During these periods of life, the female phenotype begins to form. In the prepubertal period, the prevention of infectious diseases, proper hygiene, and compliance with the rules of hygiene, in particular the genitals, are very important.
During puberty, almost the same principles of prevention should be used. In addition, a number of other factors should be taken into account. Due to the significant improvement in living conditions, this factor is now less important. However, they do not always pay attention to sufficient ventilation of living quarters, maintaining cleanliness and order, and carrying out the necessary hygiene measures.
In recent decades, television, radio, films, and books have had a great influence on the formation of girls. It is noted that under the influence of these factors, earlier sexual development occurs.
Excessive mental and physical stress during the period of formation of menstrual function can be the cause of its disorders, which are observed approximately 2 times more often than in the general population. Consequently, measures to prevent dysfunction of the reproductive system during menarche are, first of all, the correct alternation of mental and physical labor, as well as a balanced diet.
Infectious diseases, especially chronic ones (pneumonia, tuberculosis, rheumatism, neuroinfections), can cause delayed puberty, which is clinically manifested in underdevelopment of the genital organs, late menarche or absence of menstruation, and subsequently in infertility, miscarriage, early disruption or cessation of menstrual periods. functions. Other factors are also of considerable importance: a sharp change in climate, prolonged exposure to the sun and then swimming in cold water, prolonged stay on damp, insufficiently warmed ground (in early spring, after rain, etc.). These factors can cause the development of inflammatory diseases of the genital organs. At this age, inflammatory diseases occupy an important place in the structure of gynecological morbidity, which in the future can cause the occurrence of other inflammatory diseases of the genital organs. We pay special attention to this, due to the fact that inflammatory diseases of the genital organs can subsequently become one of the causes of infertility, most often in the form of uterine bleeding and the formation of sactosalpinxes. Long-term inflammatory diseases can also cause the development of neuroendocrine diseases and tumors of the genital organs. Thus, timely treatment of inflammatory diseases is a measure to prevent these complications.
In recent decades, a new problem has arisen related to the fact that girls from prepubertal age are in a state of systematic overload: classes in general education and music schools, teaching foreign languages, and often also classes in some sports section. Mental and physical overload from childhood can become one of the causes of dysfunction of the reproductive system.
Often, to prevent obesity, girls at puberty sharply reduce the amount of food they eat. In this case, along with a decrease in body weight, appetite disappears and anorexia nervosa occurs. This condition can cause menstrual dysfunction, including persistent amenorrhea.
Due to the fact that physical education has become increasingly widespread in recent decades, many girls begin to play sports in childhood.
V. G. Bershadsky (1976) studied the state of the reproductive system in the prepubertal and pubertal periods in female athletes (gymnasts and swimmers). More than 1,000 girls who systematically engaged in these sports were examined. The author found that if fairly intense sports activities began at prepubertal age, i.e. at 6-8 years, then the first one, as a rule, occurred in a timely manner, the menstrual cycle was established immediately and the girls showed practically no complaints.
If girls started playing sports later - at the age of 12-14 years, then after different periods of time they developed menstrual dysfunction: algomenorrhea, premenstrual syndrome, opsomenorrhea. It was shown that if sports began at the age of 6-8 years, then a regular menstrual cycle was established immediately in 69% of girls and within 6-12 months in 87%. If classes began at the age of 12-13, then regular menstruation was established immediately in only 41% and after 6-12 months - in 78%.
Prepubertal period
In the twelfth to thirteenth year of life, after the crisis of the tenth year, the period begins that is usually called prepubertal (before puberty). Until now we have not made a distinction between boys and girls, since it was insignificant, but now it is becoming noticeable.
The physiological development of girls begins earlier due to physical maturation. Height suddenly increases and a lot of physical strength is spent on this. As a result, girls begin to get tired faster, they feel less efficient and cannot play sports as before. Often during this period there is a tendency to anemia (if the process progresses, anemia occurs), functional disorders of the cardiovascular system are possible (tachycardia, shortness of breath even with light exertion, frequent sighs). Mental changes are often noticeable: moodiness, bad mood, tendency to depression, reluctance to eat, deterioration in school performance.
Unlike girls, who began to get tired, the opposite process occurs in boys. They are literally bursting with excess vitality, they are overly sensitive to the words of their parents, they slam doors, cannot stand comments, put their feet on the table, stomp their feet, run away, eat cold food, are rude at school and at home, do poorly at school, due to than relatives and teachers experience great stress and pressure.
What are the internal reasons for this restructuring? Children seem to “fall apart” from their body, their shell. Strong internal isolation arises - in this period we are talking about the development of volitional forces, awareness of one’s “I,” and self-affirmation. If during this period it is rational not to help the child, then in the presence of such disproportionate volitional efforts, a growing state of “negativism,” the form will further fall apart. Naturally, parents often turn to doctors in an attempt to help their children. However, the accepted method of prescribing various sedatives does not bring any benefit.
Homeopathic medicines
A much greater effect can be achieved with the help of homeopathic iron and its compounds. In this case, we are not talking about replacement therapy; simply, iron can teach a child to use his volitional efforts correctly.
If there are disproportionate volitional efforts and negativism, it is good to apply a cloth with Ferrum metallicum ointment 0.4% to the area of the gallbladder - daily at night in the form of a compress (from 6 days to 3 months). Often, feeling relief, children themselves ask for this compress. This treatment is especially effective for blondes. Such an ointment is available from the anthroposophical company Vala-R.
If symptoms related to digestion predominate: refusal to eat, pickiness in foods, preference for cold food, it is necessary to give Ferrum carbonicum D30.
If symptoms from the circulatory system predominate: rapid pulse, palpitations, attacks of pallor and lightheadedness, a tendency to anemia (often in girls during this period), Ferrum chloratum D30 should be given.
Girls in case of anemia, which is now much less common, can take Ferrum silicium comp. or Levico comp. - 3–5 grains 2 times a day until the condition improves.
If a child is breathing incorrectly: shortness of breath and lack of air occur for no reason, he cannot cope with stress as before in physical education, it is useful to give Ferrum aceticum D30 and plant acids, for example, malic acid. Previously, in the village they did this: they stuck a nail into an apple, and after a while the child ate this apple. Now you can give apple cider vinegar: add it to your drink (in tea, in juice, one teaspoon at a time).
If problems with thinking arise, for example, inattention, poor concentration, rapid fatigue from activities, then Ferrum metallicum D30 should be given.
In all of the above cases, Ferrum siderium D30 (meteoric iron) works well.
The course of administration in all cases is 4 weeks, 3-5 grains 2 times a week. After a three-week break, the course can be repeated.
From the book Children's Diseases. Complete guide author Author unknownNEONATAL PERIOD, OR INFANTLY PERIOD This stage continues from the time the child is born and continues until the 28th day of life, being divided into two periods: early and late. The early period begins from the moment the umbilical cord is ligated and continues until the 8th day
From the book Music Therapy for Children with Autism author Juliet AlvinSecond period Martin's main problem in life was his anxiety, lack of self-confidence, even in the simplest tasks, which prevented him from establishing relationships with people. The boy always looked for approval, support, became confused if he did not understand something, and
From the book Rehabilitation after myocardial infarction author Mikhail ShalnovThird period Martin's musical development was extremely slow. It was difficult to measure his progress, but the boy had to be encouraged to realize his achievements, despite the fact that the lag in intellectual development was becoming more and more obvious.
From the book Healing Soda author Nikolai Illarionovich DanikovFourth period Martin grew physically and socially, becoming a teenager. He has made progress in many areas. I studied successfully at school, could now read and write, expanded my vocabulary, and began to speak better. Overall, he was nine years old developmentally. He started studying
From the author's bookFirst period The musical gift usually gives rise to the need for music. My relationship with Jeffrey was based on the fact that he saw me first and foremost as a musician who could help him satisfy this need of his. I had to invent special unconventional
From the author's bookSecond period
From the author's bookThird period Geoffrey had severe problems with social integration. He passionately desired to be accepted and popular and at the same time understood his “special” position in school. It was important for him to be in a group and act the same as others, and maybe better
From the author's bookI period Most often, myocardial infarction begins with increasing pain in the chest, often of a pulsating nature. Characterized by extensive irradiation of pain - in the arms, back, stomach, head, etc. Patients are restless, anxious, and sometimes note a feeling of fear of death. Often
From the author's bookII period II period is acute (febrile, inflammatory), characterized by the occurrence of necrosis of the heart muscle at the site of ischemia. Signs of aseptic inflammation appear, hydrolysis products of necrotic masses begin to be absorbed. The pain is usually
From the author's bookIII period III period (subacute, or scarring period) lasts 4-6 weeks. It is characterized by normalization of blood parameters (enzymes), body temperature normalizes and all other signs of an acute process disappear: the ECG changes, at the site of necrosis
From the author's bookIV period IV period (rehabilitation period, recovery) – lasts from 6 months to 1 year. Clinically there are no signs. During this period, compensatory hypertrophy of intact myocardial muscle fibers occurs, and other compensatory mechanisms develop.
From the author's bookI period Heart rhythm disturbances are especially dangerous for all ventricular arteries (ventricular form of paroxysmal tachycardia, polytropic ventricular extrasystoles, etc.) This can lead to ventricular fibrillation (clinical death) and cardiac arrest. At the same time
From the author's bookII period All 5 previous complications and the actual complications of the II period are possible. Pericarditis: occurs when necrosis develops on the pericardium, usually 2-3 days from the onset of the disease. Chest pain intensifies or reappears, constant, pulsating, pain when inhaling
From the author's bookIII period Chronic cardiac aneurysm occurs as a result of stretching of the post-infarction scar. Signs of inflammation appear or persist for a long time. Increased heart size, supra-apical pulsation. Auscultation double systolic or diastolic murmur
From the author's bookIV period Complications of the rehabilitation period are classified as complications of coronary artery disease. Cardiosclerosis post-infarction. This is already the outcome of myocardial infarction, associated with the formation of a scar. Sometimes it is also called ischemic cardiopathy. Main manifestations: rhythm disturbances, conduction disturbances,
From the author's bookMenopause? During menopause, monthly discharge initially stops and then stops altogether. As a result, a woman becomes overweight, has hot flashes and chills with profuse sweating. If she doesn't stop constantly
They are faced with the following question: “Puberty - what is it?” After all, sudden changes in the behavior and development of a schoolchild are visible even to the naked eye. The time when restructuring occurs in a teenager’s body, ending with puberty, is called puberty. At this time, the basic characteristics of the body are laid down, which largely determine character and so on. In young people it occurs at 12-16 years old, in girls - at 11-15 years old.
Physiological changes
So, let’s try to understand in detail the question: “Puberty - what is it?” During this time, adolescent development occurs. The skeletal system is finally formed, changes occur in cerebral activity and even in the composition of the blood. During this period, both increased activity of adolescents and sudden fatigue, causing a decrease in performance, are observed. Often there are disturbances in the coordination of small and large movements, young people become fussy, awkward, and do a lot of unnecessary things. This occurs due to some changes in body proportions, due to a new ratio of muscles and strength, and restructuring of the motor system. As development progresses, there may be deterioration in handwriting and sloppiness. The maturation process also affects speech development. This especially applies to boys. Their speech becomes stereotypical and laconic. During this period, there may also be some unevenness in the development and growth of young people.
It is very important for parents to understand and accept all the complexities associated with the teenage years. Of course, every mother and every father should know the answer to the question: “Puberty - what is it?” At this time, schoolchildren also experience some psychological changes. They become more hot-tempered, rude, and touchy, most often towards their parents. Their behavior is often characterized by excessive demonstrativeness and impulsiveness. Parents may also notice their child’s frequent mood swings, stubbornness, and even protest. Many teenagers become very lazy during this period. Psychologists see the reason for this in sharp and increased growth, which reduces endurance and “takes away” a lot of strength.
Puberty. Signs
Schoolchildren noticeably increase in weight and accelerate their growth. In boys, the voice becomes significantly rougher, hair appears in the armpits and pubic area. Little by little, the beard and mustache begin to grow, the genital organs enlarge, and ejaculation occurs.
Girls' mammary glands actively develop. Hair appears on the pubic area and in the armpits. The labia enlarge and menstruation begins. Girls are becoming more feminine and strive to look good all the time. Quite often the end and beginning do not coincide with the above ages. This may be caused by hereditary developmental characteristics, nutrition, nationality, environmental influences and living conditions. Lucky are those teenagers whose parents know and understand the specifics of such a phenomenon as puberty (that this is the process of a child growing up), because this time will pass for them with minimal grief and worry.
Throughout prepuberty* children become increasingly detached from their parents and seek acceptance from teachers and other adults, as well as peers.
Self-esteem begins to take center stage as children develop the cognitive ability to consider simultaneously the attitudes of themselves and many others around them. For the first time, he is judged on his ability to do socially significant things, such as getting good grades in school or hitting laps in baseball.
Thus, the central psychosocial issue in this period, according to Erikson, is the crisis between effort and worth. The child has the responsibility to conform to the style and ideals of society, so physical or intellectual deviations from a certain norm can lead to social isolation and depression.
Physical development
The average increase in body weight and height during this period is 3.0-3.5 kg and 6 cm, respectively. Growth continues unabated; Each year there are 3-6 growth spurts lasting an average of about 8 weeks each. Throughout the entire period, head circumference increases only by 2-3 cm, which reflects a slowdown in the rate of brain growth; the myelination process is completed by age 7. The child's physique remains constant in middle childhood.
There is a progressive increase in muscle strength, coordination and endurance, which allows children to perform complex movements - dancing, playing basketball or playing the piano. High-order motor skills are the result of both development and training; success is determined by variability in innate skills, interests, and physical abilities. Epidemiological studies have shown a decrease in the overall level of physical development of children over the past 15-20 years. A sedentary lifestyle at this age predisposes to an increased risk of obesity and cardiovascular disease.
The development of the external genitalia does not occur, but interest in the opposite sex and sexual behavior persist and intensify until the onset of sexual development. Masturbation is common, but not in all children. In some cultures, sexual relations begin before children reach puberty.
The role of parents and doctors
“Normal” includes a wide range of concepts related to the size, shape and ability of a school-aged child. Almost equally important is the child’s attitude towards his physical characteristics, which can vary from pride to shame or outright indifference. Concern about one's own “deficiency” leads the child to avoid situations where his physical characteristics may appear, such as physical education classes or examinations by a doctor. Children with actual physical disabilities may experience particular stress. Children may have a combination of medical, social and psychological risks; multifactorial problems are the rule rather than the exception among children at risk for late complications. A routine physical examination provides an opportunity to identify concerns and allay children's fears.
For example, girls often worry about being overweight and may resort to dangerous diets to meet some ideal. Poor height, especially in boys, can lead to poorer performance in school and increase the risk of conduct disorders (although a child's social class remains a major cause of these disorders). The availability of recombinant growth hormone preparations has made it possible to use them in short children, even in the absence of a confirmed deficiency of this hormone. The decision to initiate such treatment must take into account the cost of these drugs, the associated inconvenience for the child and parents, and the significance of short stature for the individual child.
The appearance of a child can cause a certain reaction from parents, provoking them to an unjustified decrease in the child’s self-esteem or the development of vanity in him. Pediatricians can help parents assess the true risk to the child's health and individual variations in what is normal. When taking a history during your child's routine visit, it is important to inquire about regular physical activity. Participation in team sports allows you to develop dexterity, team spirit and physical endurance, but excessive coercion of a child can lead to negative consequences.
Prepubertal children should not participate in competitive sports with high physical and emotional demands (such as weight lifting or American football) because poor musculoskeletal development predisposes them to injury.
* Prepubertal age(from lat. prae- before, before + pubertas maturity, puberty; synonyms: junior school, prepubertal period) - age from 7 to 12-13 years.
In boys it lasts from 2 to 10 years. It is characterized by stable pituitary-gonadal relationships, continued low sensitivity of the gonads to gonadotropic hormones and a high threshold of sensitivity of the hypothalamus to sex steroids. The level of gonadotropic hormones and testosterone decreases compared to the first year of a child's life.
Despite this, the slow, gradual formation of the morphological structures of the testis still continues. Up to 4 years, the testes still have some features of the fetal gonads, in particular, they still retain a certain number of gonocytes. By 4 years of age, gonocytes completely disappear, fetal spermatogonia disappear by 6 years of age. Transitional forms are formed from fetal spermatogonia, which then turn into resting spermatogonia of type A.
Activation of spermatogonia reproduction, up to the appearance of the first resting spermatocytes, begins in boys at the age of 6 - 7 years. From the embryonic period to 6 years, the testis secretes a substance that inhibits meiosis in germ cells. As the testis grows and differentiates, its tissues stop producing this inhibitor and begin to produce a factor that is formed in the rete testis, the epididymis, and stimulates meiosis. Around this time, even a little earlier - from the age of 5 - a lumen begins to appear in the tubules, their diameter increases.
At the same time, differentiation of reproductive epithelial cells into typical Sertoli cells begins. The reproductive epithelium in the seminiferous tubules develops independently of the germ cells [Gabaeva N. S., 1982]. If germ cells die for any reason at this stage of ontogenesis, a normal number of Sertoli cells may remain in the tubules, which subsequently leads to the development of sertoli cell syndrome in aspermia.
The differentiation of Sertoli cells is completed by the time the first spermatids appear in the seminiferous tubules. The completion of the formation of Sertoli cells consists in their loss of the ability to proliferate and form tight junctions between cells - the basis of the blood-testis barrier.
At the same time, the development of other components of the blood-testis barrier - the cells of the inner layer of the intrinsic membrane of the seminiferous tubules - is completed [Raitsina S. S., 19826]. In addition, the degree of development of peritubular tissue depends on the state and nature of differentiation of germ cells. The completion of the formation of the blood-testis barrier coincides with the completion of meiotic prophase and precedes the meiotic division of germ cells; it also coincides with the formation of the lumen and the beginning of fluid secretion by the seminiferous tubules. For the final stages of meiosis, especially complete isolation of spermatocytes and spermatids from external influences is required, which is achieved by their movement into the inner layer of Sertoli cells [Raitsina S. S., 19826].
In the interstitial tissue surrounding the tubules, Leydig cells degenerate towards the end of the child's first year of life. Then, throughout the period before puberty, they are almost absent, which coincides with low testosterone levels.
Quite significant qualitative transformations in the morphological structures of the testis, starting from 6 years of age, described above, coincide with the first quantitative and qualitative changes in the hormonal system of the reproductive system, which are associated with an increase in the specific function of the adrenal cortex [Berezhkov L. F., 1974; Donovan, van der Werff Ten Bosch, 1974]. From 6 to 8 years of age, the production of adrenal androgens with relatively low biological activity, mainly dehydroepiandrosterone and its sulfate, as well as Δ 4 -androstenedione, increases.
There is a certain sequence in the formation of the secretion of various steroids by the adrenal glands and gonads.
Thus, the level of dehydroepiandrosterone in plasma increases first at the age of about 6 years, then from 8 to 10 years the level of androstenedione increases, and only at the beginning of puberty does the secretion of testosterone and estrogens increase. According to Forest et al. (1977), the testes from the prenatal period to puberty produce predominantly androstenedione. By the period of puberty, Leydig cells are able, under the influence of specific enzymes, to convert a significant part of androstenedione into testosterone, which changes their ratio in favor of the latter. Since the biological activity of testosterone is higher than androstenedione, this leads to an increased androgenic effect on target tissues.
"Disorders of sexual development in boys"
P.M. Skorodok, O.N. Savchenko
