3. ADOLESCENCE and PUBERTY Mamdouh Wahba

4. Adolescence is the transitional period between childhood and adulthood

6. ADOLESCENCE: Latin Word: “Adolescere” Latin Word: “Adolescere” Emerged as a concept in the 1890 Emerged as a concept in the 1890 G. Stanley Hall was the first to provide full definition in 1904 in his book “Adolescence”. G. Stanley Hall was the first to provide full definition in 1904 in his book “Adolescence”.

8. ADOLESCENCE IS THE MOST CRITICAL PERIOD OF LIFE

9. ADOLESCENTS GLOBAL POPULATION 1.3 billion Out of 7.2 billion

10. PUBERTY IS THE FIRST PHASE OF ADOLESCENCE

11. START OF PUBERTY In girls: 9 – 13 years In girls: 9 – 13 years In boys: 10 – 14 years In boys: 10 – 14 years

12. DURATION OF PUBERTY IN GIRLS: 5 YEARS IN GIRLS: 5 YEARS IN BOYS : 6 YEARS IN BOYS : 6 YEARS

13. PUBERTY DOES NOT START AT THE SAME TIME IN ALL BOYS AND GIRLS

14. PUBERTY IS MANIFESTED BY TREMENDOUS, RAPID, PROGRESSIVE CHANGES

15. PUBERTAL CHANGES: PHYSICAL PHYSICAL PSYCHOSOCIAL PSYCHOSOCIAL BEHAVIORAL BEHAVIORAL ANT. PITUITARY

16. PHYSICAL CHANGES

17. IN BOTH BOYS & GIRLS Rapid and marked weight gain, Rapid and marked weight gain, Rapid and marked height growth, Rapid and marked height growth, Activation of sweat glands, Activation of sweat glands, Activation of sebaceous glands, Activation of sebaceous glands, Appearance of body hair Appearance of body hair

18. PHYSICAL CHANGES DURING PUBERTY IN BOYS

19. TESTICULAR ENLARGEMENT First sign of puberty Called gonadarche Gradual increase Reaches adult size in 6 years

20. GENITALIA  Gradual increase  Adult size at 18 years  Erections and orgasm  First dry orgasms  Wet dreams

21. PUBIC HAIR First hair appearance called pubarche Spread to thighs Upwards towards the umbilicus.

22. BODY AND FACIAL HAIR Axillary hair Peri-anal Upper lip and beard Peri-areolar

23. HEIGHT GROWTH More slowly than girls Lasts longer Feet and hands first Then limbs and trunk

24. OTHER CHANGES Voice changes Male musculature Broad shoulders Broader jaws Pubertal gynecomastia

25. PHYSICAL CHANGES DURING PUBERTY IN GIRLS:

26. BREAST DEVELOPMENT: Starts at 10.5 years, Lump under the areola, Thelarche, Size and shape vary much even in the same girl

27. PUBIC HAIR: Appearance of pubic hair is called puberche First appears on labia Extends to mons pubis

28. MENSTRUATION First menstruation is called menarche Average age 12.7 years Initially irregular and anovulatory cycles

29. INTERNAL ORGANS Leucorrhea Increase size of ovaries Increase size of uterus

30. HEIGHT GROWTH: First legs and feet Accelerates between thelarche and menarche Declines after menarche Spine growth

31. OTHER CHANGES Pelvic bones widen Fat deposition

32. PRECOCIOUS PUBERTY Primary : no pathology Secondary: –G–Granulosa cell tumor –M–Malignant teratoma –H–Hypothalamic –S–Supra-renal in boys

34. DELAYED PUBERTY No 2ry sex characters: –T–Turner’s syndrome 2ry sex characters: –I–Imperforate hymen –U–Uterine hypoplasia –T–Testicular feminizing syn.

35. PSYCHOSOCIAL & BEHAVIORAL CHANGES DURING ADOLESCENCE

36. *UNSTABLE MOOD, *IRRITABILITY, *BRISK REACTIONS, *UNHAPPINESS, *ANXIETY, *FEELING BORED, *SENSITIVITY,

37. *WORRYING ABOUT BEING NORMAL, *FEELING NOT BEING LOVED, *MOVING TO INDEPENDENCE

38. *SELF CONSCIOUS, *CONCERN ABOUT APPEARANCE, *OTHERS’ OPINION, *COMPARING TO OTHERS

39. *GET AWAY FROM FAMILY, *CLOSER RELATION TO PEERS, *CHANGING RELATIONSHIPS

40. * CRITICAL SPECIALY TO FAMILY, *REPULSIVE TO SOCIAL NORMS, *OPPOSE AUTHORITY, *STUBBORN,

41. *RISK TAKING, *EXPERIMENTATION, *INTEREST IN OPPOSITE SEX

42. ASSIGENMENT: WHY THERE IS ALWAYS PARENT-ADOLESCENT CONFLICT? WHY THERE IS ALWAYS PARENT-ADOLESCENT CONFLICT? WHAT SHOULD PARENTS DO FOR ADOLESCENTS? WHAT SHOULD PARENTS DO FOR ADOLESCENTS?