Daily Freeman (Kingston, NY)

Reassure your daughter as she goes through puberty

- 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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