1. Describe the physical changes that occur at puberty. 2.

Discuss the reactions of the adolescent to physical changes that take place. 3. Demonstrate an understanding of the processes by which the adolescent 1.) PHYSICAL CHANGES OF PUBERTY (http://www.pamf.org/teen/health/puberty/physicalchanges.html and http://www.pamf.org/teen/health/puberty/girlschanges.html) Physical Changes for Males Puberty Event Age at which it happens Growth of testicles and scrotal sac 10-13 1/2 Growth of pubic hair 10-15 Body Growth 10 1/2 -16 1/2 Growth of penis 11-14 1/2 Change in voice About the same time as penis growth Facial and Underarm Hair About 2 years after pubic hair appears Acne About the same time as underarm hair appears Genitalia and Pubic Hair = In the early stages of puberty, the scrotum grows larger and boys might experience some reddening of the skin and notice texture change in the scrotal skin. Pubic hair might start appearing at the base of their penis. While the scrotum grows, the penis increases in length and has a smaller increase in width. About a year after the penis starts growing, most boys have their first ejaculation. This is at times scary or worrisome to boys, but it is perfectly natural and a part of the pubertal process. At the same time, boys might also be noticing that more pubic hair is growing and that it is becoming darker, coarser and curlier. The penis continues to grow, and the head of the penis develops. The scrotal skin gets darker and the scrotum also continues to grow. When the penis is fully developed, pubic hair will have grown like an upside down triangle around your penis and will probably have spread to your thighs as well. Growing = Puberty can also cause boys to go through a growth spurt, which results in an average growth of about 4.1 inches a year. Their head, hands, and feet are the first things to grow. Then they grow in their arms and legs, and finally their torso and shoulders catch up with the rest of their body. Possible Breast Development = During puberty, some boys do experience slight breast growth, but this is usually temporary and disappears after a while. However, if it does not disappear after puberty and continues to worry boys, parents/they might want to consult their doctor about it. Voice Change = Their voice deepens, and while the process is gradual, they might experience their voice breaking at times. This is normal and natural. Body Hair = Facial hair first appears at the corners of boys upper lip and then spreads across the upper lip, to the upper parts of the cheek, below the bottom lip, and finally to the sides of their face and their chin. Underarm hair is also growing at this time as well. Acne = Accompanying underarm hair growth, their sweat and oil producing glands also start developing,

Timing of Puberty = Puberty starts at different times and lasts for different periods of time for everyone. It can start as early as 9 years of age to as late as 13 1/2 years of age. The sequence of pubertal development usually ranges from 2 to 5 years. This is sometimes very difficult, as some of the boys peers may have entered and completed puberty before they have even started. Physical Changes for Females Puberty Event Age at which it happens Growth of breasts 7-13 Growth of pubic hair 7-14 Body Growth 9 1/2-14 1/2 First Period 10-16 1/2 Underarm Hair 2 years after pubic hair shows up Acne Around the same time as underarm hair Breasts = Breast development begins between 7 years of age and 13 years of age and continues through puberty. Breast development starts with the flat area around the nipple (areola) becoming enlarged and some breast tissue forming under the nipple. When breast development is complete, each breast is distinct and the areola no longer appears swollen. Breast size varies from woman to woman. Pubic Hair = Pubic hair starts along the vaginal lips, the outer opening of a girls private parts. The hair becomes darker and coarser and grows like an inverted triangle. Sometimes, the hair spreads to the insides of thighs, as well. Growing = Puberty also causes girls to go through a growth spurt, which results in an average growth of about 3.5 inches a year. Their head, hands, and feet are the first things to grow. Then they grow in their arms and legs, and finally their torso and shoulders catch up with the rest of their body. Height growth is of course accompanied by an increase in weight. This weight gain is perfectly normal and a part of puberty. Without gaining this weight, girls cannot grow taller, develop breasts, or get their first period. Acne = Finally underarm hair begins to grow, and a girls sweat and oil producing glands also start developing, which eventually results in acne when these glands are clogged. Back to top Timing of Puberty = Puberty starts at different times and lasts for different periods of time for everyone. It can start as early as 7 years of age to as late as 13 years of age. The sequence of puberty from breast development to complete physical maturation may take a year and a half or last as long as 6 years. 2.) REACTIONS OF ADOLESCENT TO PHYSICAL CHANGES OF PUBERTY This is sometimes very difficult, as some of an adolescents peers may have entered and completed puberty before they have even started. There is no way to slow or speed up the process, but puberty happens to everyone.

Heightened Self-Awareness = One of the most common effects of puberty is a sense of heightened selfawareness, or self-consciousness. Puberty brings many physical changes, and adolescents become aware, for the first time, that these changes are not only noticeable to themselves but to others as well. Self-conscious = Many physical changes of puberty, including increased body odor and acne, can be a source of embarrassment and can increase feelings of self-consciousness. Increased Need For Independence = Puberty is a time of self-discovery and many adolescents experience a desire to distance themselves from their parents. While this can be a frustrating situation for their parents, the adolescnet's need to be viewed as a separate, unique individual is a normal part of the process of growing into adulthood. 3.) DEMONSTRATE AN UNDERSTANDING OF THE PROCESS OF PUBERTY Puberty is the stage of life at which secondary sex changes begin. These changes are stimulated when the hypothalamus synthesizes and releases gonadotropin-releasing hormone (GnRH), which in turn triggers the anterior pituitary to begin the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH initiate the production of androgen and estrogen, which in turn initiate secondary sex characteristics, the visible signs of maturity. Girls are beginning dramatic development and maturation of reproductive organs at earlier ages than ever before (9 to 12 years). Although the mechanism that initiates this dramatic change in appearance is not well understood, the hypothalamus, under the direction of the central nervous system, may serve as a gonadostat or regulation mechanism set to turn on gonad functioning at this age. Although it is not proved, the theory is that a girl must reach a critical weight of approximately 95 lb (43 kg) or develop a critical mass of body fat before the hypothalamus is triggered to send initial stimulation to the anterior pituitary gland to begin the formation of gonadotropic hormones. Role of Androgen = Androgenic hormones are the hormones responsible for muscular development, physical growth, and the increase in sebaceous gland secretions that causes typical acne in both boys and girls. In males, androgenic hormones are produced by the adrenal cortex and the testes; in females, by the adrenal cortex and the ovaries. The level of the primary androgenic hormone, testosterone, is low in males until puberty (approximately age 12 to 14 years). At that time, testosterone levels rise to influence the further development of the testes, scrotum, penis, prostate, and seminal vesicles; the appearance of male pubic, axillary, and facial hair; laryngeal enlargement and its accompanying voice change; maturation of spermatozoa; and closure of growth in long bones. In girls, testosterone influences enlargement of the labia majora and clitoris and formation of axillary and pubic hair. This development of pubic and axillary hair because of androgen stimulation is termed adrenarche. Role of Estrogen = When triggered at puberty by FSH, ovarian follicles in females begin to excrete a high level of the hormone estrogen. This hormone is actually not one substance but three compounds (estrone [E1], estradiol [E2], and estriol [E3]). It can be considered a single substance, however, in terms of action. The increase in estrogen levels in the female at puberty influences the development of the uterus, fallopian tubes, and vagina; typical female fat distribution and hair patterns; breast development; and an

end to growth because it closes the epiphyses of long bones. The beginning of breast development is termed thelarche. Secondary Sex Characteristics = Adolescent sexual development is categorized into stages In girls, pubertal changes typically are manifest as: 1. Growth spurt 2. Increase in the transverse diameter of the pelvis 3. Breast development 4. Growth of pubic hair 5. Onset of menstruation 6. Growth of axillary hair 7. Vaginal secretions The average age at which menarche (the first menstrual period) occurs is 12.4 years. It may occur as early as age 9 or as late as age 17, however, and still be within a normal age range. Irregular menstrual periods are the rule rather than the exception for the first year. Menstrual periods do not become regular until ovulation consistently occurs with them (menstruation is not dependent on ovulation), and this does not tend to happen until 1 to 2 years after menarche. This is one reason why estrogen-based oral contraceptives are not commonly recommended until a girls menstrual periods have become stabilized or are ovulatory (to prevent administering a compound to halt ovulation before it is firmly established). In boys, production of spermatozoa does not begin in intrauterine life as does the production of ova, nor are spermatozoa produced in a cyclic pattern as are ova; rather, they are produced in a continuous process. The production of ova stops at menopause (the end of the fertile period in females). In contrast, sperm production continues from puberty throughout the males life. Secondary sex characteristics of boys usually occur in the order of: 1. Increase in weight 2. Growth of testes 3. Growth of face, axillary, and pubic hair 4. Voice changes 5. Penile growth 6. Increase in height 7. Spermatogenesis (production of sperm)