Re­as­sure your daugh­ter as she goes through pu­berty

Daily Freeman (Kingston, NY) - - YOUR DAILY BREAK - An­thony Ko­maroff AskDr.K

What should I ex­pect when my daugh­ter goes through pu­berty? How can I help her as she goes through these changes?

Full dis­clo­sure: I don’t have any per­sonal or parental ex­pe­ri­ence to tap into for this ques­tion. Ex­pe­ri­enced col­leagues and friends al­ways em­pha­size how im­por­tant it is to dis­cuss pu­berty with your daugh­ter be­fore these changes be­gin. She needs to know what to ex­pect and also that these changes are per­fectly nor­mal. Oth­er­wise, she might be fright­ened by the first signs of change, such as her first men­strual bleed­ing.

Pu­berty typ­i­cally lasts for four or five years. In girls, it usu­ally starts be­tween the ages of 8 and 13. Re­mind your daugh­ter that it is nor­mal to be­gin pu­berty any­where within this range. (But do men­tion it to your child’s doc­tor if your daugh­ter is showing signs of pu­berty be­fore age 8, or if there are no signs of pu­berty by age 13.)

Dur­ing pu­berty, the whole body changes shape and size. For most girls, the first sign of pu­berty is breast growth. This will start with a small round lump (breast bud) un­der one or both nip­ples. The lump will grad­u­ally grow, along with the dark area around the nip­ples (are­ola). A fam­ily friend once told me that her daugh­ter had be­come ter­ri­fied that she might have breast cancer when her breasts started to grow. This hap­pened not long after the girl over­heard her mother telling a friend that “breast cancer runs in my fam­ily.”

Girls gain weight and mus­cle and grow taller dur­ing pu­berty. This growth peaks about one year after pu­berty has be­gun. The stor­age of body fat also changes, so that the hips, but­tocks and legs get larger while the waist seems to get smaller.

Hair grows in the pu­bic area, on the legs and un­der the arms. Glands in the skin make more oil and sweat. Body odor and acne may be­come no­tice­able.

Most girls be­gin to have pe­ri­ods (men­stru­ate) about two years after the start of breast devel­op­ment. On av­er­age, in the United States, girls get their first pe­riod around age 12 ½. How­ever, men­stru­a­tion may start as early as 9 years or as late as 17 years old. A girl’s first few men­strual pe­ri­ods tend to be ir­reg­u­lar, un­til the ovaries ma­ture and start to pro­duce eggs reg­u­larly.

In ad­di­tion to these phys­i­cal changes, pu­berty brings emo­tional changes. For ex­am­ple, many pre­teens feel anx­ious or self-con­scious about the phys­i­cal changes of pu­berty, es­pe­cially when com­par­ing them­selves with oth­ers. Your child’s moods will also change quickly and of­ten dur­ing this time. Mood swings are nor­mal and are prob­a­bly re­lated to chang­ing hor­mone lev­els.

Do your best to sup­port, en­cour­age and guide your daugh­ter though this new and dif­fer­ent, but also ex­cit­ing and im­por­tant, time. Even if you’ve done a good job of ex­plain­ing what to ex­pect, the changes of pu­berty may frighten your daugh­ter. Your on­go­ing ex­pla­na­tion and re­as­sur­ance are as im­por­tant as your prepa­ra­tion of your daugh­ter for the com­ing of pu­berty.

Dr. Ko­maroff is a physi­cian and pro­fes­sor at Har­vard Med­i­cal School.)

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