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Discussing Puberty with Your Daughter

Discussing Puberty with Your Daughter
By Philip L. Levin, MD

Physical developmental changes create great excitement for pre-teen girls, and often, create anxiety in their mothers. In adolescence, girls mature from willowy straight-line children and begin the process of becoming curvaceous women. It is a time of great change.

Between the ages of 10 and 15, girls reach their adult heights as they go through physical changes of sexual maturation, known as puberty. The actual age of onset for a girl’s puberty varies greatly, although once she’s started, every girl will go through the three stages in a similar time sequence.

The earliest sign of body changes in young girls is the development of a slight bulge of fat, giving the sense of a rounded belly. This isn’t a warning of impending obesity. Instead, it’s just a storage of fat that will later be used by the girl’s body to develop breasts and hips. Reassure your daughter that these changes are normal.

The first definite visible evidence of puberty in most girls is a half-inch lump under one or both nipples, called breast buds. These buds usually appear at age nine or ten. Boys often will develop these as well, since at that age their bodies produce both the estrogens and testosterone hormones, although theirs will disappear after a few months. There’s great variation in the age of breast development, and so much so, that pediatricians have concluded girls do not need to be evaluated for a too-early onset of puberty so long as breast development hasn’t begun before age seven.

It’s worth noting that in the United States, African-American girls generally enter puberty a year before Caucasian girls, and go through all stages earlier, including menstruation.

The second sign of puberty for most girls is the appearance of pubic hair. Early hair is sparse, soft, and straight, and later becomes darker, coarser and curlier. Underarm hair appears two years later.

In the United States, most girls start their menstrual period at about age 13, but again, there is a wide range. Initial cycles often are irregular. Mothers should prepare their daughters for this experience, which can be frightening if it occurs without having been explained beforehand. In particular, girls should be supplied with sanitary pads to carry with them “just in case” they’re caught off guard in school. It’s appropriate to bring your daughter to her doctor if she hasn’t begun her menstruation by age 17.

Another aspect of adolescence is a change in sleep pattern. Teenagers tend to go to sleep two hours later and wake up later as well, needing somewhere between eight and ten hours of sleep a night. This can create difficulties during school times, when teenagers are forced to wake early to catch a bus.

A good time to start discussing sexual development with your daughter is when her breast buds first appear. Explanations about how babies are formed — beginning with the production of the egg, fertilization, and implantation in the uterus — can settle a lot of misunderstandings and fears in the burgeoning adolescent.

Tell her that the reason for menstruation is that the uterus prepares each month for a baby, but since there’s not one forming, the excess tissue is discarded during the cycle. Then, it repeats again the following month. Most girls will be aware that breast development is for producing milk for the baby, but they may not know that milk is produced only when there actually is a baby, and the breasts will dry up once the baby stops nursing.

For some girls, this might be a good time to introduce the ideas of abstinence and birth control, and parents should follow their own beliefs — religious, medical, or hopefully both — in determining the nature and direction of this sensitive and highly-personal conversation.

Adolescence brings many changes to a girl’s body as well as to her psyche. Provide your daughter with the basic information of what to expect. Be sure she has adequate nutrition, sleep,and encouragement, and she’ll grow into a graceful, happy adult.


Philip L. Levin, M.D. is a Coast-based physician and writer. He is the author of numerous award-winning stories and poems, many nonfiction articles, and eight published books, including two children’s books.

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