puberty. Problems of puberty. puberty, puberty

Puberty in boys implies a whole range of changes, both physiological and biological.

All these changes are aimed at the development of important sexual and somatic functions under the influence of certain male hormones.

Usually, puberty in boys begins at the age of 12 and lasts until 17, during which time, as a rule, the physiological sphere is completely formed.

At the same time, the development of the intellectual and emotional spheres requires a much longer period of time - up to 22 years.

The period of puberty in boys is characterized by an intensive acceleration of growth in combination with an increase in body weight. In a few months, an increase in growth can reach 3 centimeters. Along with this, there is a significant increase in the size of the gonads and phallus.

The beginning of the development of male genital organs is evidenced not only by their increase in size, but also by the occurrence of such characteristic phenomena as erection and wet dreams.

Age

The onset of puberty in boys usually occurs at 10-12 years of age.

Until that time, all the most important characteristics were laid at the pituitary level in order to prepare the body of the future man for the upcoming changes that indicate gender.

Sometimes the beginning of this important period occurs at the age of 14-15, which is also a deviation from the norm and is not a cause for concern.

Upon reaching the specified age, the voice begins to break, increased male-type hair growth and a number of other characteristic signs appear.

In most cases, puberty lasts up to 17-18 years, although sometimes it can be delayed up to 20, due to individual characteristics and external factors.

Signs of puberty in boys

External sexual characteristics

Puberty in boys develops in stages. At each stage, certain characteristic external signs appear.

The main sign of the onset of puberty in boys is an increase in the size of the penis.

At the age of 13, it reaches approximately 6.3 cm, and at 15 - 6.7 cm. The size of the testicles at this stage is about 4 cm.

An important external characteristic feature is the growth of hair in the pubic region.

At the initial stage (12-13 years old), the form of hair growth resembles a rhombus, but as they grow older (17-18 years old), the hairline gradually spreads to the inner thighs.

From the age of 13-14, the process of male pattern hair growth begins.

First, a soft, barely noticeable fluff appears above the upper lip - it gradually becomes harder and more intense.

At the same time, hair appears on other parts of the body - arms, legs and chest. By about the age of 15-16, the hairline of the face and body is fully formed in a teenager.

During puberty, boys begin an intense period of growth and increase in muscle mass. At this stage, the shoulder girdle becomes stronger and wider. The pelvic region, on the contrary, becomes narrower. The complexion of the body gradually acquires pronounced male proportions.

Puberty brings many young men and significant skin problems, which are associated with increased activity of the sweat and sebaceous glands. The skin becomes rougher and greasy, they often appear inflamed rashes.

A striking characteristic sign of the sexual development of boys is the formation of an Adam's apple, or "Adam's apple".

At this stage, the muscles of the throat develop intensively, and the vocal cords increase in size, in connection with which the voice begins to coarsen and “break”. This process usually continues between the ages of 13 and 15.

Musculoskeletal apparatus

During puberty, significant changes affect the musculoskeletal system.

Due to the fact that tissue growth occurs unevenly, for some time adolescents may look awkward and disproportionate.

The sequence of increasing tissues in size is as follows:

Bones.
Muscles.
Nerve fibers and blood vessels.

The development of body parts occurs disproportionately. First of all, the length of the hands and feet increases, then the limbs as a whole.

Only after this stage, the shape of the face and torso begin to change. The lower jaw becomes larger and more pronounced. The trunk becomes shorter.

For some time, a teenager may feel discomfort associated with coordination of movements. This is due to the unusual large size of body parts and the gradual increase in muscle mass.

Psychological features

The psychological, emotional and intellectual spheres of a young person undergo many changes.

External changes that a teenager is dissatisfied with can lead to self-doubt, shyness, isolation and depressive states.

Following these phenomena comes a craving for freedom of action and the search for one's own individuality.

Frequent mood swings are an integral feature of the puberty period in boys, so apathy can abruptly change into aggression and vice versa.

At this stage, parents should show wisdom and tact, as well as create a favorable environment for the personal development of a teenager and the most important male qualities.

premature maturation

Premature puberty in boys is not common in practice.

This phenomenon can be discussed when, before reaching the age of 9-10, the boy begins to show some signs characteristic of the puberty period.

For example, he looks somewhat older than his peers, his body odor changes and the first rashes appear on his skin.

Often, precocious puberty is false.

You can distinguish this phenomenon from true premature maturation by checking the degree of development of both testicles. If they grow and develop, early maturation has indeed begun. The danger of this phenomenon is due to its causes - violations of the natural work of the hypothalamus or the transfer of diseases of the brain.

True precocious puberty requires immediate treatment, as it can lead to stunting of the child.

Later development

Among the main signs of late sexual development (maturation) of boys is the lack of growth of the genital organs by the age of 13, as well as the lack of hair in the pubic region by 15.

There are several factors that can cause this delay:

the presence of diabetes;
renal failure;
anemia;
Klinefelter syndrome.

As well as some other pathologies related to the structure of chromosomes. With this phenomenon, the help of a competent specialist is required.

The pubertal period in boys under favorable developmental conditions lasts from 10-12 to 17-18 years. Early and late development may indicate pathologies, therefore, they require qualified medical intervention.

Puberty (puberty) facts

Puberty is the period of puberty and fertility.

The time when puberty begins varies considerably among adolescents; however, puberty typically occurs in girls between the ages of 10 and 14 and in boys between the ages of 12 and 16.

Both genetic and environmental factors are likely involved in the timing of puberty.

Fat and/or body composition may play a role in regulating the onset of puberty.

Puberty is associated with the development of secondary sexual characteristics and rapid growth.

Some medical conditions may worsen or become apparent during puberty.

Early puberty is puberty that occurs earlier than usual. It is more common in girls than in boys..

When does puberty occur

The onset of puberty is quite individual. Puberty for girls usually occurs between the ages of 10 and 14, while puberty for boys usually occurs later, between the ages of 12 and 16; in some regions, puberty for girls begins earlier, around age 9, meaning that puberty lasts from about 9 to 14 years of age.

Adolescent girls reach puberty today at an earlier age than ever before. Dietary and other environmental factors may be responsible for this change in puberty. For example, the average age of menstruation for girls in 1900 was 15 years old, today it has dropped to 12 and a half years.

What determines when puberty begins? Why is puberty coming?

The time of onset of puberty cannot be predicted to the exact day, most likely, it is determined by a number of factors. One theory suggests that reaching critical body weight may play a role in the onset of puberty. It has been suggested that the increase in childhood obesity may be due to the general early onset of puberty in the general population in recent years.

Leptin, a hormone produced by fat cells (adipocytes) in the body, has been proposed as one of the possible mediators of puberty. In animal studies, artificial leptin deficiency delayed the onset of puberty, but puberty was activated once leptin was administered to the animals. In addition, girls with higher concentrations of the hormone leptin are known to have higher body fat percentages and earlier onset of puberty than girls with low leptin levels. The concentration of leptin in the blood is known to be associated with puberty in boys and girls.

Leptin, however, is likely only one of several influences on the hypothalamus, the area of the brain that releases a hormone known as gonadotropin-releasing hormone (GnRH), which in turn signals the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone. hormone (FSH). Pituitary secretion of LH and FSH is responsible for sexual development.

Genetic factors are likely involved in the timing of puberty. In addition, a gene has been identified that appears to be critical for the normal development of puberty. The gene, known as GPR54, codes for a protein that appears to have an effect on GnRH secretion by the hypothalamus. Individuals who do not have a working copy of this gene are not able to boast of the usual puberty for their age.

What other changes in the body occur during puberty in boys and girls

Puberty is usually accompanied by a rapid increase in height, known as a spurt, which typically lasts for two to three years. About 17%-18% of an adult's height is reached at puberty. Although the increase in height affects the trunk and limbs, growth in the limbs usually occurs first. The growth spurt characteristically occurs earlier in girls than in boys, showing a real growth spurt on average about two years before boys. In girls, the growth spurt usually precedes the onset of menstruation by about six months.

Bone growth and mineralization during puberty

Puberty is accompanied by bone growth and an increase in bone density in boys and girls. In girls, bone mineralization peaks at the onset of menstruation, after the time of peak growth rate (growth spurt). Studies have shown that first there is an increase in bone width, then bone mineral content, and finally bone density. Due to the discrepancy between the timing of bone growth and the achievement of full bone density, adolescents during puberty may be at increased risk of fractures.

Weight changes during puberty

Changes in weight and body composition occur in both boys and girls. Adolescent girls have a higher percentage of fat than boys, with a redistribution of fat in relation to the upper and lower parts of the body. While boys, along with an increase in fat, demonstrate rapid muscle growth. By the end of puberty, boys have about one and a half times more muscle mass than girls of comparable height.

Other changes during puberty

The maturation of the cardiovascular system and lungs leads to an increase in the efficiency of these organs, associated with a general increase in endurance and strength. These changes are more pronounced in boys than in girls.

What medical conditions are associated with early or late puberty?

precocious puberty

Early puberty is the medical term for puberty that occurs earlier than usual. While medical professionals do not fully agree on the age at which precocious puberty is defined, many physicians believe that a medical evaluation for precocious puberty should be done if breast or pubic hair development occurs before age 6 or 7. Boys who show signs of developing secondary sexual characteristics before the age of 9 are also considered to have precocious puberty. Precocious puberty can be associated with psychological difficulties that can affect a child's emotional development.

Precocious puberty is much more common among girls than boys. Many girls experience precocious puberty in the absence of any disease or condition. In boys, however, precocious puberty is more likely to be related to an underlying medical problem. While in many cases the exact cause of precocious puberty is difficult to pinpoint, a small number of cases are related to ovarian or testicular abnormalities, thyroid or other hormonal problems, genetic conditions, tumors or trauma, and infections of the brain.

Precocious puberty can be treated by treating the underlying condition that is responsible for the condition or by lowering high levels of sex hormones with drugs known as GnRH agonists, which block the production of sex hormones to stop sexual development.

Delayed puberty

Delayed puberty is the late onset of puberty. Puberty is generally considered delayed if there is no increase in testicular volume in boys by age 14 and no breast development in girls by age 13 and a half. Sometimes, delayed puberty is usually a hereditary feature, and after some delay, normal development begins in adolescents. This is sometimes referred to as constitutional delay and is responsible for the vast majority of delayed puberty. Constitutional delay, which affects both growth and puberty, is much more common in boys than girls.

Chronic diseases such as diabetes or cystic fibrosis can also delay the onset of puberty. Genetic conditions, problems with the pituitary or thyroid gland, problems with the ovaries or testicles, and malnutrition are other causes of delayed puberty. Many girls who have too little "reserve" of fat also experience a delay in the onset of puberty, as a certain amount of fat appears to be required for the onset of puberty. Athlete girls can also have periods delayed by up to one year or more compared to regular girls.

Denial of responsibility: The information provided in this article about puberty is for the information of the reader only. It cannot be a substitute for advice from a health professional.

PUBERTY (lat. Pubertas, pubertatis - manhood, puberty; synonyms - adolescence, senior school age), the transitional time from childhood, during which the body reaches biological puberty.

Corresponds to puberty: in girls, on average, from 12 to 16 years; in boys - from 13 to 17 - 18 years. During its duration, activation occurs, which determines the rapid somatic and sexual development of the girl and boy. By the end of puberty, the organism is anatomically and functionally ready for procreation. In recent years, in all countries there has been a pronounced trend towards accelerated development of children and earlier onset of puberty than was observed 80-100 years ago. The reason for this phenomenon is not entirely clear. It is assumed that acceleration is associated with civilization and urbanization of the population, a change in the nature of nutrition, excessive consumption of proteins and sugar.

Puberty is an important, responsible and difficult stage of life, which is characterized by a complete lack of harmony. The body is stretched, limbs grow disproportionately. The teenager does not have time to get used to such a rapid growth, his movements are angular, his gait is clumsy. Neither the boy with the piercing mustache, nor the girl with fully developed feminine forms have yet come to the adult world, but have already left the world of childhood. Hence the duality of their position and actions and their many troubles. The loss of balance is caused by the restructuring of the hormonal system of the body, the difference in the pace of physical, spiritual development of a teenager and the degree of his social maturity, independence. All this can not but affect the mental state.

Puberty: Psychology of a teenager

A teenager often does stupid things, does things that are inexplicable from the point of view of logic. Obviously, it is precisely the special vulnerability and emotional instability of adolescents that can explain the fact that this age accounts for a significant percentage of suicides and suicidal attempts. At this age, the next phase of psychosexual development begins - the phase of romantic love, on the one hand, and erotic desires, on the other. Erotic sexual desire (desire not only spiritual, but also bodily contact, tenderness, caress, touch) worries a teenager. The first love begins with friendship, joint activities, games, dances. Then there comes a moment when young lovers touch each other with trepidation, their feelings rise to the next rung of the sexual ladder - to hugs, kisses, caresses. Under normal circumstances, neither romantic adoration nor erotic attachment require immediate sexual fulfillment. However, we must remember that with the onset of menstruation in girls, the sensitivity of extragenital zones increases, and this causes some compliance, responsiveness to sexual stimuli.

Puberty:

With the advent of wet dreams, boys enter a period of hypersexuality, when the desire to relieve internal tension can easily arise by performing certain actions. At this age, adolescents begin to think about the ways and possibilities of a specific realization of inclinations. It is at this time, under the influence of the case, unacceptable forms of sexual activity can be fixed.

With the onset of puberty, adolescents become smarter, their intellectual abilities and observational abilities increase, thinking becomes more logical, imagination is richer. Sometimes there are cases of very early puberty, which depends on the abnormal development of the sex glands or the appearance of tumors in them.

Puberty:

With early puberty, secondary sexual characteristics appear up to 7-10 years. In such cases, you should immediately seek the advice of a doctor. Conversely, later development of secondary sexual characteristics is possible - after 17 years. If up to 15 - 16 years of secondary sexual characteristics did not appear, one should think about developmental delay; in this case, appropriate treatment is also necessary.

The maturation of the reproductive apparatus of both men and women begins earlier than the conditions for living together and the proper development of the fetus in the mother's body are created. Sexual life in this period is undesirable, as it undermines the health of an incompletely mature organism. The period of puberty is a very responsible and peculiar "critical" period in the development of the body of adolescents, which often determines their entire future life.

Puberty: a change in the boy's body

Sex organs and fertility

The first sign of puberty in boys is testicular enlargement (adrenarche). The testicles in the period from 1 year to the onset of puberty almost do not change in size, the length is 2-3 cm, and the width is 1.5-2 cm. 6 years after the onset of puberty, the testicles reach a volume of 18-20 cm³, however, individual differences must be taken into account testicular size in men. The testicles have two main functions: hormone production and production, with the former starting earlier and stimulating the latter. Already a year after the start of maturation, spermatozoa can be detected in the morning urine of boys. (penis) begins to grow shortly after the growth of the testicles begins. As the penis grows, they arise, and then. On average, boys reach potential fertility by the age of 13, and full fertility by the age of 14-16.

Hair growth (adrenarche)

Precocious sexual development- the onset of puberty in girls under 8 years of age and in boys under 9 years of age.

With pathological processes in the pineal gland, hypothalamus, in the hypothalamic-pituitary system, changes occur that resemble those during normal puberty and the secretion of gonadotropic hormones of the pituitary gland, which in turn leads to sexual development that mimics the prepubertal and pubertal periods (the so-called true premature sexual development in both boys and girls, which is always isosexual). With tumors of the gonads, tumors or dysfunction of the adrenal cortex, false premature sexual development begins: the secretion of gonadotropins does not increase, and the excessive production of sex hormones by the adrenal cortex or tumors of the gonads does not correspond to the changes characteristic of normal prepubertal or pubertal periods, the gonads remain infantile.

In girls, false precocious sexual development can be heterosexual - with adrenogenital syndrome or isosexual - with tumors, in boys - isosexual.

Symptoms of precocious puberty

Acceleration of growth and increase in body weight, ahead of peers in sexual development.

Girls have an increase

Puberty is the period of a person's life during which his body reaches biological puberty. This period is called puberty and is characterized by the appearance of secondary sexual characteristics (see), the final formation of the genital organs and sex glands. The onset of puberty depends on many factors - nationality, climatic conditions, nutrition, living conditions, gender, etc. In boys, it begins on average from 15-16 years old, in girls from 13-14 years old and ends, respectively, by 20 and 18 years old. It should be emphasized that significant individual deviations are noted in the timing of the onset of puberty. In physiological terms, this period is characterized by the maturation and the beginning of the functioning of the gonads. In the adrenal cortex, androgens begin to be intensively produced (see), the secretion of pituitary gonadotropins increases (see Gonadotropic hormones), which accelerates the development of the gonads. In girls with an increase in the function of the ovaries that produce, the mammary glands, external and internal genital organs begin: uterus, labia. At the age of 14-15 years, sometimes earlier, there is a formation of a menstrual cycle (see). An objective criterion for the maturity of the gonads is menstruation in girls and (see) in boys. The most common sequence of appearance of sexual characteristics is presented in the table.

The sequence of appearance of signs of puberty

Age in years	Signs of puberty
Age in years	girls	boys
8	The pelvis becomes wider, the hips are rounded
9	Increased secretion of sebaceous glands
10-11	The beginning of the development of the mammary glands	Beginning of growth and testicles
12	The appearance of hair on the genitals, enlargement of the genitals	Larynx growth
13	The alkaline reaction of the vaginal secretion becomes sharply acidic	Enlargement of testicles and penis. Slight appearance of hair on the genitals. The beginning of the formation of the male type
14	The appearance of menstruation and the appearance of hair in the axillary cavities	Change in voice (breaks down), slight enlargement (swelling) of the breasts
15	Pronounced changes in the size of the pelvis and its proportions according to the female type	scrotum, the appearance of a mustache and the appearance of hair in the axillary cavities. Significant testicular enlargement
16-17	Menstruation occurs regularly, with ovulation (see).	Increased hair growth on the face, body; male type of pubic hair. The appearance of wet dreams
18-19	Skeletal growth stops	Deceleration of skeletal growth

Often, normal puberty proceeds in a slightly different sequence. In these cases, it is sometimes very difficult to find a clear boundary between the norm and pathology. One of the reasons for such deviations are violations of hormonal systems, in other cases, the constitutional features of a teenager during the puberty period, as well as psychogenic factors that can cause severe endocrine disorders, acquire certain significance. It is extremely important to consider these cases, since the irrational use of hormonal drugs in the treatment can lead to significant damage to many systems. During puberty, sometimes small temporary deviations are observed, that is, variations in the normal developmental process. They are regarded as physiological phenomena. Girls may have significant growth of the mammary glands (macromastia), and precocious puberty does not occur. Physiological variations of puberty also include juvenile uterine bleeding, amenorrhea (see). Painful menstruation is often observed, accompanied by headaches, vomiting, and weakness. These disorders are usually observed in girls with an unstable nervous system. Boys may have a slight enlargement of the mammary glands (pubertal gynecomastia) that resolves completely.

Late(pubertas tarda) is considered puberty, observed in girls at 18-20 years old, in boys at 20-22 years old. With this pathology, therapeutic measures should be aimed at improving living conditions, nutrition and the introduction of male, female sex hormones and drugs containing pituitary gonadotropic hormones. Delay of sexual development and growth retardation is observed at infantilism (see). The underdevelopment of the reproductive apparatus and the absence of sexual characteristics of this sex - hypogenitalisl (see) - are due to dysfunction of the endocrine glands and, above all, the pituitary gland.

Early(pubertas parecox) is considered puberty, occurring in girls under 8 years old, in boys under 10 years old and characterized by the premature appearance of secondary sexual characteristics, the rapid development of the genital organs and accelerated growth. In boys, this manifests itself in accelerated growth, and then an early cessation of growth (which subsequently leads to short stature), rapid growth of the genital organs and the appearance of secondary sexual characteristics (hairiness, low voice, pronounced skeletal muscles). There are also wet dreams. In girls, there is an acceleration of growth, and then an early cessation of growth, it becomes wide, the size of the uterus and ovaries increase. There are cases of menstruation at preschool age.

Early puberty, combined with accelerated growth, but a sharp disproportion of the skeleton, short stature and mental retardation, is defined as macrogenitosomia praesox.

The question is closely related to the problem of puberty. This is a system of medical and pedagogical influences on adolescents with the aim of educating them in certain norms of behavior in their sexual life. The task of sex education is to create a physically healthy generation whose sexual life must be subject to the moral standards of our society. The joint training and upbringing of boys and girls, their early involvement in public life, the combination of training with industrial work, and broad development among young people also create the basis for a reasonable tribal education.

Puberty (Latin pubertas) is the process of growth and differentiation of the sex glands, genital organs and secondary sexual characteristics. Puberty proceeds with the most complex changes in the nervous, endocrine, cardiovascular and other systems of the body, as well as in physical development, and ends with the onset of puberty.

An important role in puberty is played by the hypothalamic region, which is in an inextricable functional relationship with the pituitary gland. During puberty, the activity of gonadotropic hormones of the pituitary gland increases markedly, and the content of androgens and estrogens in the blood and urine increases. Estrogens synthesized by the ovaries cause an increase in the uterus, vagina, labia minora, mammary glands and keratinization of the vaginal epithelium. Androgens determine sexual hair growth, growth of the penis and scrotum in boys, and in girls - the clitoris and labia majora. Sex hormones, especially androgens, stimulate the growth and differentiation of bone tissue, promote the closure of growth zones, and enhance muscle development. In these processes, the protein-anabolic effect of sex hormones is manifested. The relationship between the various systems that regulate puberty is shown in fig. 1.

Rice. 1. Scheme of relationships between various systems that regulate growth and sexual development (from Gillenswerd, according to Wilkins).

Puberty begins earlier in girls than in boys. During this period, the excretion of estrogens and gonadotropins in the urine increases markedly in girls, and androgens in boys. Recently, in all countries, the timing of the onset of puberty has shifted to an earlier period. So, according to the observations of V. S. Gruzdev, relating to 1894, menstruation began at the age of 15 years 8 months; at the present time (1965) they begin more frequently at 13-14 years of age. In young men, the date of onset of puberty is determined by the first ejaculations. The beginning and duration of the pubertal period depend on family (constitutional) characteristics, body structure and environmental conditions (nutrition, climate, living conditions, etc.). Puberty begins in girls from 8-11 and usually lasts up to 17 years, in boys - from 10-13 to 19 years.

During puberty, hypertonic reaction and hypotonic state, pulse lability, acrocyanosis, Trousseau spots, orthostatic albuminuria, spontaneous hypoglycemia, and sometimes mental disorders can be observed. The degree of puberty is judged by secondary sexual characteristics - hair growth on the pubis (11-13 years old) and in the axillary region (12-15 years old), in girls, in addition, by the timing of the onset of menstruation and the development of the mammary glands (10-15 years old) , as well as with the help of radiographs of the hand and distal ends of the bones of the forearm. The beginning of puberty corresponds to the ossification of the sesamoid bone, then synostosis appears in the first metacarpal bone and terminal phalanges; at the end of puberty, complete synostosis of the epiphyses of the radius and ulna occurs. Assessing the degree of puberty in boys by the size of the external genital organs must be carefully, since their growth is often somewhat behind.

precocious puberty(pubertas praecox) is true and false. When true, there is a relationship between the hypothalamic-pituitary region, the sex glands and the adrenal glands. There are constitutional (essential) and cerebral forms of true puberty.

The constitutional form is observed almost always in girls and is due, apparently, to a family predisposition. Secondary sexual characteristics appear early, even from birth, but more often at 7-8, and menstruation - at 8-10 years. Menses are ovulatory. In boys, secondary sexual characteristics can appear as early as 9-11 years old, less often earlier. There is macrogenitosomia (premature enlargement of the external genital organs). At 12-13 years of age, puberty ends.

Initially, children with precocious puberty are ahead of their peers in physical development. However, in the future, due to the closure of the growth zones, some of them develop short stature and disproportion - the lower limbs are relatively short in relation to the body (Fig. 2). The mental development of such children often corresponds to age, and if it lags behind, then by about 2 years. In girls, excretion of follicle-stimulating hormone and estrogen in the urine reaches the level of puberty. The content of 17-ketosteropds in the daily urine exceeds the age norm. In tumors of the adrenal gland and gonads, the level of excretion of hormones is much higher. A vaginal smear confirms a normal menstrual cycle.

The prognosis for the constitutional form of precocious puberty is favorable. Treatment is not carried out.

In the cerebral form of true puberty, there are lesions of the hypothalamic region (tumors, hemorrhages, congenital defects of the brain, encephalitis) or a tumor of the pineal gland. Currently, most researchers believe that even with tumors of the pineal gland, premature sexual development is due to secondary changes in the hypothalamus due to internal hydrocephalus. In children, early and rapid development of the genital organs and secondary sexual characteristics is noted. Mature Graafian follicles and corpus luteum appear in the ovaries. In the testicles, interstitial cells are formed and spermatogenesis occurs. The content of gonadotropins, estrogens, 17-ketosteroids in the urine corresponds to the pubertal period.

Premature puberty is also noted in multiple fibrous dysplasia, in which there are changes in the skeletal system, skin pigmentation and increased activity of the thyroid gland.

False puberty (pseudopubertas praecox) occurs with pathological changes in the adrenal glands, ovaries or testicles. Ovulation and spermatogenesis are absent. After removal of the tumor, the reverse development of secondary sexual characteristics is possible.

Delayed puberty(pubertas tarda) is characterized by the late development of the genital organs and glands, as well as the appearance of secondary sexual characteristics. In boys, it is diagnosed at 20-22 years old, in girls at 18-20 years old. Most often occurs under the influence of a constitutional (family) factor, less often due to insufficient hygienic conditions and alimentary reasons. Late puberty is observed sometimes up to 15-16 years. At the same time, physical and often mental development lags behind. The differentiation of the skeletal system also lags behind, more often by 2-4 years. Most children in the coming years reach their peers in sexual development.

The assessment of puberty should be carried out on the basis of a number of signs and especially radiological data on the differentiation of the skeletal system. Correspondence of ossification processes to actual age, as a rule, excludes a lag in puberty.

Variations in puberty. Premature development of the mammary glands (premature thelarche) in girls may be the only sign of deviation. The absence of secondary sexual characteristics, estrogenic changes in the vaginal smear, and enlargement of the internal and external genital organs makes it possible to distinguish this process from true puberty. It is assumed that premature telarche is based on an increased reaction of mammary tissue to estrogens. In the future, this reaction may disappear. Treatment is not required.

In boys, pubertal gynecomastia is often observed (see), expressed more often on the left and disappearing without treatment. Treatment with male sex hormones is contraindicated.

Premature secondary hair growth (premature pubarche) develops on the pubis, in the armpits without other signs of virilization and is more often observed in girls. Only from 10-12 years old it is combined with an increase in the mammary glands, external and internal genital organs. Later, children develop normally. Urinary excretion of 17-ketosteroids corresponds to the age norm or slightly exceeds it. Children with precocious puberty require medical supervision and should be examined periodically.

During puberty, sometimes there is an increase in the thyroid gland II and III degree without dysfunction. Treatment is not carried out. Often, especially in boys, acromegaloid phenomena (also physiological) develop. Perhaps the predominance of masculine or feminine. The prognosis is favorable. In the same period, the so-called pseudo-Freilikhov type of obesity is sometimes noted, somewhat similar in appearance to obesity in adipose-genital dystrophy (see). At the same time, the distribution of fat is uniform with some predominance in the chest, abdomen and thighs. The arms and legs are often shortened. Body length and bone differentiation correspond to actual age. Hypogenitalism is absent or slightly expressed. Urinary excretion of 17-ketosteroids and 17-hydroxycorticosteroids is normal. Basal metabolism is reduced or normal. Puberty occurs at the usual time or somewhat late. Medical treatment is not required.

During puberty, girls with symptoms of basophilism (basophilic cells of the pituitary gland function intensively) have female-type obesity, strips appear on the hips, buttocks, and chest. Blood pressure is often elevated. However, sexual development is not disturbed or even accelerated. Menstruation occurs on time, and the cycle is preserved. The prognosis, as with the obesity options described above, is favorable.

Pubertal wasting occurs predominantly in girls. The first symptoms: lack of appetite, abdominal pain, belching and vomiting, often repeated. The skin is dry, wrinkled. Bradycardia, muffled heart sounds, arterial hypotension, amenorrhea are noted. Unlike pituitary cachexia, there is no atrophy of the mammary glands and hair loss. The main exchange is reduced. Thyroid function is not impaired. The content of 17-ketosteroids in the urine is reduced, after the introduction of ACTH it reaches the norm. Follicle-stimulating hormone in the urine is often absent or reduced. The prognosis is usually favorable. Treatment - requires careful care, chlorpromazine, protein-anabolic steroids. Methandrostenolone (or nerobol) 5 mg per day, nerobolil intramuscularly 25-50 mg once a week (4-6 injections).

The diagnosis, prescription of medications, especially hormones, as well as the prognosis of diseases and conditions during puberty must be approached with caution.

Rice. 2. Girl 2.5 years old: early sexual and physical development (height 110 cm).

Puberty is the time from the beginning to the end of puberty. It begins in boys and girls with hormonal changes, which contributes to the development of secondary sexual characteristics. Children are difficult to tolerate changes, which are always individual. Time frames can be set genetically, but the normal range is very wide. The upbringing and attention of parents determines how this period will pass.

What is this period

Puberty, or puberty, is the period of puberty when a teenager's body undergoes changes that make him mature and fertile. The child becomes more mature not only physically, but also psychologically. Translated from Latin, pubertas means “manhood” or “puberty”. During puberty, many things begin to change: appearance, body, psychology, and even how a teenager perceives himself, people and the world around him.

Experts were able to identify that puberty is triggered by special signals that are sent from the brain to the gonads. In girls - to the ovaries, in boys - to the testes. The gonads respond by producing various hormones that stimulate the development and growth of bones, muscles, brain, reproductive organs, and skin.

In the first half of the period, body growth begins to noticeably accelerate, and ends only with the completion of puberty of a teenager. At first, the differences in the structure of the body of a boy and a girl come down mainly to the genitals. But throughout this period, significant differences begin to form in the form, size, composition and functions of various structures and systems of the body, the most obvious of which relate to secondary sexual characteristics.

At what age does it start

While early puberty is normal for girls, boys often experience delayed puberty. Very often, parents worry about this and take the child to specialists. Although there is nothing terrible in this phenomenon. It is important to know that if a girl's precocious puberty occurs, then this should not be a cause for concern for parents. The beginning of this period is genetically predetermined - the body will begin to change at the same time as that of the parents.

Doctors have established a certain characteristic of the time of puberty: in boys, this age basically begins at the age of ten. The deadline is fifteen years. In girls - from the age of seven, the deadline for its onset is possible at thirteen years.

If until the age of fifteen girls are ahead of boys in development, then later on boys begin to actively overtake girls.

Puberty in both sexes lasts about five years. The start time is always very individual. But if it really started happening very early, then the child's parents can consult a pediatrician. Only with the help of an experienced doctor can you correctly assess the condition of the child and, if necessary, prescribe appropriate tests and additional medical examinations. This will help to find out what is the cause of the failure and deviations from the norm. But serious problems in children are quite rare.

If the extreme age has passed, and the period of puberty has not yet come, then this should be treated. Parents should contact a pediatrician or endocrinologist. It is important at this time not to express your doubts and fears about the normal development of the child himself, because this can cause him psychological trauma and develop complexes - in adolescence, the psyche of children is very vulnerable. It would be best to discuss your concerns with a specialist, and only after that invite the child to the office.

The course of puberty

It is impossible to find two girls or boys who go through everything the same way. But there are several patterns that unite all teenagers. Puberty is triggered in the child's brain by a special hormone - gonadoliberin. Then the pituitary gland is stimulated and luteinizing and follicle-stimulating hormones (LH and FSH, respectively) begin to be produced.

These hormones are present in both boys and girls but affect different parts of the body. In the female body, these two hormones act on the ovaries, due to which estrogen begins to be produced. All of them together prepare the body of women for motherhood.

In the male body, these hormones begin to provoke the production of testosterone and sperm. It is testosterone that is responsible for the changes that occur in a young teenager during this period. Hormones turn children into adults. After this period is over, the person will be completely ready to continue his race. Psychological maturity will come much later.

There are common signs of puberty:

increase in growth;
hair growth;
change in body shape;
the appearance of odors;
deterioration of the skin.

Boys

The onset of puberty in boys is considered by physicians to be the appearance of secondary sexual characteristics. These include:

the appearance of hair in the armpits and in the genital area, legs and arms;
voice change;
penis and scrotum enlargement;
erection;
acne.

It is from them that parents can notice that their child has begun to become an adult. The duration of maturation in boys is different.

The appearance of secondary sexual characteristics in boys begins to change the genital organs, the penis and scrotum increase in size, an erection appears. Nocturnal emissions often occur. Then the prostate gland begins to increase in size and the seminal vesicles come into play.

Erotic dreams and erections in a dream are normal for this age. Acne may cover the skin of the face. Hair in boys during this period begins to appear in a variety of places. If a boy has female-type hair, it should be immediately shown to an endocrinologist - this can be an alarming symptom that may indicate hypogonadism (testosterone deficiency in men).

Male and female pattern hair

In boys, in adolescence, the voice changes, it becomes rougher and lower, which indicates the puberty of a teenager. In just a few months, the voice can become completely unrecognizable. Serious changes take place in the development and structure of muscles and bones, the skeleton begins to form according to the male type: the shoulders expand and the hips seem much narrower compared to the shoulders, and the torso is shortened.

Girls

Puberty in a girl precedes the onset of puberty, which begins from the moment of the first menstruation. The average period of onset of puberty is 11-13 years. But experts have noted that today girls begin to experience puberty earlier - as early as nine or even seven years old (when only primary sexual characteristics should be expressed). Then you should seek help from specialists who will correct this problem. If the deviation is not critical, then parents should not worry. During this period, it is categorically not recommended to treat a girl with any hormonal drugs: they can undermine her health and lead to incurable infertility.

The main changes in puberty are the following factors:

increase in growth;
development of the mammary glands;
change in figure, the appearance of hair on the body;
menstruation;
the awkwardness of the figure.

In the seventh or eighth year of life, girls begin to grow actively, adding 8 cm per year. After a year, a sharp growth spurt stops, and the girl grows by 1–2 centimeters. This pace will continue until the age of eleven. The most active growth spurt is 10 cm per year from 11 to 12 years. In subsequent years, growth will increase by a maximum of 4–5 cm. At this time, weight also increases: instead of the usual one or two kilograms, girls can gain up to eight. If the weight is added faster, you should consult a doctor to avoid obesity.

One of the important factors in the development of a girl in prepubertal is the formation and growth of the mammary glands. There is a change in the nipple and halo, it increases in size. Then the mammary gland itself changes. First, it takes the form of a cone, so it lasts twelve months. A year later, it takes on a round shape. There is hair growth in the perineum and armpits. The figure of the girl becomes more rounded, the hips begin to expand and become rounded, the waist becomes more noticeable. The structure of the hair may change, they become stronger and thicker.

The menstrual period comes, it appears at the age of thirteen or fourteen. This is direct evidence that the body is developing correctly. It is important that menstruation lasts no more than five days. After the first menstruation has come, the girls practically stop growing. The cervix begins to form mucus in a small amount. This leads to the appearance of a whitish vaginal discharge, the so-called teenage leucorrhoea.

In addition to the above factors, during the puberty period, the disproportion of the whole body appears in the figure of girls. This is just a temporary feature that will soon disappear. At this time, parents should explain this to the girl, who can be extremely worried and complex about her unattractiveness. Often the bones begin to grow unevenly: first, the arms and legs are stretched, they become disproportionately long. The face also looks elongated. Even the gait of a teenager becomes angular and awkward.