Health Education in Puberty: From the standpoint of an obstetrician gynecologist.
Puberty in females refers to the period in which sexual capacities develop under the influence of female hormones produced in the ovaries. Obstetricians gynecologists provide health education and other support to children so that every girl can experience sound growth of her body and mind and reach sexual maturity (ability of pregnancy and childbirth and self reliant motherhood) A girl entering puberty experiences her first menstruation, subsequent establishment of regular menstrual cycles, and the growth and maturation of genitalia (ovaries, uterus, breasts, vulva and vagina, etc. accompanied by considerable psychological and behavioral changes (independence from her mother, awakening of interest in the opposite sex, and sexual behaviors) Menar che occurs in about 80% of girls by the 1st year (age 12 13) of junior high school and in about 90% of girls by the 3rd year (age 14 15) A series of events precedes the onset of menarche. The lowering of the sensitivity level of sex hormone in the brain (hypothalamus) combined with releasing of central inhibition resulting from increased leptin secretion and other changes, enhances and activates the secretion pulses of gonadotropin releasing hormone (GnRH) This in turn acts on the pituitary gland to promote the secretion of gonadotropins (follicle stimulating hormone [FSH] and luteinizing hormone [LH] which promotes the production and secretion of sex steroid hormones (estrogen [E] and progesterone [P] from the ovaries. Finally, the feed back to the higher center completes the hypothalamus pituitary ovarian axis. In a woman's lifetime, puberty is the only period in which the concentrations of sex steroid hormones from the ovaries increase with age. Within each menstrual cycle, the levels of E and its precursor steroids known as ovarian androgen (A) increase during the first half of the cycle before ovulation, and both decrease after ovulation. The level of P increases after ovulation and then declines with E unless pregnancy takes place. The stimuli of these sex hormones secreted from the ovaries in regular periodical cycles induce the development of sex functions and the gradual maturation of maternal functions.
Japan Medical Association journal JMAJ