world, attract the opposite sex, and be a father or mother. He seems to be trying to oust his parents and push them from the heights of power. Parents subconsciously feel this and, of course, are not very happy.
There may even be friction between father and daughter, between mother and son. Between 3 and 6 years of age, a boy is deeply infatuated with his mother, and a girl with her father. After 6 years, the child tries to forget about this hobby and denies it. But when, during adolescence, he experiences a strong pressure of feelings, they first rush, like a spring mountain stream, along an old dry riverbed, that is, again towards his parents. However, the teenager subconsciously feels that this is not good. At this age, his first big task is to change the direction of his feelings from his parents to someone outside the family. He tries to destroy his love for his parents with hostile feelings towards them. This at least partly explains why boys are rude to their mothers and why girls can be inexplicably antagonistic towards their fathers.
Parents are certainly attached to their teenage children, and this helps us understand why a mother privately or openly disapproves of the girls her son likes, and why a father may vehemently object to young men courting his daughter.

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 are growing up, the period of puberty begins, when a young maiden blossoms 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 about?

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

What will menstruation depend on?
The reproductive function of a girl will depend on the girl’s health and her compliance with personal hygiene rules. In healthy and seasoned girls who play sports, periods usually pass easily. But weakened, overtired or frequently ill girls may experience malaise, pain in the lower abdomen, headaches and aching in the lower back during menstruation. A healthy girl may also have slight weakness, but this usually does not interfere with her normal lifestyle, she just needs to slow down the pace of training and activities.

Girls can lead a normal life during their periods; they are not contraindicated from going to school or doing physical education; they only need to stop jumping, carrying heavy objects, or cycling. During menstruation, you should eat less salt and hot spices; they can increase the flow of blood during menstruation. Teach your daughter to keep a menstruation calendar, it will be calmer for both you and her - remember, sexual activity begins in teenagers without asking our permission, and if you have periods, pregnancy is always possible. While, unfortunately, her mother will have to think for the girl, the girls have wind in their heads. In a calendar, let him mark the start and end date of menstruation, its duration and abundance, this will also help to note health problems if they arise. Regular menstruation indicates 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 in matters of 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 the next. They follow each other continuously due to the cyclical nature of hormonal processes in the body, regulated by the girl’s maturing brain. On average, the cycle can be from 22 to 24 days, less often longer. Menstruation itself lasts 3-7 days. The entire cycle can be divided into several phases during which special changes in the body occur.

First period or menstrual bleeding– this is the first day of the cycle, during which the endometrium and its vessels are rejected, coming out with bloody discharge. This is a mixture of blood, mucus and mucous membrane cells; in one cycle, up to 30-100 ml of blood is lost, but if it is much more, immediately go with your daughter to the doctor. The first days of menstruation are more abundant, in the subsequent days they are scanty.

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 estrogen, the inner layer of the uterus begins to grow, the follicle reaches 20-25 mm. Follicles are taken from ready-made buds; by the time a girl is born, there are about 400 thousand of them in the ovaries; about 500 will mature during her life.

Third phase- this is ovulation, it is at this time that the egg is released and it is during this time that women become pregnant. It is important to know this so that the girl understands the essence of protection against 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 endometrium thickens and loosens, and the egg dies. A decrease in hormone levels and again a transition to the first stage of the cycle - endometrial rejection. If a girl becomes pregnant, her menstruation will stop - the absence of menstruation is the first sign of pregnancy, although they may be absent for other reasons.

What does menstruation depend on?
The correctness and regularity of a girl’s cycle depends on her sexual and hormonal health. The main gland in menstruation is the hypothalamus; after an equal amount of 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 a malfunction occurs at any of the links in this chain, this leads to disruption in the development of menstrual function and requires the participation of a doctor. For the first two years, irregular menstruation is allowed, but by the age of 16-18, all menstrual functions should be clearly established, the cycle should become regular and not cause much discomfort. If this does not happen, this is a reason to contact a teenage gynecologist.

Teenage girls today have poor nutrition, often girls 15-18 years old are either obese or excessively thin, many live in constant stress from exams, unrequited love or family problems, all this unbalances hormones and the 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 when a girl reaches a weight of 43-47 kg; in girls who are on a diet or exhausted, menstruation often disappears or occurs much later. Very low weight women are infertile due to their weight alone. Even if a 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 diet! But without diligence, the opposite state is no less dangerous. Fat chicks 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 leads to earlier maturity.

Not only the quantity, but also the quality of food is important - alcohol, fatty, salty and spicy foods with excess meat lead to earlier ripening. If a girl, in pursuit of fashion, limits herself to some elements of nutrition or goes on a diet, this will affect her sexual functions, and sometimes this can be irreversible. Deficiency of vitamin A, zinc and iodine is especially dangerous; this is the exclusion of meat, fish and eggs from the diet.

Other factors.
There are also external factors that influence the onset of puberty - climate and geography of residence. Girls from mountainous latitudes and southerners menstruate earlier, but girls from lowland latitudes and northern regions menstruate 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 influence the onset of menstruation; girls in adolescence do not have very pronounced physical strength and endurance. Professional sport is a difficult test for them - it greatly affects the health of the sexual sphere and general health. Stress in sports or ballet inhibits the development of the sexual sphere and is combined with delays in growth and development in general. Look at the gymnasts and acrobats - they are all small and childish at 16-17 years old. In addition, female athletes during puberty may show signs of androgenization - the voice becomes rougher, the secretion of sebum increases, and menstruation is disrupted. This depends on strength training and muscle development - this happens among swimmers and rowers; half of the female athletes with medals have very serious problems as women. Therefore, think about what is more important to you: your daughter’s sporting achievements and medals, or the presence of grandchildren in the family.

Another significant problem is bad habits among girls. Our subculture and teenage parties instill in them the wrong styles of behavior - they try smoking as early as 12-14 years old, try alcohol secretly from their mothers, and even begin sexual activity long 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 are more likely to develop acne and a pale complexion, and their voice becomes rougher - this is due to androgen hormones. They also affect the menstrual cycle - it becomes irregular and painful.

And bad habits also damage eggs so much that many years later, 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 succeed as a woman, and in a few years she will help you succeed as a grandmother!

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