The Teen years or Adolescence is a dreadful challenge for both the teenager and the parents. It’s a struggle for both to cope with the rapid change occurring physically and psychologically. Adolescent girls go through a series of visible physical changes. As these changes occur they might bring along some concerns.
The blooming of the little angel to the wonder woman does not happen suddenly but takes the full teenage years. This process of transition is called PUBERTY.
Puberty in girls generally starts by 11 years of age. It can start earlier or later however. It starts with the development of Breast Buds. (Thelarache). The next step is the development of Pubic and underarm hair; some girls may notice it in other parts of the body such as hands and legs, upper and lower lip too. (Puberache). The final stage if Puberty is the start of monthly periods/ menstruation (Menarche). The periods start usually about 2 years after the start of breast development.
Over the next few years the breasts become larger and rounder and takes up an adult shape, the pubic hairs become densely curled up, they start sweating, they become taller by about 2 to 3 inches per year, their body weight increases and the shape gradually changes to have the adult curves ( wider Hips and Thighs with a narrower waist)
The common concerns
The physical awkwardness
There might be a differential growth of the breasts (one breast developing slower than the other), coarse hair on the face and limbs, a sudden change of height and weight. All of these are normal changes which settle down over the next few years.
Period or menstrual irregularities
The regular pattern of menstruation is an orchestrated harmony amongst the brain the eggs (ovaries) and the womb (uterus) and as any orchestra, take time and practice to establish. During this maturation process which might typically take about 2 to 4 years, there might be irregularities in the pattern of periods. They might come frequently or skip days or even months.
More than 6 out of 10 girls will have pain during periods with varying intensities typically for a day or two in the beginning of the periods. For some the pain might restrict routine activities and hence need simple analgesics to cope. Pain which require medical attention are those which seriously affect lifestyle, the one which starts before the periods and over lasts the periods, pain associated with other symptoms such as fainting attacks, nausea, vomiting, heavy bleeding or painful sex.
If menstrual periods do not occur by 14 or 16 years of age it is wiser to take an opinion from the specialist. The cause can range from a simple hormonal disturbance to more sinister causes such as chromosomal or developmental abnormalities
Polycystic Ovarian syndrome
PCOS is an increasingly common condition due to hormonal disturbances where one might have irregular periods beyond the years of maturity of the period cycle (Typically 4 years). There might be associated symptoms of stubborn Acne, unwanted facial hair and a struggle of weight gain. This warrants specialist supervision and attention regarding lifestyle modifications and medications.
Irritation and Infection
This is a quite common problem in young girls seeking medical advice. It might be in form of unusual discharge from the vagina, itching or redness or pain around the vulva (external area) or vagina (internal tract). It can be influenced by factors like general health, hygiene, health of sexual partner, medication use and hormonal balance. The cause can be bacterial, viral fungal or by other microorganisms. The treatment would depend on the type of infection.
Globally the age of initiation of sexual activity is moving towards the Teenage years. Awareness about the right contraceptive choice and its effects will enable the young one to protect her from infections and unwanted pregnancies.
Maintaining menstrual hygiene and health is the most essential care for an adolescent girl. The basic guidelines are
Use of a disposable sanitary towel / napkin or a tampon instead of a reusable one
Regular Change of napkins even with less bleeding to prevent infections and chaffing
Appropriate cleaning with only water and adopting the front to back technique
Application of a thin film of antibiotic ointment after bath and at bedtime to prevent discomfort from chaffing
Drink loads of healthy drinks, water and have healthy snacks to cope with the usual tiredness
Carry a Menstrual Kit while travelling (A zip pouch with napkins / tampons, small soft towel, cleaning tissues, hand sanitizers, antibiotic ointment, moisturizer and some simple pain killers)
Protection Sexually transmitted infections and unwanted pregnancy
Teenagers should be encouraged to meet a specialist for a nonjudgmental awareness on such safety and protection. Whatever may be the mode of contraception, use of a Condom ONLY will ensure a protection against infections.
A dietary modification with inclusions of green vegetables, fruits, healthy drinks and dairy products and incorporating some form of exercise should start at these crucial years to expect a healthy adult life. These sensitive years lay the foundation of the balance amongst the reproductive hormones and hence the regulation of the lifestyle at this stage is imperative.
Apart from the universal vaccination schedule, this is also the time to get the shots against cervical cancer. It might seem too early a time for a protection but the vaccine works best before one gets sexually active. The cancer is a long term adverse effect caused by a kind of virus (Human Papilloma Virus-HPV) which usually infests a female in the initial years of sexual activity; the vaccine ensures enough power in the body to fight against the effects of the virus.
Written byDr Sudeshna Roy
Dr. Sudeshna Ray (MD, MRCOG- London) is a Consultant Gynecologist & Obstetrician visiting Jaslok, Saifee and Breach Candy hospitals, Mumbai, India. She specializes in critical pregnancy care, Pelvic Laparoscopy and Robotic gynecological procedures. She believes in enhancing awareness on various aspects of women’s health and preventive care through social media, print and other platforms. Her passion makes her travel and talk to various corporates, schools, and colleges around the country. She is involved in various social and charitable activities as well.