Physical Development in Girls: What to Expect
Breast Development (Thelarche)
The first visible evidence of puberty in girls is a nickel-sized lump under one or both nipples. Breast buds, as
these are called, typically occur around age nine or ten, although they
may occur much earlier, or somewhat later. In a study of seventeen
thousand girls, it was concluded that girls do not need to be evaluated
for precocious puberty unless they are Caucasian girls showing breast
development before age seven or African American girls with breast
development before age six. It is not known why, but in the United
States, African American girls generally enter puberty a year before
Caucasian girls; they also have nearly a year’s head start when it comes
to menstruation. No similar pattern has been found among boys.
Regardless of a girl’s age, her parents are often unprepared for the
emergence of breast buds, and may be particularly concerned because at
the onset of puberty, one breast often appears before the other.
According to Dr. Suzanne Boulter, a pediatrician and adolescent-medicine
specialist in Concord, New Hampshire, “many mistake them for a cyst, a
tumor or an abscess.” The girl herself may worry that something is
wrong, especially since the knob of tissue can feel tender and sore, and
make it uncomfortable for her to sleep on her stomach. Parents should
stress that these unfamiliar sensations are normal.
What appear to be burgeoning breasts in heavyset prepubescent
girls are often nothing more than deposits of fatty tissue. True breast
buds are firm to the touch.
Q: “My daughter just started developing breasts. Should she be wearing a training bra?”
A: There’s no need for one right now, as long as she’s
comfortable. But given the sensitivity of early breast tissue, some
girls find it more comfortable to wear a soft, gently supportive
undergarment like an undershirt or sports bra. Let her decide. Girls’
feelings about their first bra are decidedly mixed. Some are thrilled to
take this early step toward womanhood, but others are mortified by the
thought of wearing a bra to school.
Q: “Why is one of my breasts bigger than the other?”
A: In the early stages of puberty, it is not unusual for one
breast to be noticeably larger than the other. Young girls aren’t always
told this, however, leading many to worry that they’re going to be
“lopsided” forever. Breast size usually evens out within a year or so,
although most adult women’s breasts are slightly different in size.
Unless the difference is significant, padding the bra cup for the
smaller side is frequently considered a satisfactory solution. However,
sometimes the difference in size is very pronounced. This condition, asymmetrical breasts, is
more common than you might think. The situation occasionally resolves
itself, but if not, some young women may want to pursue plastic surgery.
However, any such operation should be delayed until at least six to
twelve months after breast growth has stopped, usually a minimum of one
year following the first menstrual period. The standard approach among
physicians is to see young patients every six months for several years,
then assess whether the option of surgery should be offered.
Pubic Hair (Pubarche)
For most girls, the second sign of puberty is the appearance of pubic hair in
the pubic area. (About 10 to 15 percent will develop pubic hair before
the breasts begin to bud.) At first the hair is sparse, straight and
soft, but as it fills in it becomes darker, curlier and coarser. Over
the next few years, the pubic hair grows up the lower abdomen,
eventually taking on a triangular shape; finally it spreads to the inner
thighs. About two years after the onset of pubarche, hair begins to
grow under the arms as well.
Changing Body Shape
Preadolescent females acquire what, in common language, is often
called “baby fat,” which may give them a more rounded belly; this
development may cause considerable anxiety for these girls. That’s
hardly surprising in light of our culture’s conditioning women, even
from an early age, to aspire to thinness. The weight gain of puberty
comes at a time when a girl may be comparing herself to the malnourished
supermodels she sees worshiped in fashion advertisements or to their
plasticized counterpart, the unrealistically proportioned Barbie doll.
These young female patients, and their parents, often worry that baby
fat is a harbinger of impending obesity—usually the deposition of adipose tissue
(connective tissue where fat is stored) around the middle is part of
normal development. The body will soon redistribute the fat from the
stomach and the waist to the breasts and the hips in order to mold a
womanly figure. However, excessive abdominal fat, often characterized by
a “D” shape, should be addressed, since obesity predisposes youngsters
to diabetes, high blood pressure and other serious health concerns.
Menstruation (Menses/Menarche)
Girls often have many misconceptions and unfounded fears about
menstruation. The time to begin discussing this subject with your
daughter is when the breasts start to develop, heralding the arrival of
puberty. Typically, one and a half to three years pass before the first
menstrual period, or menarche.
Here’s how a mother or father might go about explaining the concepts
of ovulation and menstruation to a twelve-year-old. It’s helpful to have
on hand a book or pamphlet that includes an illustration of the female
reproductive system.
“When you’re older, you’ll be able to become a mother, if you
decide to. Even though that’s a long time from now, your body is already
getting itself ready for the day when you choose to have a baby.
“Now that you’ve entered puberty, each month one of your two
ovaries will release a ripened egg inside you. A woman becomes pregnant
when a man’s sperm unites with the egg. If fertilization takes place, the fertilized egg attaches itself to the inner lining of the uterus, which is also called the womb. This
is where the baby lives while it’s growing and waiting to be born. The
uterus prepares for this possibility by forming a thick layer of tissue
and importing extra blood, just in case.
“Most months, though, the egg doesn’t meet a sperm. Since the body
won’t be needing the extra tissue and blood, it discharges the red
fluid out your vagina. This is called your menstrual period, and it will
happen every three to five weeks or so. During the three to seven days
that you’re having your period, and for a few days afterward, you need
to wear a special absorbent pad in your panties. Or you can use
something called a tampon, which is made of soft cotton and goes inside
your vagina.
“Menstruation is normal and healthy. It means that you are growing
up. It doesn’t stop you from doing the things you want to do, like
swimming or playing sports. In time, you will begin to ovulate and be
capable of getting pregnant.”
Teenagers’ Common Concerns
Q: “How will I know when I’m going to get my first period?”
A: Although there’s no way to pinpoint the day, most girls
reach menarche at about the same age as their mothers and older sisters
did. Prepare your daughter in advance. Buy her a box of sanitary pads
and show her how to wear them.
Explain that her menstruation may be highly irregular at first, with
as many as six months passing between periods. Even once a girl becomes
regular, any of a number of conditions can cause her to miss a cycle:
sickness, stress, excessive exercise, poor nutrition and, of course,
pregnancy.
If your daughter has not menstruated by age 16 or 17, or is more
than a year older than her mother was at the time of menarche, consult
your pediatrician. Although everything is probably normal, it’s wise to
rule out any medical problems.
Q: “What if I get my period while I’m at school and have an accident?”
A: This is probably every girl’s greatest fear. Have your
daughter keep a few sanitary pads in her book bag or knapsack at all
times, in case of an emergency. Explain that the initial bleeding during
a period is usually light, and that she should be able to get to the
girls’ room or the nurse’s office in time.
Q: “Should I use sanitary pads or tampons?”
A: “I usually suggest that girls start out with pads for the
first month or so, until they get used to having their period and seeing
how heavy the flow is,” Dr. Felice explains. “It depends upon when a
girl is ready and how comfortable she is with her body.” Some girls
prefer tampons because they do not like the feeling of wetness or the
odor that pads may emit. Other girls may be squeamish about inserting a
tampon in their vagina and opt for pads. Buy your daughter some of each
type and in absorbencies ranging from light to heavy so she can
experiment to find what works best for her.
Q: “Does it hurt to have your period?”
A: The first several periods are almost always painless. Once a
girl begins to ovulate, she may experience some discomfort before,
during or after her period. Common symptoms include cramping, bloating,
sore or swollen breasts, headaches, mood changes and irritability, and
depression. Menstrual cramps, probably the most bothersome effect, can
range from mild to moderate to severe. If your daughter complains of
pain in the lower abdomen or back, talk to her pediatrician, who may
recommend exercises and an over-the-counter pain medication such as
ibuprofen.
When To Call The Doctor
Contact your daughter’s pediatrician if she experiences any of the
following symptoms, or if there is any concern that there might be a
problem:
- A sudden, unexplained change in her periods;
- Heavy menstrual bleeding that soaks more than six to eight pads or tampons per day for more than seven to ten days;
- Persistent bleeding between periods;
Girls, see if this sounds familiar. You look in a mirror
one morning and notice you're taller -- and rounder. Through your
nightgown, you see your breasts are bigger. You don't remember looking
like that a few weeks ago! Over the next few weeks, you start noticing
hair in places you've never had hair before. You've heard girls at
school talk about getting their periods, and you wonder if that will
happen to you soon. You feel ultraconfident, and then super sensitive --
all in the same day. What in the world is going on? Welcome to puberty.
Technically speaking, puberty is nature's way of
transforming a child into an adult, all for the sake of reproduction.
While both girls and boys go through puberty, girls reach puberty and
sexual maturity at earlier ages than boys do.
So what's causing all of these changes? Hormones!
Actually, the female hormone estrogen is the main one that's triggering
all the changes in your body. Let's look at some of the changes girls
can expect at puberty.
Increase in Height and Weight
Starting at around age 9, girls begin to gain about
17% to 18% of their adult height. If someone has commented that you are
"all hands and feet," it's true! Your limbs grow first, then your trunk.
Most girls grow fastest about six months before they start their first period (menarche).
You'll probably gain weight
in puberty -- most girls do. You may notice more body fat along the
upper arms, thighs, and upper back. Your hips will grow rounder and
wider; your waist will become narrower.
Your doctor will check your height and weight
each year to make sure you are growing properly. If you are gaining
weight too fast, you may need to increase your exercise and substitute fruits and vegetables for junk foods.
Puberty Breast Development
Breast development is an early sign of puberty in girls. This can happen before age 9 in some girls, but later in others.
If you are self-conscious, you might want to start wearing a "training bra," which is a soft bra with no real support.
Talk to your mom, older sister, or an aunt about
buying a training bra. They can help you to make sure you get one that
is comfortable and that lets you feel confident in your clothes.
Girls and Puberty
Increase in Hair
While for most girls, breast development is
the first sign of puberty, others might first notice pubic hair. An
increase in hair on your arms and legs, in your armpits, and around your
pubic area happens to girls early in puberty.
If you want to shave your legs and underarms, ask
your mom or another woman you trust about selecting the safest razor.
Someone who is experienced in shaving needs to show you how to shave
safely; using a gentle shaving cream, water, and a razor.
Keep in mind that not all women shave their body
hair. In some cultures, it is acceptable to leave the armpits and legs
unshaven. You have to decide what is best for you and your family's
customs.
Your First Menstrual Period
Soon after they develop breasts, most girls have
their first menstrual period. This usually happens between ages 12 and
13, but menstruation can start earlier or later. During a menstrual
period, there are two to three days of heavier bleeding with two to four
days of lighter flow.
Menstruation happens to all girls, so try not to be
embarrassed in learning more about it. Talk to your mom or an adult you
trust about having your period.
During your period, you'll need to wear a sanitary
pad or tampon. Your mom (or other adult) can purchase these products and
show you how to use them. Be sure to keep extra pads or tampons in your
school locker in case your period starts suddenly during the school
day. If you forget, ask to see a school nurse or ask a female teacher
for help.
Cramps and Your Period
Cramps are caused by the increased production of
hormones during your period. This causes the muscles of the uterus to
contract. You might also notice:
Cramps and Your Period
Cramps are caused by the increased production of
hormones during your period. This causes the muscles of the uterus to
contract. You might also notice:
- Aching in your upper thighs
- Back pain
- Bloating
- Nausea
- Diarrhea
- Fatigue
Medications such as ibuprofen (Advil) and
acetaminophen (Tylenol) can help ease period pain. Putting a heating pad
or hot water bottle on your abdomen may also help. If your cramping is
severe, talk to your health care provider.
Girls and Puberty
Girls and Mood Swings
Because of the surges in hormones during
puberty, many girls feel moodiness at times, especially right before
their periods. This is called premenstrual syndrome (PMS). PMS may
cause:
- Irritability
- Difficulty sleeping
- Fluid retention
- Anxiety
- Dietary cravings
Once your period starts, the PMS symptoms usually
disappear. It's helpful to exercise during PMS and your period in order
to boost your mood and help you feel your best. If your mood is lower
than normal, talk to your health care provider about your feelings.
Some girls have a decrease in self-esteem and body
satisfaction if they hit puberty earlier than their friends. Other
girls feel different if they enter puberty later than their friends do.
That's why it's important to understand what's happening to your body,
and realize that every girl goes through the same changes -- some
sooner, some later. But if you have not gone through puberty by age 14,
including menstruating, you should see your health care provider.
It's important to eat a balanced diet, exercise daily, get plenty of
sleep, and stay at a healthy weight during this time. Continue to see
your primary health care provider for regular checkups, so you can feel
your best and have someone knowledgeable to go to with your questions or
coincerns.
