2. Objectives
By the end of class student will be able to;
1. Define reproductive and sexual health
2. discuses changes during puberty
3. Explain common problem occur during puberty
4. Describe Nursing care and counseling during puberty
3. Reproductive health
Reproductive health is a state of complete physical, mental and
social well being and not merely the absence of disease and
infirmity, in all matters relating to the reproductive system and to
its functions and processes.
4. Sexual health
A state of physical, emotional, mental and social well-being in
relation to sexuality; it is not merely the absence of disease,
dysfunction or infirmity.
5. Cont…
• Sexual health requires a positive and respectful approach to sexuality and
sexual relationships, as well as the possibility of having pleasurable and
safe sexual experiences, free of coercion, discrimination and violence.
• For sexual health to be attained and maintained, the sexual rights of all
persons must be respected, protected and fulfilled.” (WHO, 2000)
6. Puberty
• It is the time when our bodies change toward an adult body
• Puberty is a time of great change and growth
9. Physical change
• As a result of rising hormone levels, physical changes are
triggered in the body and the reproductive organs begin to
work.
10. Physical change in girls
The changes girls will notice between 9-16 years are:
A rapid growth in height and breasts beginning to grow
Hair growth under the arms and between legs
Hips becoming wider
A curvier appearance to the body outline due to fat being
laid down under the skin
11. Cont…
A slightly deeper voice; and
The menstrual cycle beginning with their first period.
These changes happen over 2-3 years.
12. When we talk about these things it is normal to feel?
Curious Disgust
Comfortable
Shy Embarrassed Excited
13. Physical change in boys
The changes boys will notice between 11-17 years are:
A rapid growth in height
Hair growth under arms, between legs and on the face
A widening of the shoulders
Muscles becoming more developed creating an angular outline to the
body
14. Cont…
A much deeper voice – called ‘breaking’; and
The enlarging of the reproductive organs and beginning of the sperm
production
Nightfall (ejaculation during sleep)
These changes happen over 3–4 years.
15.
16. Emotional change during puberty
The huge changes that take place in the body can make puberty an
emotional rollercoaster.
These teenage mood swings can be caused by:
• The brain still developing – especially the area in charge of impulse
control and managing risks and consequence
• Hormonal fluctuations of oestrogen and testosterone
• The frustration of changing from a child to an adult
• Wanting independence and control
• Peer influences and the desire to belong to peer group
17. Cont…
• The beginning of sexual responses to others
• Awareness of body image
• Self-esteem
18. Spiritual changes at puberty
• We begin to question values instilled at home due to exposure to other
value systems in our peers.
• We begin to look outside the immediate family for guidance about our
beliefs, values and purpose in life.
• Influence of and approval from peers can begin to matter more than
parental influence.
19. Social changes at puberty
• We spend more time with peers than family.
• There is more opportunity and likelihood of risk taking behaviour when
outside adult supervision.
• We begin to experiment with behaviour associated with becoming an
adult.
20. Cognitive changes at puberty
• Our brain development and gender differences can impact on learning
styles and problem solving approaches.
• Maturity levels and hormonal changes can begin to impact on behaviour
in classroom.
21. Cont…
• Subjects, teachers and learning preferences can begin to shape
interests, skills and abilities.
• We become aware that there are many ways to be smart and
many pathways through education.
22. Cont….
• Genes mostly determine how tall you will grow, the color of
your hair, the size and overall body shape.
• Other things that affect our body are the foods we eat, how
active we are and how much sleep we get.
23. Stage of puberty in female
1=Stage One
• Between the ages 8 and 11
• The ovaries enlarge and hormone production starts, but external
development is not yet visible.
2=Stage Two
• Ages of 8 and 14,the first external sign of puberty is usually
development.
24. Cont…
• The area around the nipple (the aureole) will increase in size.
• The first stage of pubic hair may also be present
• Height and weight increase .
25. Cont…
3=Stage Three
Age 9 and 15
Breast growth continues
pubic hair gets coarser and darker.
whitish discharge from the vagina may be present.
first menstrual period begins.
26. Cont…
4=Stage Four
• Age 10 to 16
• Pubic hair may begin to have a more adult triangular pattern of
growth.
• If menarche did not happen in Stage Three, it should start now.
• Ovulation also occur in this period But it will not necessarily occur on
a regular basis. (It is possible to have regular periods even if
ovulation does not occur every month.)
27. Cont…
5=Stage Five
• Ages 12 and 19
• Full height is reached
• ovulating regularly.
• breasts are developed fully for the body.
28. Pubertal stages in boys
1=Stage One
• ages nine and 12
• No visible signs of development occur, but, internally, male hormones become a
lot more active.
2=Stage Two
• Ages nine to 15
• Height increases and the shape of the body changes.
• Muscle tissue and fat develop
• The aureole, the dark skin around the nipple, darkens and increases in
size.
29. Cont…
• The testicles and scrotum grow,
• the penis probably does not grow.
• A little bit of pubic hair begins to grow
30. Cont…
3=Stage Three
• Ages 11 and 16
• The penis starts to grow
• Pubic hair is getting darker and coarser
• Grow in height, and even their faces begin to appear more mature.
• The shoulders broaden, making the hips look smaller. Muscle tissue
increases and the voice starts to change and deepen.
• Finally, facial hair begins to develop on the upper lip.
31. Cont…
4=Stage Four
• Ages 11 to 17
• At this time, the penis starts to grow in width
• The testicles and scrotum also continue to grow
• Hair may begin to grow on the anus.
• Underarm and facial hair increases as well
• Skin gets oilier, and the voice continues to deepen.
32. Cont…
5=Stage Five
• Age 14 to 18
• Boys reach their full adult height
• Pubic hair and the genitals look like an adult man's At this point, too,
shaving is a necessity.
33. What will I look like when I grow up?
That depends mostly on your heredity, the genes you got when an egg cell
and a sperm cell from your birth parents came together to make the cells
that developed into you.
35. What about feelings?
You may have mood swings – happy one day, sad the next.
You may love your friends or family at times and not want to have
anything to do with them at other times.
Sometimes you may feel grown-up, other times like a kid
There may be lots of tears and arguments.
Changing hormones cause some of these feelings.
36. Sexual feelings
• You may think about or have dreams about things such as:
• Being touched
• Flirting
• Falling in love
• It could be someone your age, someone older, someone you know or
someone you don’t know like a celebrity.
• It might be someone of your sex or someone of the opposite sex or both.
37.
38. Common problems during puberty
• Common problems during puberty include mental and emotional issues,
such as stress and depression.
• Eating disorders such as anorexia and bulimia (If left untreated, an
eating disorder can cause a person to experience a delay in puberty as
well as other physical issues, such as heart problems, bleeding in the
esophagus, and even death.)
• Some teenagers reach puberty before their friends and others develop
much later.
• School pressures can additionally put a teenager under a lot of stress.
39. Cont…
• Starting puberty early or late are common problems during
adolescence also feel uncomfortable or nervous about their
body.
• Acne and pimples are common and can be embarrassing
• Body odor becomes much more noticeable
• Boys usually experience a deepening of the voice
• Changes in the body may cause girls and boys to become
overly concerned with their weight
40. Cont….
• Some teenagers are unable to cope with problems during adolescence
and may develop behavioral problems during this time such as fights,
underage drinking and illegal drug use, and other illegal activities.
• some teenager may first show signs of disorders such as schizophrenia
or conditions such as depression.
• Depression among teenagers can be due to biological and genetic
conditioning or as a result of stress.
• Although a teenager's life may seem carefree, it usually contains a lot of
stress due to school and social pressures.
41. F I S T S
Fighting
Injuries
Sex
Threats
Self-defense
