Puberty often begins earlier than parents think. Breast budding in girls—their first sign of puberty—starts at age 10 on average, with some girls starting as early as 8 and others not starting until 13. The peak growth period (in height, weight, muscle mass, etc.) in girls occurs about one year after puberty has begun. Menstruation (period) usually starts about two years after the onset of puberty; on average, the first menstrual period occurs just before girls turn 13.
There are many opportunities during this time of life for you to talk to your daughter about the changes she's experiencing. Your daughter needs to understand the physical changes that will occur in her body during puberty. You should emphasize that these changes are part of the natural process of growing into adulthood, stimulated by hormones (chemicals that are produced by the body.)
Also, while fully respecting her desire for privacy, keep track of your daughter's bodily changes. As the age ranges above indicate, there are wide variations of the "normal" onset of puberty. Remind your daughter that while she and her friends will grow at different rates, they will eventually catch up with one another. Avoid good-natured teasing of your daughter about her pubertal development. Because most girls feel self-conscious during this time, they will become embarrassed if they are kidded about the changing shape of their bodies and general appearance.
On occasion, girls start puberty either very early or very late. There is no need to over-react to this phenomenon. Even so, girls should be checked by a physician if they begin pubertal changes before age 8. Likewise, see a doctor if there are no pubertal changes in a girl by age 13.
Talk to your daughter about the following physical changes that will happen during puberty. The changes are listed in the order in which they generally occur.
- Body fat increases
- Breasts begin to enlarge
- Pubic hair grows
- Height and weight increase
- First menstrual period occurs
- Hips widen
- Underarm hair grows
- Skin and hair become more oily
- Pimples may appear
Her body will begin to build up fat in the stomach, buttocks and legs. This is normal and gives her body the curvier shape of a woman.
In most girls, puberty is more commonly recognized by breast growth. When her breasts start to develop, she may notice small, tender lumps under one or both nipples that will get bigger over the next few years. When the breasts first begin to develop, it is not unusual for one breast to be larger than the other. However, as they develop, they will most likely even out before they reach their final shape and size. As her breasts develop, she may need a bra. Some girls feel that wearing a bra for the first time is exciting—it is the first step toward becoming a woman! However, some girls feel embarrassed, especially if they are among the first of their friends to need a bra. Be supportive and sensitive to her needs and reactions.
Soft hair will start to grow in the pubic area. This hair will eventually become thick and very curly. She may notice hair under her arms and on her legs. Many girls will question whether or not they should shave this hair. There is no medical reason to shave; it is simply a personal choice. If she decides to shave, be sure to teach her to use warm water and soap, and a clean razor made for women. It is a good idea for her to use her own personal razor or electric shaver and not share one with family members or friends.
Height and weight
Arms, legs, hands, and feet may grow faster than the rest of her body. Until the rest of her body catches up, she may feel more clumsy than usual. Typically, a growth spurt precedes the onset of her period.
Many concerns about puberty center on menstruation. Spend time helping your daughter prepare for her first period. There is no reason for a girl to be surprised by the first onset of her period (menarche), not knowing what is happening or why. Remember, menstruation may begin sooner than you expect. Certainly, once your daughter's breast development has started, the two of you should fully discuss the topic of menstruation. If you do not have adequate knowledge, ask your family physician to refer you to some informational sources. Some doctors schedule special educational visits at the time of puberty.
Discuss the biology of menstruation, describing it as a normal bodily process. Mention that her periods may be irregular, particularly in the beginning, as her body adapts to rapid physiological changes. Also, let her know that several months before her first period, fluid may be secreted by glands within her vagina. This substance may be clear or white in color and watery to thick in consistency. Tell her not to worry and that this occurrence—called physiologic leukorrhea—is normal.
Explain that she may experience some cramping before or during her periods. If cramps become severe, her doctor may have some suggestions for alleviating them, such as physical exercise or medication such as ibuprofen or naproxen sodium.
Of course, discuss hygiene related to menstrual cycles. Be sure your daughter has the supplies she will need for her first period. Since she may be away from home when that first period begins, discuss how to use tampons or pads. She should understand the need to change her pads or tampons several times a day and that tampons should not be worn overnight. Of course, girls can shower or bathe while menstruating.
Many girls will ask if they can participate in activities such as swimming, horseback riding, or physical education classes during their periods. Reassure your daughter that she can take part in normal activities while menstruating. Exercise can sometimes even ease the cramps associated with periods.
Her hips will get wider and her waist will get smaller. This physical change also contributes to the curvier shape of a woman.
Skin and hair
Her skin may become more oily, and she will notice that she sweats more. This is because her glands are growing, too. It is important to teach her to shower or bathe every day to keep her skin clean, and to use a deodorant or antiperspirant to keep odor and wetness under control. Despite her best efforts to keep her face clean, she still may develop pimples or acne. This is normal because her hormone levels are high. Almost all teenagers develop acne at one time or another. Whether her case is mild or severe, there are ways to keep acne under control. Talk to her doctor about treatment options for acne.
The pelvic exam
It used to be thought that most young women should have a pelvic exam by the end of high school. Now pelvic exams are reserved for when she is sexually active or has any of the following signs or symptoms:
- Heavy vaginal discharge that itches, burns, or has an odor
- No signs of puberty (breast growth, underarm hair, or pubic hair) by age 14
- No periods by age 16
- Regular periods for four to six months and then no periods for more than four months
- Menstrual cramps that cause her to miss school or significantly disrupt her normal activities
- Heavy bleeding
- Bleeding lasting longer than 10 days
- Any signs of pregnancy (a missed period, tender breasts, upset stomach)
Pap tests are now delayed until age 21, regardless of sexual activity. Testing for gonorrhea and chlamydia can be done from a urine sample, so your daughter need not be afraid of a pelvic on her first visit to the gynecologist. This visit is a great time for your daughter to talk to her doctor about important health issues, such as:
- Her growth and development
- Breast health
- Pregnancy and birth control
- Infection risk and prevention
- Advice about her health
The breast exam
Once your daughter begins to have periods, good breast care should be emphasized. Your family doctor will examine her breasts for lumps, staging maturity of the breasts, skin discoloration, or dimpling. He or she also will look for any discharge from the nipple or swollen glands under the arms. Your daughter's doctor also may teach your daughter how to do a breast self-examination which used to be encouraged every month. Although current data does not support the usefulness of breast self-examination in this age group, it will be important for her to become familiar with the way her breasts normally feel, so that she can make her doctor aware of any changes.
Many women get their periods every 28 days and can set their watches by its arrival. However, there also are many women whose periods do not fit into such a regular schedule. Every woman's menstrual cycle is different. It may take a while for your cycle to become regular, but keeping track of your periods is a great way to become familiar with your cycle. By tracking, you might notice a pattern every month. You should carry tampons, pads or panty liners in your backpack or purse so you won’t be caught unprepared.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/10/2014...#9537