Women's Health: Normal Puberty

'Am I normal?'

There is a wide range of ages in which the normal changes of puberty begin. There is no exact order for the development to unfold. Far from being reassuring, this variability only seems to highlight to some girls their own sense of abnormality. The message here is that for the vast majority of girls, the sequence and timing of these changes are normal.

The six important bodily changes that occur in puberty are:

• development of breasts,
• growth of pubic hair,
• growth of underarm hair,
• development of external sex organs,
• growth in height,
• menstruation.

Height, weight and shape

Children between the ages of four and puberty tend to grow in height at a fairly constant rate of about five centimetres per year. Somewhere around the age of ten and a half, girls suddenly begin to grow at six - 12 cm per year for about two years. This is called the growth spurt. Thereafter, growth rapidly falls off to only one to two centimetres a year by the age of 15 and, shortly after that, to almost nothing. During this time proportions change:

• hips widen to help future childbirth,
• waists slim as fat moves from the tummy to the hips and thighs,
• buttocks become more prominent,
• legs lengthen in proportion to the rest of the body.

The growth spurt includes muscle development. As boys have their growth spurt two years later, this is a time for girls to assert their supremacy! Early 'spurters' tend to worry that they will be too tall. In fact, their growth stops earlier, so late 'spurters' may have caught up by the age of 16. Faces also alter, with the nose and jaw becoming more prominent. There is also some deepening of the voice, although not as marked in girls as it is in boys.