This page supplies basic information on the changes occurring in the female body during puberty. It should only be use to obtain information and not to diagnose or to treat medical conditions.

Puberty and adolescence is an important stage in a women's life, with major changes occurring in her body. This is the period when the secondary sexual characteristics start developing. Pubic hair starts growing, hair appears in the arm pits and the breasts begin to develop. The following step is the occurrence of the first menstrual period. This first period is scientifically called the menarche. Full sexual maturity is achieved when menstruations are regular and ovulation occurs. Her body is now ready to conceive and reproduce life.

The age of onset of puberty and of the menarche is decreasing. Over the last hundred years there was marked drop in the age when girls become sexual mature.

The first menstruation is usually anovulatory and the bleeding can be heavy and prolonged. Normal regular periods are usually obtained within 12 months, although this period may vary. When is abnormal bleeding a cause for concern? There is difference of opinion but our advise will be that medical attention is necessary when they stay abnormal for longer than 12 months or if you are concerned by other aspects. Examples are severe bleeding, continuous bleeding or period cramps. It is difficult to define excessive bleeding but we think any bleeding that can't be controlled by normal sanitary measures should be further investigated. Prolonged bleeding is also difficult to define but we think that bleeding that last longer than 10 days should also be investigated.

The whole process is still not completely understand and some not yet discovered factors may also play a role.

Some of the early follicles regress before they ovulate causing estrogen levels to drop and this usually causes the first menstruation. The first periods are thus frequently anovulatory and irregular.

Eventually a follicle will reach maturity and ovulation will occur and a normal fertile menstruation cycle commences.

Unseen changes occurring in the ovaries and womb during puberty are illustrated in the next part.

The ovary before puberty.

The next drawing show the presence of a follicle in the ovary. The real Graaffian follicle that bulges into the peritoneal cavity usually only develops towards the end of puberty. Follicles develop but regressed and stop functioning without releasing an egg cell. When these follicles cease to function , the estrogen levels drop and the endometrium is discarded. The first few cycles might therefor be irregular and heavy. The cycle should become regular within a few months.

The next drawing shows the endometrium during puberty. This is before menarche (the first menstruation)

The endometrium is thicker but not as thick as the preovulation ovulation endomtrium endometrium. (Compare with the endomtrium during normal menstruation .

The next step is at the end of puberty when the cycle will be normal and the changes discussed at the normal menstruation and the normal ovary will occur in the uterus and the ovaries.

At what age should the female body be completely developed and a should a normal cycle be present? Full sexual maturity is usually achieved within 12 -24 moths after the first menstruation(menarche) and the first menstruation occurs between 11-13 years on average. This age differs in different parts of the world and in different populations groups and should only be used as a sough guide.

For which conditions during puberty is medical help nessary or what is abnormal?
1. Menstrual pain
2. Absence of secondary sexual characteristics ( breast , pubic hair ) at age 16.
3. Acne
4. Obesity or excessive weight loss (anorexia).

Prevent emotional and self image problems and have acne treated. In many cases (especially severe cases) it will need a team effort from both a gynecologist and dermatologist.

Obesity and irregular menstruations could be the early warning signs of diseases like polycystic ovaries (PCOS).