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Active Lifestyles 
13 - 18 Year Olds
The following characteristics describe the sequence of events in girls as they go through puberty:
- Breasts begin to develop and hips become rounded.
- The increase in the rate of growth in height begins.
- Pubic hair begins to appear, usually within 6 to 12 months after the start of breast development.
- The uterus and vagina, as well as labia and clitoris, increase in size.
- Pubic hair is well established and breasts grow further.
- The rate of growth in height reaches its peak by about 2 years after puberty began (average age is 12 years).
- Menstruation begins, almost always after the peak growth rate in height has been reached (average age is 12.5 years).
Once girls start to menstruate, they usually grow about 1 or 2 more inches, reaching their final adult height by about age 14 or 15 years (younger or older depending on when puberty began).
Boys tend to show the first physical changes of puberty between the ages of 10 and 16 years. They tend to grow most quickly between ages 12 and 15. The growth spurt of boys is, on average, about 2 years later than that of girls. By age 16, most boys have stopped growing, but their muscles will continue to develop. Other features of puberty in boys include:
- The penis and testicles increase in size.
- Pubic hair appears, followed by underarm and facial hair.
- The voice deepens and may sometimes crack or break.
- The Adam's apple, or larynx cartilage, gets bigger.
- Testicles begin to produce sperm.
Reviewed by Dr Stuart Crisp, paediatric specialist registrar
What is puberty?
Puberty is usually defined as the time when the onset of sexual maturity occurs and the reproductive organs become functional. This is manifested in both sexes by the appearance of secondary sexual characteristics - growth of the breasts and first menstrual period in girls, and a first ejaculation (release of semen from the penis) and deepening of the voice in boys.
How will a child's puberty affect the parents?
A year or two before reaching puberty, the child will change physically and emotionally. Their growth increases suddenly, before slowing and finally stopping around the age of 18. The accelerated growth that girls experience in puberty happens at an earlier age than for boys.
At puberty, the child's attitude towards his or her parents is likely to change. Often, children think their parents are hopeless, annoying and old-fashioned. In return, parents may find their child cheeky and sullen. Obviously, it can be a time of conflict.
During puberty, this development continues and the confrontations between teenagers and parents may continue.
It is perfectly natural and inevitable that tensions and controversies between parents and teenagers arise. In fact, it may be more alarming to the parents if there are no conflicts at all, as it may be a sign that their child is hiding their problems.
If teenagers continue to suppress emotional problems, they may eventually have problems establishing a normal relationship with other people.
How do young people view themselves at puberty?
At puberty, most children are uncomfortable with their image. They may not like the way they look. They feel clumsy, shy and insecure.
For boys, their voice breaks and for both boys and girls acne and pimples makes the situation even worse. Few teenagers consider consulting a doctor with these problems and a request by their parents seldom helps.
During puberty your child is developing into a sexually mature adult. Their sexual organs grow and their body changes physically. Boys and girls begin to grow hair under their arms and pubic hair between their legs. Girls develop breasts and boys grow hair on their faces.
During puberty young people want to be like everyone else of their age. So girls may be unhappy if they have their first period before the rest of their class or if they are the first - or last - to develop breasts.
For boys, the growth of pubic hair may cause similar problems.
Puberty - child or adult?
Puberty is a time of contrast as the child shifts between feelings of being a child and becoming an adult.
Friendship with others of the same age may strengthen a teenager's self-confidence. Insecurity may make them want to imitate other people in their age group.
Puberty is a time of life when the child begins to feel liberated. But support from parents is still of paramount importance. Parents are not only a safety net, but also the platform from which the child can jump out and eventually experience the whole world.
