Puberty

Women’s Health is such a vast field that it is impossible to condense it in a few pages. A Woman passes through many stages in her life right from Childhood, Puberty or Adolescence, Adulthood [Reproductive age], Perimenopause and Menopause and finally Postmenopausal /Geriatric. Each stage has problems and diseases that are specific for that stage. Lets take each stage and discuss few important conditions and problems associated with it.

Puberty is the period when a girl undergoes physical changes related to secondary sexual characteristics leading to her getting her first menstrual period. The average age nowadays is around 10 to 12 years though there are cases as early as 8 and as late as 15.The most frequently faced issue in this stage is of Irregular periods. We first have to understand that the initiation of periods is a complex interaction between various glands and our higher centres in the brain. So, the external environment, stress, exercise [either too much or lack of also affects it. This entire axis HPO as it is known, takes some time to mature. So, getting irregular periods for the initial 2 to 3 years is not alarming at all. I have seen anxious mothers rushing to doctors and starting hormonal treatments. Our human body is a complex, highly organized, self-healing, marvel that we humans cannot duplicate. Best is to give it time to mature and if it persists beyond 3 years post puberty, then consult your doctor. Of Course, if the bleeding is heavy or extremely painful ,then treatment is advisable.

The second common problem in this group is either heavy or scanty periods and painful periods. If the bleeding is so heavy that the person becomes anaemic and weak, then a doctor must be consulted. Similarly, if the periods are so painful that the routine gets affected as in being unable to attend school, then a doctor has to be consulted. Here, I would like to stress that there is no harm in giving specific pain killer to your child if she is in pain. People have a preposterous notion that these medicines are habit forming or addictive. The other frequently consulted problem is regarding overweight issues, development of acne and excessive facial hair. This is a temporary phase of the hormonal axis maturing and the hormones balancing each other. In most of the cases, proper hygiene and skin care is enough. In few cases only where the acne eruptions are large and painful, a dermatologist’s intervention is needed. Besides these, mood swings, eating disorders, irritability and anger issues are few problems faced by the adolescents. Of course there are few cases of failure of attaining periods by 16 years of age. There are many causes for the same that needs thorough investigation and treatment.

Most of these problems can and should be treated with non-medical , adjuvant treatment. Exercise and balanced diet are the two main pillars of the treatment. Exercise has been shown not only to help reduce the weight ,release ‘feel good substances’ but also helps in maintaining hormonal balance .Similarly ,a well balanced,nutritious diet is equally important. Nowadays lots of diet fads are the rage like the keto diet, intermittent fasting, gluten free diets or turning vegan. A word of caution here.