HEALTH EDUCATION

Puberty

Puberty happens to everybody, but it doesn’t happen to everybody at the same time.

Generally, girls start puberty earlier than boys. The bodies of some girls begin changing at age eight. Others don’t start changing until they are 14.

Boys’ bodies start changing from age 10 to 12. Most often these changes are complete before a person is 20.

Some of the changes are the same for girls and boys. We get taller. We begin to grow hair under our arms and around our vulvas or penises. We sweat more, too, mostly under the arms. That’s when a lot of people start washing more often and start using deodorants. Also, our voices deepen. This usually happens more suddenly in boys than in girls.

Many of us get pimples during puberty — on the face, back, chest, or buttocks. We get them as our skin starts growing thicker and the glands under it start making more oil. Our pores become clogged and infected. That’s another good reason to wash and shampoo often.

Hormones make our bodies grow up
Our bodies make chemicals called hormones that guide our growth into women and men — estrogen and progesterone in girls and testosterone in boys. Often we grow so fast that we feel clumsy. We even may have uncomfortable growing pains, usually in our arms and legs.

Estrogen causes lots of the changes. Girls’ breasts begin to get fuller. Often one breast grows faster than the other. Their hips get rounder. Their waists get narrower. Their vulvas and clitorises grow slightly, too.

Girls may have a white, sticky discharge from their vaginas called leukorrhea. They shouldn’t worry about it unless the vulva becomes itchy or irritated. If it does, a girl should visit her doctor or health care provider.

Boys’ testicles get bigger and hang lower. Usually one hangs lower than the other. Their penises grow larger and get hard more often — and unexpectedly. Boys gradually start growing beards after their voices change. Sometimes boys’ breasts become tender and somewhat enlarged, too. This is called gynecomastia. It usually lasts only a year or two, and then the size of the breasts returns to normal.

We inherit our size, eye color, and skin color from our parents. We also inherit large breasts or small breasts, thin legs or thick legs, big penises or small penises, and thick beards or thin beards. Most of the time we inherit average breasts, legs, penises, or beards. But we are all very different, no matter what — and that’s normal.

As boys become men
Boys and men have erections.

Boys and men become sexually excited by sexual thoughts, wet dreams, or sex play with themselves or another person. Their penises fill with blood and get hard and erect. Boys and young men get erections for no reason at all. "Spontaneous erections" can be very embarrassing.

A sticky liquid spurts out of erect penises if men get very excited. This is called ejaculation or "coming." The liquid is semen or "cum," not urine. Ejaculation and urination cannot happen at the same time.

Semen contains sperm and is also called "ejaculate." Boys and men may have orgasms without ejaculation. They may ejaculate without orgasm. A hard penis becomes soft again after orgasm. And it will become soft again even without orgasm or ejaculation.

Sperm are made in the testes. There are millions in every drop of healthy semen. They move from the testicles to the seminal vesicles through tubes called the vas deferentia. In the seminal vesicle, they mix with other fluids to form semen. Usually, a teaspoonful to a tablespoonful of semen is released at a time.

The time when sperm is first produced is called spermarche (sper — MAR — key). Men’s bodies make sperm all their lives. New sperm develop every minute. Sperm are absorbed by the body if they are not ejaculated.

Wet dreams often come as a surprise
Most boys and men have wet dreams. This happens if they get erections and ejaculate during their sexual dreams. These dreams leave them wet or sticky around their bellies and penises. Some boys wake up thinking that they’ve "wet the bed." Some boys never have wet dreams. Dreams or no dreams — both are normal.

As girls become women
Girls and women have orgasms during sexual dreams and sex play.
Women and girls become sexually excited by sexual thoughts and dreams or sex play with themselves or another person. Their vaginas become wet, their clitorises become erect, and if they become very sexually excited, they may have orgasms or a series of orgasms. In some women, a clear fluid spurts out of the urethra during sexual excitement or orgasm. This is also called ejaculation.

The vagina connects the sex organs of the vulva to the other reproductive organs inside the body.

The soft folds of the walls of the vagina adjust to the size of the penis during vaginal intercourse and stretch during childbirth. Girls and women also have two ovaries, a cervix, a uterus, and two fallopian tubes.

Each ovary holds hundreds of thousands of pinpoint-sized eggs. Girls are born with all the eggs they will ever have. One ovary releases a mature egg about once a month. This is called ovulation. Before ovulation, the uterus builds up a spongy, soft lining. It is made of tissue and blood. This lining is like a nest for the egg if pregnancy happens.

After ovulation, the egg moves through a fallopian tube toward the uterus. Most of the time, the egg breaks apart before it gets there. Then the tissue and blood aren’t needed. They flow out of the uterus, through the cervix and vagina out of the body. This is called menstrual flow or a "period..."

Menstruation (the period)
Different women have different amounts of flow during their periods. Usually, there are only four to six tablespoonfuls of blood in the whole flow. This is a small amount. The rest is bits of the unused lining and other fluids. By the time your period ends, the flow will have amounted to between half a cup and a full cup of liquid.

But the egg doesn’t always break apart. If the egg meets a sperm in the fallopian tube, they can join together. The joining of the egg and sperm is called fertilization. Pregnancy begins if a fertilized egg attaches itself to the lining of the uterus. The lining stays in place until the pregnancy ends. That’s why pregnant women do not have periods.

The first time menstruation happens is called menarche (meh-NAR-key). Some families celebrate menarche as the time when a girl becomes a woman. Other families are more private about it. But whether or not menarche is celebrated, it is an exciting and important moment in a girl’s life. It is also normal for girls to feel nervous or scared when they start getting their periods.

The time from the first day of one period to the first day of the next is called a menstrual cycle.

On average, menstrual cycles begin between the ages of 12 and 13. They end when women are between 45 and 55 years old.

Periods last about five days. It may be seven to 21 days from the beginning of a woman’s period to ovulation. Then there are usually about 14 days from ovulation to the beginning of the next period.

During puberty, it’s not unusual for three, four, five, or six months to go by between periods. Eventually, they happen every four or five weeks. Sometimes there is a spotting of blood between periods. Some women know when they are going to have their periods by the way their bodies feel. Others don’t. Some women keep a record of their periods on a calendar to become more familiar with their cycle.

Some girls and women may have physical or emotional discomfort up to two weeks before menstruating. This is called premenstrual syndrome (PMS). Usually mild, PMS happens in fewer than half of all women.

Women use sanitary pads, tampons, or menstrual cups to absorb menstrual flow.

Every package has instructions. Sanitary pads, tampons, and menstrual cups come in different sizes and varieties. Some are for lighter flows. Some are for heavier flows.

Pads stay in place by sticking inside the underwear. Tampons and cups fit inside the vagina. The walls of the vagina hold them in place. Each tampon has a string that hangs out of the vagina. The tampon is removed easily by pulling the string slowly. Some cups have a "stem" that can be pulled for removal. Other cups are removed by hooking a finger around the rim. Some cups are emptied, washed, and used again. Other cups are disposable.

Pads, tampons, or cups and regular bathing are all a girl or woman needs to stay clean during her period. Douches, vaginal deodorants, and perfumed pads and tampons are unnecessary and may irritate the vulva and vagina.

Some girls wonder if using tampons or cups will stretch the hymen and make them lose their virginity.

The hymen is a thin skin that stretches across the opening of the vagina. There is usually an opening in it to let menstrual flow out of the body.

The hymen is very important to some people. They believe that a girl without a hymen is no longer a "virgin" — that a boy has put his penis in her vagina. Girls are born with various sized openings and shapes of the hymen. Some girls are born with very little hymenal tissue. They may seem to have no hymen at all. Others stretch theirs open during certain kinds of exercise like bicycling or horseback riding. Using tampons doesn’t usually stretch the hymen open all the way.Cups may be more difficult to use if a woman has a lot of hymenal tissue.

Girls and women who use tampons change them every three or four hours, or more often if bleeding is heavy.

Too many bacteria can develop if a tampon is left in place too long. This can cause a rare illness called "toxic shock syndrome" (TSS). Although very rare, TSS is very serious. If you vomit and develop a high fever, diarrhea, muscle aches, sore throat, dizziness, faintness, or weakness, and a sunburn-type rash while using a tampon, take it out and see your clinician — fast. You can reduce your risk by using a pad or cup or less absorbent tampon while sleeping.

Usually, women and girls do not have serious problems with their periods.

Some feel depressed, tired, or moody. Some have cramps or nausea on the first day or two of their periods. Exercise and a healthy diet may reduce cramps. Putting a hot-water bottle or heating pad on the abdomen can help, too.

Usually cramps aren’t severe enough to prevent normal activities. If they are, a girl should talk with her parent, the school nurse, a teacher, or a clinician. There are very good medicines that lessen the pain of menstrual cramps.



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