1. Always Changing Puberty Education for 4th Graders

2. Class Overview Your body may be changing
Timing is different for everyone – from 9-14 years old
Girls are usually 2 years ahead of boys
Each girl grows at her own pace
In this class we’ll discuss the changes you will go through as you grow up. As you grow you’ll notice changes in how you look and feel. These changes are part of a stage in your life called Puberty.
You may be starting to experience some of these changes now, or you may not. Everyone is different, so don’t worry if your friends seem to be growing more quickly than you
It doesn’t matter when you start; your body will decide when the time is right.
Puberty usually starts between the ages of 9 and 14 and lasts for a few years.
You’ll know that you’re starting to go through puberty when you suddenly begin to grow taller and your body grows into a more womanly shape. Other more specific changes will be discussed throughout this class.

3. Class Guidelines Don’t be afraid to ask questions
Be respectful of your peers
No personal stories
Use appropriate medical terms

4. Class Agenda Puberty Personal Hygiene Nutrition Personal Safety
Physical Changes
Menstruation
Feminine Protection/Cramps
Emotional Changes
Personal Hygiene
Nutrition
Personal Safety
Questions

5. Puberty: What Happens First?
Breast buds appear
Pubic hair in private places
Height and weight increase rapidly
As the breast buds appear, the nipples become raised and this area may be tender.
Fine straight hairs start growing close to the labia.
You may experience growth spurts and changes in weight. Weight gain is normal as your body begins to grow and mature. Make sure you practice healthy eating habits to keep your weight at a healthy level.

6. Puberty: Then What? Hips widen Vaginal discharge
Menstruation may occur
Your hips may start to widen in relation to the waist, giving a more rounded, softer shape.
Your vagina begins secreting a clear, whitish fluid called vaginal discharge.
Menstruation may start for some girls. This usually occurs about 2 ½ years after breast buds and body hair appear.

7. Puberty: What Is Menstruation?
Menstruation is part of the female reproductive process
Average 28-day cycle, but different for everyone
Your period is when you lose fluid at the end of the cycle
Menstruation is part of the female reproductive process when a woman’s body prepares for possible pregnancy.
The average cycle is 28 days long (approximately one month), but this varies from person to person – and even from period to period.
Your period is defined as the monthly discharge of lining of the uterus (endometrium) which passes out of the body through the vagina.

8. Puberty: Periods Usually last 3-7 days Might not be regular at first
Only lose about 7 teaspoons of blood
It doesn’t hurt!
When you start to have periods, they may not be regular. After your first period, the next one might be 2 or 3 months later, and it might last 1 day or 10. Your body will take a while to become regular – maybe 2 years or more.
The average woman loses about teaspoons of menstrual fluid during her period, but only about 7 teaspoons of it is blood. Your body contains more than 5 quarts of blood, so it doesn’t miss the little bit you lose during a period.

9. Puberty: Periods Feminine Protection Options - Pads - Pantiliners
- Tampons
There are 3 types of feminine protection you can use during your period. These include pantiliners, pads, and tampons.
1.) Pads are worn outside your body in your underwear and come in many different sizes depending on the heaviness of your period and
body size.
2.) Pantiliners are smaller and thinner than pads and good to use when your period is light or as a backup in your underwear if you wear
tampons.
3.) Tampons are held in place by the walls of your vagina and expand as they absorb your menstrual flow. They are a good choice if you're
involved in athletic activities, and are the only form of protection you can use while swimming. Make sure to read the important safety
information inside each Tampon box.
Talk to your mom, older sister, school nurse or another trusted adult to help you choose the right form of protection when the time comes.

10. Puberty: Cramps - Pains in the lower abdomen or inner thighs
What are they?
- Pains in the lower abdomen or inner thighs
What can I do to relieve cramps?
- Take a warm bath
- Hold a heating pad on your lower stomach
- Exercise
- Check with an adult before taking
medication

11. Puberty: Emotional Changes
Feelings may change from day to day
Caused by hormones
Don’t worry; it’s all part of growing up!
During puberty you may become more emotional and react more strongly than you did before, regardless of whether it’s a school or peer-related issue. These wide emotional swings are caused by hormones.
Mood swings and feelings are all a normal part of growing up. Don’t be afraid to talk to a parent, teacher, school nurse, or other trusted adult if you are feeling overwhelmed or need help/advise.
As a pre-teen, you may also experience a change in self-confidence as your body grows. This growth can occur faster or slower than your peers, often causing you to feel awkward or embarrassed.

12. Personal Hygiene Sweating Controlling Body Odor
Your body produces more sweat, resulting in body odor
Controlling Body Odor
Bathe/shower daily with soap
Use deodorant or antiperspirant
Put on clean clothes and socks, especially after gym class or sports practice
During puberty your sweat glands begin to produce more sweat. Body odor occurs when bacteria that live on the skin act on the sweat produced by these glands.
To control body odor, the 1st step is to bathe daily with soap and water. This removes dirt and oil from the skin and reduces the bacteria that can lead to body odor. Make sure to shampoo your hair regularly too from root to tip to remove excess oil and keep it feeling clean and fresh.
The 2nd step is to use deodorant/anti-perspirant. Deodorant helps you smell good. Anti-perspirant reduces perspiration and underarm wetness, and helps prevent body odor before it starts.
Body odor can be held by the clothes you wear, so always put on clean clothes after bathing, including undergarments and socks.
If you are in sports, it is especially important to bathe, use deodorant, and change clothes after your practice or game.

13. Personal Hygiene Skin Care Oil glands in your skin become more active
Oil and dead skin cells lead to acne
Cleanse skin twice a day
Don’t worry; acne is a normal part of puberty
During puberty, oil glands in your skin become more active and produce excess amounts of an oily substance called sebum.
Acne (pimples) forms when the skin’s pores become blocked with dead skin cells and sebum. Bacteria can then develop in the clogged pore and cause a pimple.
To help prevent acne, cleanse your face twice a day with medicated acne wash or cleanser.
90% of young people get acne at some point in time, so don’t be alarmed or feel like you are the only one. To prevent scarring, don’t squeeze or pick at pimples, and be patient. Don’t expect acne to disappear overnight.

14. Nutrition Eat healthy foods that help your body grow
Calcium and iron are important minerals
during puberty
Daily recommended caloric intake for active
girls your age is 1,800 calories
Calcium is crucial to optimize bone growth and development. Added protein, phosphorus, and vitamin D build healthy bones as well. Foods and drinks high in calcium include milk, yogurt, and cheese.
Iron is another crucial mineral during puberty that aids in proper growth and improves athletic performance. Iron-rich foods include red meat, iron-fortified cereals, poultry, and green vegetables.

15. Nutrition The USDA recommends the following
servings from each food group per day:
- 6 oz of grains
- 2.5 cups of vegetables
- 1.5 cups of fruit
- 3 cups of milk or other dairy products
- 5 oz of meat and beans
Minimize fats, oils and sweets
Stay active and exercise!
You can log onto for more information on the nutritional recommendations for girls your age, including healthy meal and snack ideas.
Here are some ways to fulfill a serving for each of the 5 good groups:
- 1 serving of grains = 1 cup pasta or noodles
- 1 serving of vegetables = 1 raw carrot
- 1 serving of fruit = 1 slice of melon, papaya, etc.
- 1 serving of milk/dairy = 1 cup of low-fat milk or yogurt
- 1 serving of meat/beans = 3 eggs or ½ cup of cooked beans
Oils are not a food group, and you should minimize your oil consumption to maintain a healthy diet. However, some oils are important for your health. Get your oils from fish, nuts, and liquid oil such as corn, soybean, and canola oils.
Do something physically active every day to stay healthy like running, walking the dog, playing outside, or climbing stairs.
Children and teenagers should be physically active for at least 60 minutes every day, or most days.

16. Personal Safety Dealing with uncomfortable situations
Protective gear for injury prevention
Staying safe
If you ever feel unsafe or uncomfortable, just say no! Keep saying no as many times as you need to. Then tell a trusted adult about what happened so they can help you. Some ideas of adults to talk to include a teacher or school nurse, parent, aunt, uncle, doctor, etc.
Make sure to wear the proper protective gear (helmets, knee pads, etc) when playing sports and other athletic activities to prevent injuries.
When walking alone, always be aware of your surroundings and avoid dimly lit areas with few people, especially at night. If possible, always travel with a buddy or parent when in public places such as the mall, park, etc.

17. Questions
Write question on a notecard, fold it, and place it in the Question Box
Everyone must write something on the notecard
All questions are good
I know you all have questions but may be embarrassed to ask them.
Please write your question on the notecard, fold it, and place in the Question Box.
Everyone must write something on the notecard – if you don’t have a question then write “I don’t have a question” so we will all be writing at the same time.
I will pull the questions out of the box and answer them one at a time.
There is no such thing as a wrong question, so be don’t be afraid to ask about any concerns you may have. Remember to always be respectful of all questions asked.

18. Frequently Asked Questions
What is the white stuff in my underwear?
What can I do about cramps?
How can I prevent leaks when my flow is irregular?
Why is my cycle irregular?
What are the chunks of blood mixed in with my
regular period?
Is it normal to have such a heavy flow?
For those of you that might have a hard time coming up with questions, here are a few examples of common things girls have asked about in the past.
Answers:
What is the white stuff I my underwear?
This is daily vaginal discharge. It begins a year or so before you start to menstruate and lasts for most of your adult life. Some days during your cycle the discharge is wet and liquidy, other days it is thick and rope-like. If you don't like the way it feels or you want to protect your underwear, try wearing a pantiliner to help you feel fresh and dry.
What can I do about cramps?
Try taking a warm bath, holding a heating pad on your lower stomach, or exercising to alleviate cramps. Always check with an adult before taking any kind of pain medication.
How can I prevent leaks when my flow is irregular?
It is not unusual for your period to be light one day and heavy the next. To prevent leaks you should change your pad more often and/or use a higher absorbency pad. Pads should be changed every 2 to 4 hours. It is a matter of personal choice for any girl to move on to using tampons. You should gather information and talk with your mother and read the important safety information in each tampon box before you try them.
Why is my cycle irregular?
Having an irregular cycle, as well as a changing flow, is very normal during the first year or two after you start menstruating. Your body just needs time to adjust. If you are very concerned, keep a menstrual calendar and record each period, including the flow pattern. Bring the calendar with you when you have your next doctor's appointment and explain the situation.
What are the chunks of blood mixed in with my regular period?
Menstrual fluid is not just liquid - it is made up of blood and tissue from the uterine wall. The "chunks" of blood are usually referred to as "clots" - are actually larger pieces of the endometrium (the uterine lining). These are a normal part of your period and are nothing to worry about.
Is it normal to have such a heavy flow?
Each woman is unique. If you can wear a super plus tampon for more than an hour or two without leaking, and your period is less than 10 days long you are fine. If you have any concerns, talk to your doctor at your next exam.