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• Care Notes

WHAT YOU NEED TO KNOW:

What is puberty?

Puberty is a major change that happens in your body. It is a time when you grow very fast and your body starts to change into an adult body. Puberty usually starts between ages 8 to 13 in girls, but it may start earlier or later. You may not go through puberty at the same time or in the same way as friends your age do. Puberty usually ends by about age 14 in girls.

What will happen to my body during puberty?

• Breast growth is often the first sign you are starting puberty. Small lumps called breast buds grow under your nipples first. One breast may be smaller than the other for a while. Your breasts may be sore, tender, and sensitive as they grow. A bra may give your breasts support and help you feel more comfortable. It is normal for breasts to grow unevenly. By the end of puberty, your breasts should be about the same size. Your breasts will fill out and fully develop in 1 to 4 years.
• Hair growth is usually one of the first signs of puberty. Hair will grow in your pubic area (the area between your legs) and armpits. At first, it may be scattered and light-colored. As you continue through puberty, your armpit and pubic hair becomes darker, thicker, and curly. Your arm and leg hair will grow longer and sometimes darker. Some girls begin to shave their legs when this happens.
• Changes in body shape mean you may gain 15 or more pounds during puberty. Some weight gain during puberty is needed for normal growth. If you feel you are gaining too much weight, talk to a healthcare provider. Eat healthy foods and exercise regularly to help you stay at the right weight for your size.
• Face and skin changes include oily skin and acne (pimples). Acne affects nearly every teenager and many young adults. You may get acne on your back, chest, and neck. Talk to your healthcare provider about ways to control acne. Keep your skin clean so that oil and dirt cannot build up and make your acne worse:
  • Wash your face 2 times a day with a mild soap that does not have perfume. Do not rub your skin hard with a wash cloth, because it may irritate your skin and make your acne worse. Ask your healthcare provider for directions on how to clean your skin if you have body acne.
  • Use water-based makeup, not oil-based. Oil-based makeup may cause your acne to get worse. Use loose powders instead of pressed powders that are made with mineral oil.
  • Wash off sweat, especially after you exercise.
• Growth spurts mean you may grow 2 to 8 inches or more during puberty. Girls usually stop growing about 2 years after they start their period (menstruation). Your feet and hands will grow longer and wider. Your feet may grow faster or finish growing before you see other puberty changes.
• Body odor is caused by changes in your hormones. Since your skin glands are growing, you may find that you sweat more. To get rid of or help prevent body odor, take a bath or shower every day. Use deodorant on your armpits every day. Wear clean clothes that do not have the smell of body odor on them.

What is menstruation?

Menstruation is your monthly period. It happens about once each month and lasts for 2 to 7 days. Menstruation may start at any time during puberty, but it usually happens after you have other body changes first. It may start after you begin growing taller or after your breasts begin to develop. Menstruation is a normal sign that your body is becoming an adult woman's body. Here are some things you should know about menstruation:

• You may not know when you will get your first period. There is no way to predict when your period will start, but it is usually 2 years after breast buds develop. It may come as a few drops of blood, or it may be a heavier blood flow. You may feel cramps before it comes, or nothing at all.
• You may get premenstrual syndrome (PMS). PMS is a group of physical, emotional, and mental changes that occur before your monthly periods. You may have headaches or an upset stomach before your period. You may feel more emotional and cry more than usual or feel sad. PMS may cause your body to retain (hold onto) water. This may cause you to feel bloated. Ask your healthcare provider for more information about PMS and how to control your symptoms.
• Your periods may not be regular at first. When you first start your period, you may not get your period each month. You may not even have a period during some months. This is normal. Your period should become regular in time. Keep track of your periods on a calendar. Mark the first day (or all the days) of your period each month. This will help you have a better idea of when your period might come the next month.
• Use sanitary pads or tampons during your period. Read the instructions carefully or ask how to use tampons or sanitary napkins. Carry tampons or sanitary pads with you in case you start your period at an unexpected time. Change your pad or tampon about every 3 to 4 hours to keep the blood from soaking through your clothes. Change your tampon often to help prevent toxic shock syndrome (TSS). This rare condition is caused by bacteria and may be related to leaving a tampon in for a long time. Alternate tampons and sanitary napkins during the day. Use sanitary napkins at night. This may help prevent TSS.
• Once you start your period, you can get pregnant. Your body is able to get pregnant at any time if you have unprotected sex. This can happen even if your period is not regular. Unprotected sex means you have sex without condoms or other types of birth control.

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How will I feel during puberty?

• You may have many thoughts and emotions. You may feel confused or awkward. You may get upset or mad at friends or family very easily. You may be moody without understanding why. You may be laughing one moment and crying the next. This is caused by changes in hormones, and it is normal. If you are very sad all the time for more than 1 week, talk to someone. You may be depressed and need help. Talk to a parent, friend, teacher, counselor, youth leader, or your healthcare provider. Many adults care about your feelings and may be able to help you.
• You may feel more tired and hungry. Puberty is a time of very fast growth. You may feel like you cannot eat or sleep enough. You need 9 or more hours of sleep each night. Eat healthy foods from all of the food groups. These include grains (whole-wheat bread, pasta, or rice), fruits, vegetables, dairy (milk, yogurt, and cheese), meat, and fish. Healthy foods may help you feel good and have more energy. Limit the amount of junk foods you eat, such as chips, sweets, and fast food. These foods are not healthy, because they are high in fat, sugar, and salt. They are also higher in calories and may cause you to gain too much weight.
• You may be uncomfortable with your body. You may be embarrassed easily. You may sometimes feel unhappy or uncomfortable with the way you look. This may be true especially if you have friends who are developing slower or faster than you. Remember that not everybody goes through puberty at the same time or in the same way.
• You may have changes in relationships. Your relationship with your family members may change. You may want to spend most of your time with friends instead of family members. You may feel like your parents do not know what you are going through during puberty. This is normal. It may be helpful to talk to your parents about how you are feeling.

Care Agreement

You have the right to learn about puberty and to help plan your care. Talk with your healthcare provider if you have questions or concerns about the changes you are going through. You always have the right to refuse care.The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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