1. The Anatomy of Puberty… from the Inside-Out from Top-to-Bottom from Beginning-to-End Everything you ever wanted to know about puberty…but were afraid to ask December 2010 Richard E. Kreipe, MD, FAAP Division of Adolescent Medicine Golisano Children’s Hospital University of Rochester Medical Center ACT for Youth Center of Excellence Cornell University Family Life Development Center Cornell University Cooperative Extension of New York City New York State Center for School Safety University of Rochester Medical Center Div. of Adolescent Medicine Text Copyright © 2010 by ACT for Youth Center of Excellence

2. Outline  Define terms related to puberty  Key internal and external changes in body  Common concerns and normal variants  Resources

3. Terms Related to Puberty  Gland: organ that produces hormones  Hormones: chemical messengers that travel in the bloodstream to affect other part(s) of the body  Hypothalamus: gland deep in brain that makes hormones to stimulate the pituitary  Pituitary: small gland below hypothalamus that makes hormones (FSH, LH) stimulating sex glands

4. www.typefreediabetes.com/v/vspfiles/templates/TypeFree/i mages/images_files/hypothalamus%20&%20pituitary.jpg

5. Terms Related to Puberty  Gland: organ that produces hormones  Hormones: chemical messengers that travel in the bloodstream to affect other part(s) of the body  Hypothalamus: gland deep in brain that makes hormones to stimulate the pituitary  Pituitary: small gland below hypothalamus that makes hormones (FSH, LH) stimulating sex glands  Sex glands (gonads)  Ovary: eggs; estrogen, progesterone  Testicles (testes): sperm; testosterone  Reproductive organs  Uterus (womb) →Vagina → Vulva (labia or lips)  Penis and Scrotum (sac or bag)

6. www.health.com/health/static/hw/media/medical/hw/h9991281_001_1.jpg

7. www.health.com/health/library/mdp/0,,hw143376,00.html

8. http://www.netterimages.com/image/9033.htmhttp://www.netterimages.com/image/9033.htm Publication License NI0003842

9. Physical Changes of Puberty in Males

10. Physical Changes of Puberty in Females

12. Major Features of Puberty  Hormone changes  Sex organ changes (reproductive capacity)  Secondary sex characteristics  Organ changes (eg  lymphoid; brain maturation)  Growth Spurt  Weight increase (Girls  fat; Boys  lean)

13. Between 10 and 14 years of age, the average girl’s weight increases from 72 to 112 pounds, a total of 40 pounds!

14. Additional Features of Puberty  Sequence of events  Females  Breast development  Growth spurt  Menses  Males  Testicles enlarge  Penis enlarges  Growth spurt  Onset and Tempo (Velocity)  Early developers grow more quickly in height than late developers

15. Average Age for Pubertal Events 8-11 12 131415161718 8.3 cm/yr 9.5 cm/yr Peak Height Velocity Menses Breast Black 9 yo; White 10 yo 8-11 12 131415161718 Testes Penis 2 3

16. Common Adolescent Concerns About Puberty  Onset  Too early  Too late  Height  Too short  Too tall  Acne, Body Odor  Menstrual periods  Irregular periods normal  Ovulation: Pregnancy possible  Nocturnal emissions  “Wet Dreams”  Ejaculation: Release of sperm

17. Resources  Stages of Adolescent Development http://www.actforyouth.net/documents/fACT%20Sheet05043.pdf http://www.actforyouth.net/documents/fACT%20Sheet05043.pdf  American Academy of Pediatrics—Healthy Children Website www.healthychildren.org/English/agesstages/gradeschool/ puberty/Pages/default.aspx www.healthychildren.org/English/agesstages/gradeschool/ puberty/Pages/default.aspx  Young Men’s Health.Org www.youngmenshealthsite.org/menu_genhealth.html#puberty www.youngmenshealthsite.org/menu_genhealth.html#puberty  Young Women’s Health.Org www.youngwomenshealth.org/genhealth_menu.html#puberty

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