Many of us remember going through puberty and all of the awkward and embarrassing moments of this developmental coming of age. Although we may cringe as our children head towards this monumental milestone, this is an important time for us to truly engage with our young people.
When does puberty begin
In Australia, the average age of menarche, (first menstrual period) is 10-11 years. The normal range is 8-13 years. Many factors contribute to the timing of puberty including gender, genetics, ethnicity, health status, physical activity level, household structure, family functioning and environmental exposures.
The age of puberty for girls and boys has dramatically fallen over the past 150 years. Improvements in public health, including improved childhood nutrition, reduced incidence of childhood infections and higher stress levels among adolescence have contributed to this age reduction.
The Stages of Puberty
Adrenarche precedes puberty and is associated with maturation of the adrenal cortex, particularly the zona reticularis. The adrenal gland is responsible for producing many of our bodies hormones and steroids, but without adrenarche our capacity for sex hormone synthesis is limited. The maturation of our adrenal glands and the increased capacity for steroid and hormone production (particularly dehydroepiandrosterone, DHEA), sets off a cascade of events leading to the first visible signs of sexual maturity. During adrenarche, hair growth starts to appear in the underarms and pubic area and body odor may become apparent. Acne can also start to appear during adrenarche. This stage of development typically lasts for 2 years.
Following adrenarche is gonadarche. At this stage of puberty, the physical changes taking place in both boys and girls start to become more obvious. Seemingly overnight, our young people have changed into sexual beings, looking and sounding more like adults. Significant physiological change happens during gonadarche. The growth and maturation of the gonads leads to an increase in estrogen and testosterone production. Gonadarche leads to testicular enlargement in boys. In girls, thelarche, or breast development begins, followed by menarche (the first menstrual cycle) approximately 2-3 years later. The pituitary gland produces luteinizing hormone (LH) and follicle- stimulating hormone (FSH). Working together these hormones are eventually responsible for ovulation and estrogen production in females and sperm development and testosterone production in males.
A safe place to talk
Never before in history has there been so many young people – 1.8 billion people are currently aged 10-24 years. According to the latest work by the World Health Organisation (WHO), we should work towards:
• Achieving engagement with our youth through the provision of safe and inclusive spaces for young people to express their views.
• The provision of information to facilitate the expression of young people’s views.
• Ensuring that young people’s views are communicated to someone with the responsibility to listen.
• Ensuring that young people’s views are taken seriously and acted upon, where appropriate.
The WHO have provided this framework as part of a global agenda to engage young people for health and sustainable development. We ought to provide this framework for our young people at home too.
• Engaging young people for health and sustainable development: strategic opportunities for the World Health Organization and partners. Geneva: World Health Organization; 2018.