Puberty in girls. Adolescence in girls: signs and symptoms. What time does puberty begin and end for girls?
Girls grow up quickly. Along with this process, changes occur at the physiological level, sexual characteristics appear, including hairiness in certain places. Do we find out when girls start growing pubic hair?
You can call it differently, with all sorts of scientific words, or you can call it simply: everyone has a pussy and hair grows on it. There is no need to be shy, because we are all ordinary people And natural processes in the body no one is bypassed.
Formation of pubic hair in girls starts at 10-11 years old . Gynecologists call this process the mysterious word pubarche. Most people do not remember this word, because it is not useful in life, so do not focus on it. The main thing is that the hair growth process starts by age 10 (the first hair may appear even a little earlier) and ends by age 15-16 .
Please note that the girl’s hair should look like a triangle pointing downwards. If there are deviations from this form, for example, the form is observed rhombus, then parents are advised to take the girl to the doctor endocrinologist. This is a sign of hormonal imbalance.
Prevent early shaving of the intimate area
If you have a girl at home, then you should hide your shaving accessories. A girl can see her mother or father's razors and begin to shave her own hair with them. intimate area, which will disrupt the normal process of hair formation. In the future, this will lead to, frankly speaking, a very ugly appearance of the intimate area.
How to explain to a child why hair begins to grow in the intimate area
Create such an atmosphere in the family so that the girl does not hesitate to talk about her physiological changes with mom. Discuss all issues with her, always find time for them. Don’t brush it off and explain what certain changes mean and that you shouldn’t be afraid of them. This is very important from a psychological point of view.
There is no need to be intrusive, there is no need to constantly ask and discuss this topic with your child. You can sometimes peek or ask if that’s not your custom. It is even better to tell the child by the age when the hair should appear that something will soon appear there and so that he is not afraid.
It is quite difficult at first glance to justify the need for pubic hair. In fact, there, in this area, there is a zone increased secretion pheromones. And so that they actively evaporate, nature has provided an increase in the evaporation surface area: thanks to hair, pheromones evaporate not only from the skin, but also from the hair. This is how the opposite sex can feel the partner. But for a child this is all too complicated and unnecessary, we can simply say that this is a necessary stage of growing up, a sign of adulthood, and he will have several such signs, this is just one of them.
Growth of mammary glands, pubic hair and armpits 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 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 is fine, only there are follicles in the right ovary a little more than in the left, ultrasound of the kidneys and adrenal glands, everything is fine there only right kidney slightly lowered, but with 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 lower a little, and that’s what happened. And ultrasound abdominal cavity Everything is fine there, only the gallbladder is twisted, this is what we have 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 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, when elevated prolactin 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 sexual development. 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 puberty, I went to a homepathist, took the prescribed pills, and he also said it would 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) central genesis, full 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, any 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.
-Try with synthetic analogue GnRH is performed in the morning after good 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 drug containing a daily GnRH analog (triptorelin) is administered rapidly as a single intravenous dose of 25–50 mcg/m2 (usually 100 mcg) followed by withdrawal venous blood initially, after 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 typical for puberty, i.e. exceeding 5–10 IU/l, indicates the development of complete gonadotropin-dependent PPS. Increasing FSH concentration while maintaining minimum concentrations PH in response to a test with triptorelin in patients with premature thelarche indicates a low likelihood of developing gonadotropin-dependent PPS. In children with others partial forms The PPS content of LH and FSH after the test is equal to that 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 is it treated only 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 other reasons other than increase intracranial pressure or there will be no disruption of the blood supply to the brain; in fact, a eurologist is 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 sex life. 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. In the presence of hormonal disorders your doctor may recommend tablet contraceptives, which will not only protect you from pregnancy, but will also provide 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 big city, and even more so 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 full examination from 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 urine composition 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, microdosed hormonal contraceptives, there are those that have medicinal properties for correction of hormonal status, formed against the background of premature pubic hair growth. 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. Main reasons similar situation are considered 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 (direct 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 involving 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 carried out by a neurologist/endocrinologist, and, if necessary, a neurosurgeon.
The incomplete form of the cerebral type of precocious 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.
Peculiarities hormonal levels 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 and they prescribed me to drink potato juice.after a month the compaction 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 at this moment 126 cm, weight 23 kg, there were no changes in height and weight. It may be necessary before examination or treatment, but the doctor does not 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 does not get scared bloody discharge. 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. Clinical picture, which 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 hair growth male type, acne, clitoris enlargement, voice change, male physique, increased growth. At timely diagnosis and the beginning 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 necessary treatment and promptly prescribe adequate treatment.
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. Physical development and the 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 independently 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, for Last year She grew sharply and gained weight, sweating appeared, and her character 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 sexual development is 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), therefore 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 due to pathological disorders from 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 supply 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 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 typical conditions. female body zones 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 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. The doctor at that time determined a slight inflammation, but about early development no treatment was prescribed. 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. Received directions: Ultrasound of the adrenal glands ( result is normal), analysis of discharge (slight inflammation - currently treated), general clinical tests blood and urine (normal), see 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 the 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 physiological control methods causes signs of activation midline structures with the appearance of bilateral outbreaks of sharp waves, 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. Neuropathologist EEG results He 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 here), the neurologist in district hospital, stated 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 various diseases 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 disorders. gynecological pathology. 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, 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 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 growth will stop at an early age and perhaps the height will remain at the level of 145-155 cm. If during treatment with estrogen blockers, ossification will be stopped bone tissue up to the age of 8-10 years, then after stopping the drugs, the M\function may become 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!
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 Puberty in girls begins at 7 or only at 15 years.
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 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 a body adult woman. Since that time, its growth has slowed down significantly. In the year after the start of her menstrual cycle, a girl will probably grow 4 cm, and after next year- only 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. A girl will probably grow 4 cm in the year after her menstrual cycle begins, but only 2 cm in the next year. 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, 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 medicines in most cases they can provide improvement. 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 which are considered very useful. Energetic physical exercise, Fresh air and direct sunlight improves 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 wash their armpits thoroughly with soap every day and use regularly. by special means from sweat.
*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.
Puberty is the time when complex endocrine processes occur in a girl’s body, shaping her somatic and sexual development. During this period, the girl’s body reaches biological and sexual maturity and the girl is anatomically and functionally ready for procreation.
There are two phases of puberty. The first - prepubertal - is characterized by a growth spurt, the appearance of secondary sexual characteristics (mammary glands and sexual hair growth) and ends with menarche - the first menstruation. In the second phase, the formation of secondary sexual characteristics is completed and a regular menstrual cycle is established.
Late or early onset of puberty is not always associated with pathological process and upon careful questioning it is often discovered that the mother or grandmother also began menstruating earlier or later than their peers. If this worries the girl or her mother, then it is necessary to consult a pediatric (teenage) gynecologist.
Acceleration of growth rates is observed at the age of 9 - 11 years, enlargement of the mammary glands - at 10 - 11 years, sexual hair growth - from 11 - 12 years. Menarche is usually observed at 12 - 13 years of age, and a regular menstrual cycle is established within 1.5 - 2 years from menarche. During this time, the break between menstruation can be up to 1 - 3 or more months. And a regular ovulatory cycle appears in girls five years after menarche.
Menarche
The first menstruation is one of the signs of the maturity of a girl’s body, which symbolizes the transition from childhood to becoming an adult woman. However, the growth and development of a girl with the onset of menarche is not yet complete, and therefore pregnancy is still unlikely, but possible - in the first year after menarche, 25% of girls have ovulatory cycles. Even less chance of carrying and giving birth healthy child, in particular, due to anatomical structure pelvic organs that are not yet formed, and the girl’s body is not yet ready to bear a pregnancy.
The first menstruation usually occurs two to three years after the onset of puberty. In this regard, it is necessary to talk about the so-called premature and delayed puberty. In the first case, signs such as enlarged mammary glands and pubertal hair appear in girls before the age of eight, and the appearance of menstruation before the age of 9. As a rule, this indicates early activation of the ovaries, pituitary gland and hypothalamus and can be the norm (for example, a consequence genetic predisposition), and medical pathology. In case of premature puberty, it is recommended to consult a doctor, pediatric gynecologist, or endocrinologist to rule out any pathological process.
Delayed puberty is considered to be those cases when by the age of 14 the girl’s mammary glands have not yet begun to develop and hair growth has not appeared, and by the age of 16 menstruation has not occurred. Most often this is a signal of some deviation in the development of sexual and endocrine system. In this situation, the sooner you see a doctor, the easier it will be to determine the cause of the disorder and promptly prescribe treatment.
Gynecologists and endocrinologists recommend that parents not neglect preventive examinations. After all, your girl is a future woman, a mother, so it is better to identify any pathologies immediately and prevent their development.
Menstruation
According to the encyclopedic definition, menstruation is the cyclic shedding of the thickened layer of the endometrium (the lining of the uterus) and the release of blood from the uterus, occurring monthly in women of reproductive age.
Menstruation comes monthly - a very conventional concept. Normal duration The menstrual cycle (the period from the first day of one menstruation to the first day of the next) ranges from 21 to 35 days. U healthy women and girls with an established menstrual cycle, there are almost no deviations in its duration or they do not exceed 3-4 days. If the duration of the cycle is more than 35 days or less than 21, this is a reason to contact a gynecologist to find out the reasons and prescribe treatment. However, often with climate change, in the spring months, and stress (for example, passing exams, especially graduation and entrance exams), the duration of the menstrual cycle can change significantly. You should definitely consult a doctor if your menstruation is delayed by three months or more.
All processes in a woman’s life occur cyclically, that is, with a certain periodicity, and menstruation is the most striking manifestation of the end of one cycle and the beginning of another. And it indicates that fertilization of the egg did not occur and reproductive system begins a new cycle of preparing the woman’s body for pregnancy.
Hygiene features
One of the main points when menstrual bleeding is basic observance of personal hygiene rules.
It is necessary to wash your face at least twice a day, morning and evening, and even better every time you change a pad or tampon, since menstrual blood acquires from contact with air bad smell. In addition, it is an ideal environment for bacteria. Tampons or pads should be changed as they become soaked, but at least every four hours. The reason is so frequent changes They always write in the package insert with tampons: toxic shock syndrome (TSS). You can guess that it’s time to change by looking at light feeling discomfort.
What hygiene product to use during menstruation, pads or tampons, a woman is free to decide for herself, but for a girl, explanations from her mother and a conversation with a gynecologist will be necessary.
Tampons can be used from the start of menstruation, provided:
- the right choice size and absorbency of the tampon;
Correct insertion of the tampon;
- if the girl does not have certain medical contraindications.
Girls whose hymen is not broken can use tampons specially designed for this purpose. If you cannot insert a tampon even after several attempts, you should consult a gynecologist. The hymen (hymen) may be too small to allow a tampon to be inserted. At least 2% of girls adolescence Difficulties arise with inserting a tampon precisely for this reason. In such cases, gynecologists recommend using other hygiene products.
IN last days menstruation, when a woman begins to lead a more active lifestyle compared to the first days of menstruation, it is much more convenient to use a tampon. At night, it is better to prefer pads, especially since there are special ones - “night ones”, longer and wider in size. In general, there are no strict rules for choosing hygiene products, this largely depends on individual characteristics development and lifestyle of women.
An important point during menstruation is nutrition. During this period, you need to provide the body with all the necessary elements: vitamins, minerals, calcium, magnesium, fiber. It is also necessary to balance the combination of proteins, fats and carbohydrates. It is worth limiting the girl’s consumption of sweet, salty and overly spicy seasonings.
Many girls complain that during the period preceding menstruation, their skin becomes covered with small pimples. Sex hormones are to blame for this. Don't worry, they will disappear on their own when you finish. critical days. But if they do not go away on their own, then you can seek advice from an endocrinologist or gynecologist to rule out serious disorders in the body, and, preferably, a dermatologist who will prescribe external medications aimed at improving the condition of the skin. At home, we can recommend using light antibacterial masks and, of course, following a non-strict diet.
In addition, during menstruation it is better to avoid sports competitions, lifting weights, hypothermia, monitor timely emptying of the bladder.
When your stomach hurts
U healthy girls Menstruation, as a rule, is regular; for them, menstrual irregularities are quite rare. Such disorders are manifested by a reduction or lengthening of the time interval between menstruation, an increase in the duration of menstruation itself, the amount of blood lost and pain.
Dysmenorrhea is pain before and during menstruation, resulting from contractions of the uterus under the influence of prostaglandins. High level prostaglandins leads to increased contractile activity uterus, vasospasm, ischemia, which causes painful sensations. A similar mechanism of action of prostaglandins is also triggered during childbirth. Therefore, girls suffering from severe dysmenorrhea need serious attention, since they go through a mini-birth during menstruation.
In some cases, dysmenorrhea occurs when the uterus is in an incorrect position, when a bend in the cervical canal is formed. In this case, the uterine muscle has to make strong contractions to expel the contents from the cavity in order to push the blood through. Other causes of dysmenorrhea may be inflammatory diseases pelvic organs, endometriosis, uterine fibroids. Therefore, if you have dysmenorrhea, you should consult a doctor, which will allow you to establish the true cause of this suffering and eliminate it.
By the way, there is an opinion that several decades ago women saved themselves from pain in the lower abdomen... by washing the floor with a rag in their hands, without a mop...
Opinion
* Age at menarche in girls is known to be highly heritable, and women who get their periods earlier have a higher risk of developing obesity later in life. Research shows that mothers who got their period before age 11 were five times more likely to develop obesity than those who got their first period after age 15. Children from such mothers by the age of 9 were taller and weighed more, girls matured earlier and, like their mothers, were more likely to start their periods earlier than 11 years. Children grew faster, but growth stopped earlier and weight gain began. Scientists recognized this “growth pattern” as the basis for the development of obesity, which has become a real problem in modern society.
* During puberty, girls should undergo regular health checks to learn more about reproductive health women in a confidential environment and prepare for the first menstruation.
* Keeping a menstrual diary will help identify menstrual irregularities or women's health problems.
* Girls now experience puberty earlier. If our grandmothers began menstruation at the age of 15 - 16 years, now the norm is from the age of 12.
Consultant:Eleonora Berseneva, pediatric gynecologist at Regional Children's Clinical Hospital No. 1
When does a girl turn from an ugly duckling into a swan? Remember, how often this happens, at first she was awkward, she was teased at school, and then the transformation began. And by the end of high school, the girl becomes a real princess. Why is this happening? And the “fault” for everything (although this is not a fault, but rather a merit) is puberty in girls.
Parents need to know that it doesn't happen suddenly in a year or two. According to experts, puberty in girls extends over a period of 8-10 years and ends constantly.
The first period is 7-8 years. No, girls’ puberty in the first period is not visible to the eye, and the triggers begin to work gradually. Changes occur not externally, but internally. The uterus and ovaries begin to grow, but of course they are still far from appearing.
During this period, psychological transformation is more important than physical transformation. The main thing is to prepare the girl for her future role - the role of a feminine lady, and, possibly, the mother of the family. Of course, such preparation is not carried out through tedious lectures on sexual development and the role of women in society. It is important to do this through play, that is, in a playful way. Read fairy tales to the girl and let her fantasize, associate herself with the princess, or encourage her interest in her mother’s life, for example, the choice of clothes, shoes, cosmetics. Girls can also buy cosmetics. But, of course, a special children's room. Something like "Little Fairy" with vitaminized lip gloss. That is, it is necessary to introduce signs of gender roles into the girl’s consciousness.
The next period, characterizing puberty in girls, begins at the age of 10 years. More precisely, from this age and continues until 12-13 years. This is a time of slow, but nevertheless changes in appearance. The mammary glands begin to enlarge slightly. Even if it just looks like a slight swelling that is almost invisible to the eye, it is present. The labia also enlarge and change, but pubic and armpit hair does not appear. But for girls during this period it is closely related to growth. Bones grow excessively and disproportionately. Moreover, the speed of this process is different. First of all, the limbs and bones of the face grow, and only then the torso. What happens because of this? The girl becomes like an angular awkward doll, figuratively speaking. This is where the expression about the ugly duckling comes from. In addition, the skin becomes oily due to hormonal changes. The skin does not grow as quickly as the limbs, therefore, in order to reduce the likelihood of skin cracks and stretch marks, they actively begin to work on making it oily. On the one hand, this is a blessing, since everything is thought out by nature, but purely aesthetically it does not look very attractive. In such cases, it is better to treat the skin with special creams and lotions for teenage skin rather than washing with soap and water.
Please note that the sexual development of children - boys and girls - occurs unevenly. Girls gain height faster, but boys remain short. But this is temporary. By the end of school, both boys and girls level off, but if girls practically do not grow after that, then this process continues for boys. Therefore, men are taller than women and, if you compare graduates after 3-5 years, the difference in height will already be obvious.
And the third stage, which characterizes the puberty of girls, is the period from 13 to 17 years. It is at this time that the breasts begin to actively grow, pubic and armpit hair appears. In fact, during this period the formation of the girl is completed and she turns into a swan. It is believed that by the age of 18 she has reached puberty and is ready to reproduce. Therefore, marriages are allowed from this age.