The Perils Of Puberty

Written by Dr. Kathy Savoia

The mere mention of the word 'puberty' causes most parents to cringe, either with dread if their children are little, or with sympathy if they have passed that stage. Suddenly, the child who used to say that you were the best mom or dad in the world is shouting that they hate you at the top of their lungs. What has happened to your little boy or girl?

Puberty refers to the period of development when the sexual organs mature. However, this cannot be separated from the psychological and sociological changes which occur during adolescence, namely the mood swings, esteem issues, quest for independence and sexual exploration.Anticipating these changes and discussing them openly with your child may help minimize the conflicts and produce healthy, confident adults.

The age when puberty begins, and the rate at which it happens, varies tremendously based on the individual and family history. Further, girls begin the process and complete puberty two years earlier than boys on average. These differences can cause tremendous anxiety among peers and with the opposite sex. The physical changes in girls usually begin between the ages of 8 and 13, with the development of breast buds, followed by genital hair growth and a rapid growth spurt. The breasts may not be the same size, which may or may not correct by adulthood.

Usually, the first menstrual period occurs roughly two years after breast bud development. It is normal for menstrual periods to be irregular initially. If they are very long, heavy, or associated with excessive cramping, it is best to see your family doctor. If longer than three months lapses without a period, you should also consult your doctor. The onset of the menstrual period may be an unexpected, or frightening event, associated with a great deal of misinformation, particularly regarding fertility.

Smooth this process by open discussion regarding management of bleeding, the importance of abstinence and if necessary, birth control and condom use. This discussion may be embarrassing, but is extremely important to the self esteem and future health of your teenage girl. If you are uncomfortable having this discussion with your child, there are excellent books available or have your family doctor initiate this discussion with her.

In the male, sexual changes begin with the growth of the genital organs and the developmental of pubic hair around age 10 to 14. Usually, the growth spurt begins one year later, with the development of facial hair and deepening of the voice roughly two years later. Seventy percent of boys have some breast bud development beginning around age 11. This usually resolves within one to two years. This can be embarrassing for him, and reassurance is very important.

The issue of short stature is also an important one to most boys, and reassurance that the majority of growth isn't complete until age 18, and this rate of growth is often dependent on genetic factors, may be helpful. Boys can become fertile as early as age 12 to 13, and a frank discussion regarding abstinence and the importance of condom use if they should become sexually active is very important.

These time frames are variable, but both delayed and early puberty can occur for a variety of genetic, hormonal or anatomical reasons and a doctor's opinion should be obtained if development appears to be falling outside of these age ranges.

Acne is, of course, a significant issue for many teens and is due to the hormonal stimulation of sweat and sebaceous glands. Teens often have misconceptions about acne being caused by diet, cleanliness or make up. There are many options to control this troublesome condition from topical to oral treatments depending on severity. Be sure to see your doctor if this is an issue for your teen.

The physical changes during this period often occur so rapidly that the teen becomes self conscious and often, clumsy. They focus on minor 'defects' in their body shape and size and become oversensitive to them, developing a distorted self image. Thus, they spend hours in front of the mirror and, lacking their own identity at this time, often turn to their peers and the media to define their dress, their attitudes and their values.

Just as important, and tied closely to the physical changes of puberty are the psychological struggles of finding out who they are and what they want to do in the future. In early adolescence, they are overwhelmed by the rapid changes occurring in their bodies and the body image may vary dramatically. In middle adolescence, they become more comfortable with their bodies, become more self-centered and feel that they are invincible.

Mood swings become the norm, reckless behavior is common and peers become the standard against which they compare themselves and to whom they turn for emotional support in their struggle for independence. In later adolescence, teens are less self centered, more idealistic and black-and-white, and dating becomes more important.

Given all of these changes, it is little wonder that the rates of depression, eating disorders, teenage pregnancy, drug use, violent or reckless behavior and suicide are so high among adolescents. As parents, we must be diligent in watching for warning signs of these in our teens such as declining grades, excessive school absences, frequent medical complaints, changes in eating or sleeping habits, difficulty concentrating or excessive boredom, withdrawal from family or a change to a new group of friends, severe rebellious behavior or persistent radical personality change, sexual acting out, suicidal ideas or pre-occupation with death and drug and alcohol abuse.

Puberty is a difficult time for parents. Keep talking, keep asking questions and listen for the answers, set boundaries, encourage healthy pass times and model these behaviors, encourage independence, praise and bolster self esteem and if you are in doubt, or worried by their behaviors, discuss your concerns with your family doctor who can suggest resources which are available within the community. With patience, encouragement and love, we can raise healthy, well adjusted and independent adults who will thank us later for our love and perseverance.