What is Adolescence?
Phases of Adolescent Growth
Pubertal Milestones for Girls
Pubertal Milestones in Boys
What are the effects of physical changes on adolescence?
Developmental Impact of Puberty-Rites of Passage
Psychological responses to pubertal events
What is Adolescence?
Adolescence is defined by the World Health Organization as the period of life between 10 to 19 years of age. While puberty refers to the physical and sexual maturation of boys and girls, the term adolescence refers to the behavioural characteristics of this period, which is influenced both by culture as well as physical changes.
Adolescence is a period of growth beginning with puberty and ending at the beginning of adulthood; it is a transitional state between childhood and adulthood. The period has been likened to a bridge between childhood and adulthood over which individuals must pass before they can take their places as grown adults.
Adolescence comes from the Latin verb adolescere, which means to “grow up” or to “grow to maturity”.
Phases of Adolescent Growth
1. Pre-Puberty or Pubescence (Early Adolescence- Age 8-12 years):
This is a period of about two years before the onset of puberty. The exact age, however, depends on factors such as heredity, nutrition and the sex of the child. In most of the industrialised societies, these two processes normally start between 8-10 years of age.
However, in the developing countries where more than one-third of the total children are malnourished or undernourished, the onset of these two processes may get delayed beyond the normal limit. Moreover, within the Third World societies, there is a marked variation in terms of socio-economic characteristics between the rural and urban areas. Recent research suggests that exposure to nudity and obscenity mainly through the mass media in the urban areas stimulates the thought process and the pituitary glands, thereby causing an early onset of adrenarche and gonadarche.
Pubescence is used to denote the whole period during which physical changes relative to sexual maturation are taking place.
On an average, boys enter puberty two years later than girls. At this time the pituitary (a gland that secretes hormone and is located at the base of the skull) and hypothalamus (a part of the brain) begin sending out new hormones that trigger the pubertal changes. Both boys and girls exhibit changes that include sudden increase in height and weight, the development of secondary sex characteristics (the appearance of being a man or woman), and increased sexual interest (sex drive).
Most males and some females exhibit an adolescent growth spurt exceeding 14 centimeters per year for a short period of time resulting in changes in body proportions. Weight gain results from increased muscle development in boys and body fat in girls. The sweat glands become more active, and the sweat develops an odour. Oil glands become more active, and acne may appear.
The secondary sexual characteristics start appearing earlier for girls than for boys, for example, breast budding, appearance of pubic hair and a little white vaginal discharge.
2. Puberty (Mid Adolescence, Age 10-16 years):
It is the period in which biological changes reach their climax. In more developed societies, this phase begins by the tenth year of life in the majority of females. In the tropical countries, the beginning of this phase (10-12 years) has dropped surprisingly by 2-3 years over a period over the last five decades. Available research shows that a hormonal (endocrinological) factor rather than nutritional correlates is responsible for this change.
Several physiological changes take place during this period, the most prominent in girls being the onset of menstruation (menarche) and nocturnal emissions or wet dreams (spermarche) in boys. In girls, the bodily change continues to include the enlargement of breast, widening of hips and the appearance of pubic and underarm hair. In the case of boys, the shoulders broaden, the length of bones in arms and legs increase, and there is an increase in the amount of body and facial hair.
Puberty usually occurs in girls between 10 to 15 years of age. The onset of menstrual periods (menarche) is one of the most visible signs that a girl is entering puberty. Before having the first menstrual period, the pubescent girl will normally experience a phase of rapid growth, especially an increase in height, breast enlargement, pubic, armpit, and leg hair growth, clear or whitish vaginal secretions, and increased hip width.
The rate at which breasts grow and develop varies greatly and depends of the deposition of fat-pads beneath the skin. The development of fat-pads is different for each young woman and depends on many factors like heredity and nutrition.
Pubertal Milestones in Girls
Every girl enters into puberty at her own time. The average age at puberty for girls in India is found to be around 13.1 years. There is a great deal of variation in terms of the average age at menarche between the rural and urban areas, as well as across various socio-economic and ethnic groups. This variation depends on factors such as body girths, weight, and nutrition.
Five Stages of Puberty – Girls
1 . Age Range: Usually 9-12. Average 10.5
In Stage 1, there are no outward signs of development, but a girl's ovaries are enlarging and hormone production is beginning (adrenarche).
2 . Age Range: Usually 10-13. Average: 11-12
The first pubertal change is the breast development. Pubic hair development follows shortly after breast development. Hair under the arms appears around 12 years of age. The first sign is typically the beginning of breast growth, including “breast buds” in which a small mound is formed by the elevation of the breast and papilla (nipple). The areola (the circle of different coloured skin around the nipple) increases in size at this time. A girl may also gain considerable height and weight. The first sign of pubic hair produces long, soft hair (fine and straight) that is only in a small area around the genitals.
3 . Age Range: Usually 12-15. Average: 12-13
The breasts continue to enlarge. Eventually, the nipples and the areolas will elevate again, forming another projection on the breasts. At the adult state, only the nipple remains erect. Pubic hair coarsens and becomes darker as it continues to spread. The inner length of the vagina starts enlarging and may begin to produce a clear or whitish discharge, which is a normal self-cleansing process. Most of the girls experience their first menstrual period late in this stage but it remains irregular.
4 . Age Range: Usually 13-16. Average: 14-15
There may be an increase in hair growth, not only in the pubic area, but also under the arms and on the legs. It may spread to the thighs and sometimes up the stomach. By this time, ovulation begins in some girls, although it does not typically happen in a regular monthly routine until Stage 5.
The females' body shape also begins to change. There may be not only an increase in height and weight, but the hips may get wider and the waists get smaller. There may also be an increase in fat in the buttocks, legs, and stomach. The body size will increase, with the feet, arms, legs, and hands sometimes growing faster than the rest of the body. This may cause the adolescent girl to experience a time of feeling clumsy.
As the hormones of puberty (androgen) increase, adolescents may experience an increase in oily skin and sweating. This is a normal part of growing. It is important to wash daily, including the face. Acne may develop.
5 . Age Range: Usually 15-18. Average: 16-17
This is the final stage of development, when a girl is physically an adult. Breast and pubic hair growth are complete, and full height is usually attained by this point. Menstrual periods are well established, and ovulation occurs monthly. If the egg is fertilized with a sperm, it will grow into a baby inside the uterus. If the egg is not fertilized, the tissues and the lining inside the uterus are not needed and are shed through the vagina as menses. Two third of the menstrual discharge is blood, the remaining one third is mucous, fragments of uterine lining, and cells from the vaginal lining. The blood of menstruation is also different from the blood circulating through a woman's body in that it does not have the ability to clot, since it must pass through the cervix and flow out of the body without coagulating.
There are no standard norms for girls to attain each milestone of puberty by a specific age, especially in the developing countries. The age at which pubertal milestones are attained varies greatly across class, caste, race and ethnicity, and is influenced by activity level and nutritional status. Girls with low body fat (e.g., competitive athletes) may face a significant delay in menarche (up to a year or more).
Girls begin puberty with skeletal growth and breast budding, followed by the development of pubic hair, auxiliary hair and menarche.
Pubertal Milestones in Boys
Puberty usually occurs in boys between 13 to 15 years of age. Unlike girls, there are no visible signs that tell a boy that he has entered puberty. Hence, it becomes difficult to know for a boy exactly when his puberty occurs. The changes occur, but they occur gradually over a period of time rather than as a single event.
Every boy enters into puberty at his own time and there is differential development of several pubertal milestones across class, castes, race and ethnicity. The attainment of pubertal milestones also varies widely between rural and urban areas and depends on factors like heredity and nutrition. Initially, boys have testicular enlargement followed by the appearance of pubic hair, enlargement of the penis and spermarche. Skeletal and muscle growth are late events in male puberty. It is important to keep in mind that any variation from this standard system is not abnormal unless it is pathologic.
The following table represents the pubertal attainment of boys and the average age of attainment according to Tanner and Marshal. Please note that this scheme is not a normative principle of attaining puberty and any aberration from this standardised system, is not abnormal unless it is pathologic.
Five Stages of Puberty- Boys
1 . Age Range: Usually 11-13 years. Average 12 years
The beginning of adrenarche. No outward signs of sexual development but the increased androgen production in the body prepare a boy for undergoing the pubertal changes that become apparent in the second stage. Many boys in the transition phases between stage 1 and stage 2 may experience an enlargement in the size of the testicles and scrotum. At this point, the penis does not enlarge.
2 . Age Range: Usually 12-15 years, Average 13.5 years.
First appearance of pubic hair around 13.5 years of age that produces long, soft hair (fine and straight) and covered only in a small area around the genitals. The scrotum and testis start enlarging that is accompanied by reddening and folding of the skin. The penis enlargement begins approximately one year after the testicles begin enlarging.
3 . Age Range: 13-16 years, Average: 14.5 years
The penis starts enlarging mostly in length, although there may be small changes in the diameter of the penile shaft. Pubic hair coarsens and becomes darker as it continues to spread. Body size increases. Some boys may get some swelling in the area of their breasts as a result of the hormonal changes that are occurring. Most boys have the capacity to ejaculate at this stage. They also might experience nocturnal emissions or wet dreams.
4 . Age Range: 15-18 years, Average 16.5 years
Voice cracks. Further enlargement and development of the scrotum and testis takes place and pubic hair thickens. Other changes involving the pubic hair include curling and coarsening in texture. These changes continue throughout the fourth stage accompanied by enlargement of the penile glands with thickening of hair in the pubic area. There may be an increase in hair growth on the face, under the arms and on the legs.
5 . Age Range: 16-19 years, Average: 17.5 years
Stage five is the completion of sexual maturation. The penis, scrotum and testis are fully matured and are adult-sized. Pubic hair fills the pubic area and extends onto the surface of the thighs and up the abdomen. Pubic hair growth is complete, and full height is usually attained by this point. There is an increase in oily skin, pimples and sweating.
Post-puberty (Late Adolescence)
Late adolescence broadly corresponds to the Tanner Stage 5 described above. In this phase, the changes that were initiated during puberty continue to grow while there is a significant decrease in the rate of growth per year. The rate of growth ultimately stops after reaching the optimum. The body acquires the size and shape of an adult. The menstrual cycle of girls become well established during this period. This period also marks the transition from the dependence of childhood to the relative autonomy of the adulthood.
What are the effects of physical changes on adolescent?
In the Indian scenario, early maturing girls are more likely to experience pressure from their family for marriage before they are emotionally ready.
The Developmental Impact of Puberty
The biological changes associated with puberty are of special significance both to the young people themselves and to their community, but the ways these changes are interpreted and portrayed varies with cultural circumstances.
Rites of Passage- In many societies, the transition to adolescence are recognized by ritual. These ceremonies are often public events that herald the contributions to society the young person is expected to make in his/her adult life. In some culture it has been found by the anthropologist, Margaret Mead, that girl’s first menstruation is accompanied by spiritual rites that symbolized her emergence as a woman ready to become a productive member of the community.
Psychological responses to pubertal events
the events of puberty are rarely talked about publicly by the individuals who are experiencing them or by their community. Until fairly recently, when people recalled menarche or their first ejaculations it was often in negative or comic terms. Both boys and girls are initially secretive about the onset of nocturnal emissions and menarche. In a study it has been found that girls’ attitudes and beliefs about menstruation are only in part a result of their direct experience. In fact a girl’s physical symptoms during menstruation are often correlated with the expectations she had before menarche. Girls who reported unpleasant symptoms were more likely to have been unprepared for menarche, to mature early and to be told about menstruation by someone they perceived negatively. Similarly the responses of boys to their first ejaculations depend on the context in which it occurs.
Compiled from: Tanner JM. Growth at adolescence. 2d ed. Oxford: Blackwell; J. Geoff Malta, Adolescent Therapist, Puberty 101 Archives (A)
Compiled from: Tanner JM. Growth at adolescence. 2d ed. Oxford: Blackwell; J. Geoff Malta, Adolescent Therapist, Puberty 101 Archives (B)