You probably remember the somewhat awkward stage in life called puberty. Puberty marks the beginning of the transition from childhood to adulthood. Puberty is accompanied by many physical and emotional changes. While each girl may experience puberty differently, learning about each stage and the changes they bring can help you support your child and navigate the stages of puberty together.
Puberty happens due to changes in the hormone levels in a person’s body. There is an area called the hypothalamus in the brain that starts to release hormones. These hormones travel to the pituitary gland in the brain releasing two more puberty hormones. These two puberty hormones act on the ovaries in girls and release a very important hormone called estrogen. The adrenal glands (located on top of the kidneys) produce another important hormone called androgens.
Typically, the first sign of puberty in girls is breast development. Breast development is associated with estrogen. Estrogen also affects overall body maturation. Breasts can feel sore, tender, or itchy as they develop. The breast tissue will grow bigger with time. Breasts can often grow at varying rates. Therefore, differences in development between children are normal and not a cause for concern as long as progressive changes are being noted over time. However, if your child doesn’t develop breast budding by the age of 13, you should schedule a check-up with their pediatrician.
At the same time, girls will start to develop body hair on their legs, arms, armpits, and pubic areas. Hair growth is associated with the androgens hormones. They also may begin to sweat more, develop body odor, and notice signs of acne. When these changes occur, it is important to remind your child of good hygiene habits in a non-judgmental manner.
Menstruation is considered the final stage in pubertal development, and estrogen plays an important role in menstruation. As a girl’s body prepares for her menstrual cycle, it is common for her body shape to change and for her to gain several inches in height over the course of a few years. These physical changes can be uncomfortable if they develop at different rates than their peers.
Usually, a girl’s first menstrual cycle can start at any point from ages 9 to 16, but this can vary. Additionally, menstrual cycles may be irregular in the first two years after onset. As the hormones stabilize over time, menses become regular.
Menses can be light or heavy, but excessive bleeding that is soaking through clothing or causing dizziness or weakness, or paleness warrant a follow-up with the pediatrician.
For cramps during menses, pain medications like ibuprofen or naproxen, hot compresses, baths, and gentle yoga can all help. If your child is experiencing severe pain that impacts her ability to participate in daily activities or affects school attendance, it is important to follow up with her pediatrician.
You might wonder at what point girls should start seeing a gynecologist. Here’s a great article that was written by one of our OB/GYN colleagues that explains when girls should have their first visit with a gynecologist.
Many girls experience heightened emotions and mood swings due to fluctuating hormones during puberty. Many girls also experience PMS (premenstrual syndrome), which can cause irritability, fatigue, and anxiety.
Emotions can also be heightened due to changing appearance. It can be challenging to adapt to sudden growth, acne, body hair, and more. Girls may develop insecurities due to these changes, which can create more stress. It is important to give your child the necessary space to process these complex emotions while maintaining a positive and safe space for her to speak to you about her concerns.
Communication is key to helping your child understand the stages of puberty and their changing bodies. Be supportive and open to any questions while also leaving space for autonomy. Creating an atmosphere of mutual respect and honesty will help you approach difficult conversations with your child. It is important to let your child know they can talk to you about anything. I also encourage parents to use correct anatomical terms such as vagina, breasts, menstrual cycle, or period when educating them.
As your child goes through puberty, some additional topics you can expect to discuss include healthy relationships and boundaries, sex and consent, preventing sexually transmitted infections and pregnancy, peer pressure, and negative impacts of substance use.
If you feel uncertain about how to approach puberty or how to talk to your child about any of these topics, your child’s provider can help you find ways to navigate these conversations. And be sure to check out my colleague’s article, Puberty in Boys: What to Expect.