What is adolescence?• The transition period between childhood and

adulthood is referred to as adolescence• Between the ages of 9 and 18 boys and girls start out

as children – mentally and physically - and end the phase as adults

• Very often this phase is associated with turbulence, arguments, rebelling, depression etc… but it is not necessarily true. If understood well this can be one of the happiest phases in our lives where we start understanding who we are and what is our place in the world

Isn’t adolescence same as puberty?

• Yes and No. Adolescence and puberty are often used interchangeably.

• To be specific puberty refers to the physical changes that happen during the adolescence phase

• What are some of the physical changes that we see during adolescence– For girls – onset of monthly periods is one– Development of acne, hair on the body are all examples

of physical changes that occur during adolescence in both girls and boys

Will everyone go through adolescence?

• Yes, but no two persons experiences are the same

• Some folks go through adolescence smoothly, some go through major upheavals

• Some folks bodies go through rapid changes, while others can take time to mature

• Regardless this is a phase of life that everyone passes through

Why do we need to understand adolescence…why is it getting all this

attention?• There are many reasons why adolescence is given so much

attention– The body goes through so many physical changes and that too rapidly that

it becomes very important to understand these changes– It can be the phase of discovery for many teenagers and can be a

foundation for their future lives– Many of the changes experienced by adolescents are sexual and there are

lots of misinformation and myths about these changes. So it becomes crucial to understand the truth

– Adolescents tend to hang out with other adolescents most of the time. While this gives them a good support group to handle the changes, this can also alienate them from parents and other adults who have gone through this phase before and might have more information which could help them

Changes common to boys and girls

Growth Spurt – Rapid increase in height and body weight

• Girls: the spurt begins b/w ages 10 and 11 and is the fastest b/w 12 and 13 and starts to slow down after 14; Some girls can gain 3” in height in a year

• Boys: the spurt begins b/w ages 11 and 12; fastest at 13 or 14 and starts to slow down after 15; some boys gain 4” in height in 1 year

• Boys growth happens a bit delayed from girls, which is why there are some 12 year old girls who are taller than the boys in their class! But boys peak growth is higher than girls which is why on an average most boys end up being taller than girls

Additional info on Growth Spurt

• Growth is again dependent on a number of factors– Genetics, health, nutrition

• All these factors will determine how tall or how heavy a person becomes and also determines body shape

• In general by adulthood men have more muscle and bone mass than women, while women have more body fat

• Also during this growth phase, hipbones grow wider in girls, while shoulders grow wider in boys

Body Hair

• Before puberty most boys and girls have a thin covering of short, fine hair on their body – except on the eyebrows and the scalp where hair is thicker

• At puberty hormones called androgens are released inside the bodies of boys and girls and these hormones stimulate the growth of hair in the armpits and near the genitals (pubic hair)

• Hair on the arms and legs get thicker especially in boys and more facial hair appears on boys– Some boys also develop hairs on their chest and back

Perspiration and Sweat

• Our skin has sweat glands which release sweat when it is hot to cool us down.

• During puberty sweat glands in the armpits, genitals and anus become active and release sweat.

• This sweat initially has no smell, but as skin bacteria decomposes the sweat, it emits an odour– To eliminate this smell it is important to have a bath

daily and wash with water the area around the genitals, and the armpits

Acne• This is one of the most common problems in adolescence experienced

by almost 60 to 80% of young boys and girls• Oil in the skin helps keep the skin soft and waterproof. But during

puberty the androgen hormones cause increased activity of the glands that produce this oil. When the skin surface is blocked by dead cells, black heads are formed on the skin. And when these get infected a swelling occurs on the skin. This is acne.

• Many adolescents are very worried about acne and there are endless number of products in the market which promise a cure for acne.

• But very often the simplest cures for acne are– Washing the face periodically to remove the excess oil– Not pick on or squeeze the pimples– And remember acne is temporary and usually goes away at the end of puberty

Puberty in Girls

What does a girl go through during puberty?

• In India a girl attaining puberty is often celebrated when she gets her first period. In many cultures it symbolizes the girl becoming a woman.

• But puberty is not all about getting the first period

• A girl’s body goes through many changes – some internal and some external during puberty

What are some of these changes?

• Internal– The girl’s ovaries and the reproductive system

start to develop

• External– Breasts start developing– Pubic hair develops– Hips widen– Menstruation begins

Development of breasts• During childhood girls’ breasts are very similar to that of boys’• B/w ages 8 to 12 breasts mounds start appearing and by the

time the girl is 18 the breasts reach their full size• At the end of the development, milk glands and ducts will be

developed inside the breasts – but milk will not be produced unless a woman recently had a baby

• As breasts start developing most girls start wearing a bra. The bra is meant to provide support to the breasts especially for very large breasts so that the ligaments inside are not stretched. It is very important to choose an appropriate bra which is comfortable – neither too tight nor too loose. If the breasts are normal size then it might not be necessary to wear a bra

Why are breasts such a big deal?• Many girls worry that their breasts are too large or

too small and some worry about how fast or slow they are developing

• Girls in India also begin wearing half-saris or duppattas to cover their breasts as a sign of modesty

• Girls should understand that there is no such thing as an ideal breast. The media – magazines, movies etc reinforce the idea that men find a particular shape and size of the breast as more attractive. In reality breasts come in all shapes and sizes and it is important to be comfortable with one’s breasts

Pubic hair development

• The other more visible change for girls during adolescence is the development of pubic hair near the genitals

• Many girls are worried when they see the hair for the first time near the genital area so it is important for them to understand that everyone goes through this change

• Commonly it starts developing b/w ages 11 and 12 and it starts out as darker longer hairs. By the time the girl becomes an adult the hair becomes coarser and curlier and denser.

Changes inside the body• The female reproductive organs are

– Ovaries, fallopian tubes, uterus and vagina

• The ovaries become larger during puberty and at later stages start releasing eggs. After a girl’s menstrual periods have started the egg is released from the ovary periodically until the woman reaches her forties or fifties

• During puberty a girl’s uterus grows to the size of her clenched fist.

• During this time the vagina becomes longer and wider and before the first period also produces a white milky discharge. This is perfectly normal and is the fluid that cleans the walls of the vagina. If the discharge changes color or has a bad smell then it is a sign of infection.

Menstruation• The arrival of the first period is considered as the

passage from childhood to womanhood in girls.• If the egg released from the ovary is not fertilized

by a sperm from a man, then the spongy tissue inside the uterus breaks down and bleeding begins

• The bleeding lasts anywhere between 3 and 7 days.• Most girls get their first period between the ages of

11 and 14. It is normal for it to occur later or earlier, If a girl does not get her first period even after 16 years of age it is good to talk to a doctor

Preparing for the first period• The first period can occur anywhere – at school, home, in the

play ground – anytime – morning, afternoon, night. So it is best to be prepared for it

• Many girls notice small bloody spots or get a feeling of wetness. Sometimes girls do not notice it until it has soaked through the dress and is visible to other friends.

• One way to be prepared for it, is to carry an extra pair of underpants in case it happens away from home, or always carry a sanitary napkin or pad or a cloth and learn how to use it.

• One thing to remember is not to be frightened or embarrassed about the period. It is something that occurs to every girl.

The initial few periods• Periods usually occur once in 28 days and last for 3 to 7 days. But

this again varies from person to person and anywhere between 23 to 35 days cycle is very common

• The initial few periods are usually not very regular and some women’s cycles are not regular even later

• Some girls find it helpful to mark their periods in their calendars so that it helps them prepare for the next cycle.

• Missing a period occasionally is not a cause for concern except if you are very underweight or if there is a chance that you maybe pregnant as a result of sexual intercourse. Some women miss periods due to excessive stress. It is important to understand the cause of stress and try and reduce it.

What to expect during the periods?• Some girls may get headaches before a period starts• Some may experience “cramps” – muscular pains,

accompanied by sweating, nausea, stomach aches, pain in the breasts or backaches. Most girls outgrow this pain eventually. The intensity of the pain also varies from person to person. Taking rest by lying down, or using a hot water bottle on the stomach for relaxation can help ease the pain

• The amount of blood lost in 3 to 7 days varies from one girl to another. If you think you are losing a lot of blood, it becomes important to eat food rich in iron so that you don’t become anemic.

• Bleeding starts slowly, peaks in day 2 and 3 and slows down in day 4 and usually disappears by day 6. If you have excessive bleeding even on day 6 or 7 it is best to see a doctor.

Periods and normal activities• Periods should not be a barrier to girls. Most girls can continue

to do their normal activities even with periods. • There is no need to stay segregated from other people during

your monthly periods.• There is nothing bad or impure about a girl having periods.• Once a girl starts having her periods she can theoretically

become pregnant. That does not mean that this is the right age for marriage. Girls need to develop emotionally and physically to be able to bear a child, which is why it is always advisable to postpone marriage till 18 or 21

• Personal hygiene during periods is very important. Having a bath daily, changing sanitary napkins or cloth regularly are all essential during periods.

• If you are using a cloth to absorb the blood flow, make sure the cloth is properly washed and dried and frequently change the cloth to avoid infection

• It is also important to eat normal healthy food during the periods.

How to handle adolescence in girls

Helping girls through adolescence• As we just saw a girl goes through so many physical changes

during adolescence• Along with these physical changes she also undergoes emotional

changes• It is important for adult women- be it the mother, the teacher, an

elder sister or an aunt to provide support to the adolescent girl, so that she can be better prepared for these changes

• In many places in India girls are not allowed to continue with their education once they attain puberty. This greatly inhibits their development

• Also marriage immediately following puberty or at age 15 or 16 can be very damaging to the girl physically and mentally

Being comfortable with our bodies • During adolescence girls start becoming more aware of their body image.The

media is very aware of this change in girls and will always try to thrust images of perfect women – maybe a movie heroine or a model – to sell numerous products to these girls. It is important to be aware that there is no such perfect image and be comfortable with one’s body.Women come in all shapes and sizes.

• Boys start taking notice of girls, and vice versa and it is OK to talk and become friends with members of the opposite sex.

• When boys start paying attention to girls, very often the parents scold the girls for not behaving modestly. But one should understand that such attractions are normal during adolescence and soon wear out.

• But when this harmless attention turns into eve teasing or harassment it becomes traumatizing to girls. Talking to adults in your family about such issues can be a good way of resolving this problem. Adults should understand that the solution to this issue is not to stop sending the girl to the school, but instead come up with a better approach – talk to the boy, make sure the girl feels protected going to school, maybe by sending her to school with a group of friends. But always keep the communication line open.

Adolescence in Boys

Physical changes in Boys• Just like girls, boys also go through many physical changes during

adolescence. Some of these changes include– Growth of the penis, testes and pubic hair

• During puberty a boy grows taller, more muscular and his shoulders widen

• The penis gets longer and wider, the testes start making sperm and pubic hair grows around the genitals.

– These changes happen in stages and just like in girls, some boys mature faster than the others

• The male hormone testosterone which causes development of pubic hair, also causes growth of coarser hair in the armpits, chest, face, arms and legs

– The amount of hair varies from one person to another and depends on genetics

• Changes to the voice box or larynx start occurring at age 14 or 15. This causes the voice to change from the high-pitched voice during childhood to deeper adult voice. For some this change is gradual, while for others this can happen overnight

What do boys go through emotionally during these changes?

• Just as in girls, the physical changes in boys are usually accompanied by emotional changes.

• Boys worry about their body image too. Some of their concerns include– Size and shape of their penis– Amount of body hair– Embarrassment about voice breaking – Dealing with “wet dreams”– Muscular build

• Let us look at these factors and clarify a few of their concerns

Addressing boys’ concerns• The shape and size of the penis vary from person to person and

are not in anyway indicative of a person’s manliness. Understanding this can help boys go through the change a bit easier

• Similarly the amount of hair on the body should not be a cause for concern, as there is no such thing as the right amount of hair.– The appearance of a moustache and/or a beard can be a source of worry

to some and a sign of growing up to others. Talking to an elderly male in the house – father, elder brother or uncle will help boys decide if when and how to start shaving

• During voice breaking many boys are embarrassed when their voice suddenly switches back from the deep sound to the high pitched sound. Boys should remember this is only a temporary phase and would go away soon

Addressing boys’ concerns .. contd• Just as the arrival of the first period is an indication of sexual

maturity for girls, ejaculation of sperm and semen is an indication of maturity for boys. Relating to this some boys may experience “wet dreams” – where semen is ejected when the boy is sleeping and dreaming (not necessarily sexual). This can be very confusing for some boys as they are not sure about what happened. But this is normal and usually goes away with age.

• Boys’ bodies also come in different shapes and sizes. Common notions of perfect bodies reinforced by the media can cause some boys who are skinny to be worried. Boys should remember that the rate of maturity is different for different boys and very often at the end of puberty most boys catch up with the others. But not everyone will have the same level of muscular build. The important thing is to eat right and stay healthy.

Pressures faced by boys during adolescence

• Boys face a lot of peer pressure and from the media – movies, during adolescence to start acting like grown up men and demonstrate their manliness.

• What are some of the ways boys try and exhibit their manliness?– Smoking/Drinking – Ads in magazines and movies create an impression

that smoking/drinking is a sign of growing up and becoming an adult. So many young boys take to smoking/drinking in their teenage years.

– Using foul language is another way of acting grown up

– Boys start paying attention to girls their age. While this attention is normal, some boys start to indulge in what is called as eve teasing which causes a lot of distress to girls

– Displaying physical strength is one other way of exhibiting manly qualities. This is also tied to the need to do well in sports

– Boys also start getting together in groups and some boys start exhibiting aggressiveness by bullying other boys

What are some of the reasons for these behaviors?• Some of the behaviors discussed previously are due to

– images in the media – for e.g smoking by a popular movie hero is very often construed as being “cool”

– Peer pressure – this is also one of the reasons for boys taking to smoking, drinking or using foul language or displaying physical strength. There is a sense of wanting to belong to the group and very often demonstrating these things is a way to prove one’s manliness and join the group.

– Pressure from parents – some parents especially fathers and other adult male members of the family emphasize a lot on macho behaviors on boys – for e.g. crying, or backing off from a fight is considered to be effeminate

– Awkwardness faced by boys in dealing with girls - Boys in this age are generally very shy to talk to the opposite sex, and this shyness sometimes leads them to take on aggressive behaviors.

Helping boys handle some of these pressures

• Pressure from friends to drink or smoke or use foul language can appear irresistible. But boys should realize that saying no is an option and if those friends drop you for that then they may not be good friends to have in the first place.

• Boys should understand that assertiveness and not doing something that is morally wrong require a lot of strength of character and this strength defines adulthood more than bullying or smoking or teasing girls.

• If you are unsure about what is right or wrong in a given situation it is best to consult a trusted adult – a teacher or your parents before you make a decision.

Helping boys deal with girls• Boys at this age do not have a good idea of how to talk to the

opposite sex. There is a lot of misinformation about what attracts girls and how to deal with them.– Boys should understand girls very often like boys who treat them

respectfully, do not use foul language and are sensitive to them.

– Working in groups with members of the opposite sex is one way to overcome the shyness

– Talk to your mother or your sister if you are unsure about why girls behave in a certain way and try and get their perspective on women

• Very often boys take a lot of cue from their father or the elderly male at home and how this person treats other female members of the household. So it is important for male members to treat the female members respectfully, so that the younger boys learn to respect women

Adolescence.. A final look

In summary• As we just saw both boys and girls go through a number of physical and emotional

changes during the adolescence phase.• Understanding why these changes happen and learning how to deal with them can

ease a lot of tension both for the adolescents and for their parents• As this is a passing phase of life it is very important to enjoy it, at the same time it

can be the foundation for the future, so it is important to make good choices.• In India, unfortunately, a number of boys and girls grow up to be adults directly from

their childhood – they do not get to experience adolescence for many reasons– Girls are married off immediately after puberty.– Girls are expected to take care of younger siblings from the age of 10 and are very often

not allowed to go to school– Boys start working at very early ages in the fields or in factories to supplement income

• It is all the more important for parents to be sensitive to their children’s needs during this stage and help them get through adolescence as smoothly as possible.

• Letting children know that they can approach them with any question without fear of punishment is one of the easiest way to help adolescents