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A woman’s body undergoes many major changes during her lifetime. With the onset of menstruation (menarche) a young carefree child transforms almost suddenly into a young adult. The average age of menarche is now between 11 to 13 years (Normal range may vary from 8 to 16 years). Other body changes which are not so dramatic include gain in height, breast development and growth of adult type of genital hair. These start around the age of 8 years and continue for 5 – 6 years. With these body changes the brain also matures and an adult type of thinking pattern develops. The maturation of menstrual cycle also occurs simultaneously. This period of transition, known as puberty, is a long process and is completed by the age of 18 years.
During this adolescent or pubertal phase, a girl is faced with many problems. Pain during menstruation, menstrual irregularities, increased vaginal discharge, etc. can cause considerable trouble and are worrisome for the adolescent. Other concerns may be related to body image. These include shape, size and symmetry of breasts and genitalia, unwanted hair growth, pimples, skin color & texture, etc. Sudden and apparently strange behavioral changes are expected. An obedient, calm and stable child may suddenly become rebellious and emotional. Increasing peer pressure, coupled with the desire for independence alienates youngsters from parents and family.
All these changes and concerns are quite normal and generally pass off with time. Some common medical problems which affect health and emotional wellbeing and may have long term general and reproductive health implications may begin at this age. Anemia, obesity, under nutrition, food fads, poor personal hygiene, etc. are some examples. Life style compulsions like busy study schedule, long travelling distances, tuitions, etc. affect diet, exercise and hygiene. Among the prevailing confusion, this is the time when the reality of life dawns upon the young, fragile minds. By making their own choices and experimenting with various aspects of life, adolescents have to learn to strike a balance between their health, career and family.