Puberty – Adolescence

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Most parents particularly Dads are in a panic when it comes to puberty and their girls. The primary concern with boys is not the when or how of puberty but how it will impact their ultimate height or stature.

One of my patients who is a gymnast has hopes of competing on a higher level. She is not ready for the growth spurt that comes with physical maturity. She does not want to be larger than the successful gymnasts. She is looking at the inevitable transition of life and physical maturity. With the physical maturity we will see bone and muscle maturity and less of the injuries that are seen with the overuse and abuse of immature younger athletes.

Be mindful of the difference between puberty and adolescence. One represents physical maturity and the other is indicative of spiritual or psychological maturity. The first occurs regardless of the social or family environment the other can be hampered or enhanced by our home, family, school, or church.

Each day I am reminded of the impediments that each of us may have encountered growing up. Just over the past week I had 2 different families with very different histories. Both have adolescent boys who are freshmen in high school and both are under achieving. They suffer from low self-esteem. In each case the one common factor is that the parents are striving to give their children what they may not have had as a child. The perception that opportunity will thrive without nurturing is a common misconception. The kids do not know what they want other than they need structure and understanding. They need parents to be home both in body and mind.

We as parents are forever mindful of expenses and earning an income. That is even more difficult with so many out of work and with family discord, mental health issues. and depression. How do we deal with the issues at hand? One family comes from the Middle East. They grew up in a village where poverty was all around them. They were fortunate to have been given the gift of an education and immigrated to the US. The other case is all too common these days, the parents live in separate homes. The father was raised by a single mom. She raised 3 boys who grew up too fast. They went to work at a young age. Tried to achieve good grades. To do well in sports. Plan for their own future.

In one family the father is home but detached due to work and social pressure. In the other, there was no paternal role model that son in turn is trying to parent his children with his own perception of what he thinks is the model Dad. In each case normal adolescence did not occur for either of these dads.

These days there are few opportunities for normal adolescence. Now we have internet and instant links to sites which are willing to take advantage of our vulnerable kids. Unfortunately adolescence has been accelerated. In some cases kids move into adolescence before navigating puberty.

Getting back to the main topic of this post puberty is physical maturity of the body due to hormones becoming active.

Nutrition and good health and genetic programing all interplay.

You have growth hormone, thyroid hormone, male and female hormones. Hormones from the hypothalamus and pituitary, thyroid, adrenal testicles and ovaries. It is amazing to consider the complicated interplay of the different hormone glands and organs and body parts

Girls achieve puberty first. I do not know why but that is part of the grand plan. The first change is breast budding and as is usually the case one breast is noted to be present prior to the second. It is a tender swelling of the breast tissue, then there may be some leucorrhea which is a slight white vaginal discharge which does not smell. Some time during the next 6 months sparse central coarse pubic hair may be noted and at the same time some enlargement of the clitoris. Usually I see the first period with in 1-2 years of the breast budding. Typically the breast budding occurs between 9 and 11 years of age. It is often 1 year earlier in black american children.

Boys do not reach puberty until they are 13 or even 15. They usually go from being articulate middle schoolers, to essentially Neanderthal in their communication. Typically at 13 or 14 they now only grunt mono syllable responses to questions that is assuming that they answer at all. With puberty in boys it is less manifest than in girls. They may have tender breast tissue swelling as do the girls This freaks the dads out. Next we see some increase in testicle and penis size not a lot but gradually, over 1-2 years. Concomitantly pubic hair develops and the voice deepens. The girls may grow 2-4 inches during that first year of puberty and boys easily 4 inches.

Girls reach their maximum height within 2 years of starting their period and boys may max out at 14 or continue to grow untill 18 years of age.

For boys maximum growth velocity is during the first 2 years of puberty and then with 2 extra years of some growth after that.

I am not sure that i have seen an earlier onset of puberty over the past 30 years. So much is dependent on nutrition ethnicity and some as yet unknown environmental factors.

That is the simple explanation of puberty. The hard part is the emotional rollercoaster. The fear of the peer group challenges. The need for preparing the girls for the cat fights at school, the rivalry, the tears and the feeling of rejection from their so-called friends. The desire for acceptance and the fact that many do not have the self-esteem needed to ward off the psychological warfare that is middle school. Many teachers and parents do a good job redirecting the girls. Some parents and coaches feed into the rivalry not giving the girls the safety net or survival skills that they need.

Also of note is that during the physical development of puberty, the kids are often going through psychological changes. There may be latent tendencies to bipolar or depression which now become front and center. The child as well as the parents do not know how to voice their needs. nor do the kids have the maturity to discuss those concerns. All they know is they do not understand what is going on either physically, mentally or emotionally. The disconcerting thing is that you can have a young lady who is physically mature at 11 but emotionally extremely fragile and very immature. In fact some young adults are not psychologically mature until into their 20″s or 30″s.

Again puberty is not my biggest concern it is the acquisition of skills that our kids and there parents need to address the turmoil that is adolescence.

In generations past our days were pretty well laid out for us. We got up with the sun and went to bed as did the sun. We had chores to do not just to have chores to do but for the sustenance of the family. We had extended family networks. We had family friends and neighborhoods that we could depend on. Now with the exception of close knit faith communities I am not sure that exits any more. Our kids are blasted by tv, music, and social media with misrepresentations of the new normal with the clear intent to cast aside old values with out replacing the old with a new concrete and real foundation. Our kids are more fragile now. Their life is a house of cards. They may turn to alcohol and marijuana and their social media friends for help. We as parents do not understand our own parents nor the milieu in which we grew up in.

I do not know how to prepare you for the fragile time that is puberty and adolescence. I can only advise you to be patient and to listen to your children.

It has been hard on many of our families due to the turmoil of this last decade. Many have lost homes. Not just the house but all that can be called family and home. That must be supplanted by values, friendships and outreach.

Refer to this link for more information about talking to your child about puberty.

See the Links from the CDC on Adolescent Health.

See the Child and Family Web Guide from Tufts University for additional information on puberty and adolescence.

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