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Puberty

Puberty is a time when your body changes—inside and out. Your body is becoming more like an adult. You may have questions about your changing body. This pamphlet may help answer some of those questions. You can also ask a parent, a doctor, a teacher, or another adult you trust.

Puberty is also a good time to learn how to stay healthy. Being healthy can help you do all the things you want to do, like play sports, do well in school, and have time for fun.

This section explains

  • how your body changes

  • why your body changes

  • how to stay healthy

CHANGES IN GIRLS DURING PUBERTY

Puberty starts when your brain sends signals to certain parts of the body to start growing and changing. These signals are called hormones. Hormones control body functions. During puberty, hormones cause the following changes:

  • You grow taller and gain weight.

  • Your hips may get wider.

  • Your breasts grow.

  • You grow hair under your arms and around the vulva.

  • Your body odor may change.

  • You may get acne or pimples.

  • You get your first menstrual period (also called menstruation).

These changes do not come all at once. They do not happen at the same time for everyone. It is normal for changes to start as early as age 8 or as late as 13. Do not worry if your body starts to develop before—or after-your friends' bodies.

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BODY CHANGES

You might notice a change in your breasts first. As they start to change, the darker areas around the nipples (called the areolas) may look swollen. The breasts also grow rounder and fuller. One breast may seem a little larger than the other.

They may feel sore at times. This is all normal.

YOUR MENSTRUAL PERIOD 

Another change is that you start menstruating. Each month, a woman's body prepares for a possible pregnancy. Hormones signal the ovaries to release an egg each month. The egg moves into one of the fallopian tubes. At the same time, the lining of the uterus begins to grow and thicken.

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If the egg is not fertilized by a man's sperm, pregnancy does not occur. The lining breaks down and flows out of the body through the vagina. This is called menstruation, the menstrual period, or just your "period." Menstruation is a normal and healthy part of growing up. It means that pregnancy is possible.

There is no good way to tell when you will begin to have periods. Menstruation usually starts about 2 to 3 years after the breasts start developing. Most girls in the United States start between the ages of 12 and 14, but some start earlier or later.

Periods usually last between 2 and 7

days. They normally come every 21 to 45 days. They are often not regular at first.

You may miss a period. You may have two periods in 1 month. This is normal.

It can take 1 to 2 years after your first period for your body to get on a regular cycle. Keep in mind that if you have had sexual intercourse, a missed period can be a sign that you are pregnant.

Keeping a Schedule

It may be helpful to use a calendar to keep track of your periods. Mark an "X" on the calendar on the day your period starts and on each of the following days that you have bleeding. Count the first "X" as day 1. Keep counting the days until you have your next period. If you do this every month, you may notice a pattern. It may become easier to tell when you will get your next period.

You can use a physical calendar or a calendar on a phone or computer. There are also apps that can help you track your period.

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Being Prepared

It is best to be prepared for your period, even if you have not started it yet. Have pads, tampons, or a menstrual cup ready to carry with you to school. You can also consider buying period underwear to have at home and wear after you get your period.

Pads attach to the inside of your underwear. Period underwear has built-in protection. Pads and period underwear absorb the blood as it leaves the vagina.

Tampons and menstrual cups are inserted into the vagina. They catch the blood before it leaves the body. Tampons absorb the blood, and menstrual cups collect the blood in a small cup. You can talk with a parent, school nurse, or doctor about these options.

You should change your pad or tampon at least every 4 to 8 hours. On the first days of your period, you may need to change it more often because your flow may be heavier. If you use a menstrual cup, you should empty, wash, and reinsert it at least 2 times per day.

Period underwear can be worn for a full day. They may need to be changed more often depending on your flow and the type of underwear.

Using tampons has been linked to an illness called toxic shock syndrome. Toxic shock syndrome is rare, but you should still take steps to prevent it.

Read all of the instructions that come with tampons. Use tampons with the lowest absorbency needed to absorb your flow, and do not use tampons when you do not have your period.

Dealing With Discomforts

You should still be able to go to school and take part in most activities when you have your period. Some girls have cramps (tightness and pain) in the lower abdomen and back at the start of their periods. Some girls get headaches or feel dizzy. Some get diarrhea.

If these problems do not go away or if they bother you, you should talk with your doctor. To help ease cramps, you can try the following:

  • Take ibuprofen or naproxen sodium (if you do not have an allergy to aspirin or severe asthma).

  • Exercise.

  • Place a heating pad on your abdomen or lower back.

Talking With Your Doctor

If you have any concerns about your period, you can talk with a doctor to get help. Be sure to talk with your doctor or your parents about your period if:

  • you are 15 or older and have not had a period.

  • it has been 3 years since your breasts developed and you have never had a period.

  • you are 14 or older, have never had a period, and you have an eating disorder, exercise a lot, or have hirsutism (excessive body hair growth).

  • your periods were regular each month and then they stopped being regular.

  • your period comes more often than every 21 days or less often than every 45 days.

  • your periods come more than 90 days apart (even if that happens only once).

  • your periods last more than 7 days.

  • your periods are so heavy that you have to change pads or tampons often (more than once every 1 to 2 hours).

  • you have bad cramps that keep you from doing your regular activities and pain relievers don't help.

At age 21, you should start having cervical cancer screening. Cervical cancer screening includes a Pap test, a test for human papillomavirus (HPV), or both.

HPV is a virus that can cause cervical cancer.

When you have a Pap test or HPV test, a sample of cells is taken from your cervix with a small brush. The HPV test looks for the types of HPV that are most likely to cause cancer. The Pap test checks for abnormal changes in the cervix that could lead to cancer.

At age 21, you should start having cervical cancer screening. Cervical cancer screening includes a Pap test, a test for human papillomavirus (HPV), or both.

HPV is a virus that can cause cervical cancer.

When you have a Pap test or HPV test, a sample of cells is taken from your cervix with a small brush. The HPV test looks for the types of HPV that are most likely to cause cancer. The Pap test checks for abnormal changes in the cervix that could lead to cancer.

TAKING CHARGE OF YOUR HEALTH

Now that you are growing up, it is a good time to learn how to take care of your own health. Some simple habits, like eating well and staying active, can keep you healthy and strong. Being healthy allows you to do your best in sports and at school. Starting good health habits now also helps keep you healthy as you get older.

Another way for you to take charge of your health is to see an obstetrician-gynecologist (ob-gyn). Girls should have their first gynecologic visit between the ages of 13 and 15.

The first visit may be just a talk between you and your doctor. You can find out what to expect at future visits and get information about how to stay healthy. You can ask questions about your body, growing up, and sex.

Eating Right

To grow properly, your body needs nutrients. So, it is important to eat a balanced diet. Your "diet" is simply what you eat. A balanced diet includes a mix of foods.

Fruits, vegetables, and whole grains have lots of vitamins and minerals. Foods with protein, such as meat, fish, eggs, or beans, help you grow. Vitamin D and calcium are used to build strong bones. Calcium and vitamin D are found in dairy foods like milk and cheese. Calcium also is added to many foods, like cereal and orange juice.

To eat a balanced diet, follow these tips:

  • Eat a good breakfast every day. It should include protein, fruit, and whole grains.
    Protein and whole grains give you energy and help to keep you alert during the day.

  • Avoid eating a lot of fast food. It is loaded with calories, fat, and sugar.
    Make fast food a once in a while treat.
    When you do eat fast food, make healthy choices. Get a plain burger or grilled chicken and a salad. Drink low-fat or non-fat milk or water instead of soda.

  • Eat different kinds of foods. That way, you are more likely to get all of the vitamins and minerals you need.

Maintaining a Healthy Weight

Maintaining a healthy weight is easier if you eat a balanced diet and are active.

Being overweight poses health risks. Being too thin also poses risks. The weight that is best for you will change as you grow. The range depends on your height and age, not on what other girls weigh.

To find out what a healthy weight is for you, you need to know your body mass index (BMI). The BMI is a number based on your height and weight.

You can talk with your parents or doctor about reaching or maintaining a healthy weight.

Staying Active

To be healthy, be active. Regular exercise can make your muscles and bones stronger and give you more energy. It may also help decrease menstrual cramps.

You should try to do some physical activity for at least 60 minutes on most, preferably all, days of the week. It does not need to happen all at once. Exercising is fun if you find something that you like to do.

Try a team sport, such as soccer or basketball, or try riding a bike, dancing, walking, or running.

Getting Enough Sleep

Getting enough sleep is important for preteens and teens. When you sleep, your body and brain recharge. You need at least 9 hours of sleep each night to be at your best. But only 2 in 10 teens get this amount on school nights. On weekends, teens stay up later and sleep in, which can make it hard to get back on schedule during the week.

​To make sure you get enough sleep, you may need to make some changes in your life. Follow these tips for healthier sleep:

  • Find a good bedtime and wake-up time, and stick to it. On weekends, try to stay as close as you can to your bedtime and wake-up time.

  • Slowly wind down in the hours before bedtime. Avoid coffee, soda, or energy drinks late in the day. Stay away from the computer, TV, or cell phone within a few hours of bedtime. Do not exercise right before bed.

  • Create your own bedtime routine. You could listen to relaxing music, read, or take a warm bath. If you do the same things every night before bed, your body starts to link these things with going to sleep.

Dealing With Acne

Acne is caused by overactive glands in the skin. The glands make a natural oil called sebum. During puberty, these glands make extra sebum that can clog the pores in your skin.

Wash your face often with water and mild cleanser to help get rid of the extra sebum. That will help reduce pimples and acne. Avoid products that dry or irritate your skin. Do not scrub or pick at your skin. If you have concerns about acne or pimples, some medications can help. Talk with your doctor about your concerns.

FINALLY...

Dealing with changes is a normal part of growing up. It is the start of the next exciting part of your life. When you have questions, talk with an adult you trust.

That might be your parents, a doctor, a teacher, or a school counselor. Remember that every woman you know has gone through these changes.

Common Questions

When will I get my period?

Most girls get their periods 2 to 3 years after their breasts start growing. If your breasts start to grow early, it may take longer before your period starts. This is normal.

Can I go swimming if I have my period?

Yes. You can swim safely with a tampon or menstrual cup inserted.

What should I do if I get my period at school?

Be prepared by keeping pads, tampons, or a menstrual cup with you. If you are not prepared, talk with your teacher or school nurse. They can help you get what you need.

One of my breasts is larger than the other. Is this normal?

Yes. When your breasts start to grow, one is often larger. This unevenness is normal. Like other parts of your body, one side may not be the same size as the other.

Over time, for many girls, the breasts become closer in size. For as many as 1 in 4 girls, the difference in size may not go away.

Information sourced from The American College of Obstetricians and Gynecologists | www.acog.org
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