Can I grow more after 19

Common problems in adolescent gynecology

Puberty development

In girls between 10 and 12 years of age, puberty is often first indicated by the growth of pubic hair (Pubarch). Only a few months later, the breast also begins to grow (Thelarche). In around 20% of girls, the opposite is true, with breast growth being the first sign of puberty. Breast development often begins unilaterally, the breasts can be tense and tender. Later on, the breasts grow more symmetrically, but there is often a certain difference in size. Between the ages of 13 and 15, the breasts are “fully grown” on average (and only grow again during pregnancy or when a woman gains weight).

The first menstrual period (menarche) usually only starts when the breasts are already developed, on average about 2–3 years after the breast has started to grow.

Typically, the vagina forms a whitish secretion, called white flow, about a year before the onset of menstruation. This is a normal response to the hormonal change.

The maximum physical growth spurt can be observed about 1 year before the onset of the menstrual period.

The first menstrual period

That the first menstrual period (Menarche) sets in earlier and earlier than in the last few decades, is by no means certain. For example, data from many industrialized countries indicate that girls got their first menstrual period earlier and earlier on average up to around 1960, but that since then this point has been fairly constant at around 12–13 years. According to these studies, 90% have had their first menstrual period at 13 ¾ years and 98% (had) their first period at the age of 15. Only 10% of girls have menstrual periods before they are 11 years old. Girls with more fat deposits are on average a little earlier, and men with dark skin also start their menstrual period a little earlier.

Menstrual disorders

The menstrual cycle is often irregular in adolescence: the bleeding lasts 2–7 days and it can return after 20 days - but also after 60 days or more. Mostly, however, the menstrual period is between 21–45 days. Over the course of three years, the menstrual cycle then becomes more regular and rather shorter. After 3 years, the cycle interval for 75% of adolescent women is 21–34 days, which is typical for adult women. However, the cycle does not follow a long-term stable pattern until 6 years after menarche.

Changes in cycle length. Even though the bleeding in girls can be very far apart, it is very unusual for them to stop for more than 90 days. As with adult women, this can be due to pregnancy, long-distance travel, a lot of sport, unusual other burdens (stress, worries), illnesses such as anorexia or severe obesity as well as hormonal diseases.

Increased menstrual pain (Dysmenorrhea): Girls suffer from this more often than adult women - the reason is that the monthly ups and downs of the hormones have not yet settled down. Many girls are recommended to take the pill by their gynecologist for menstrual pain, even if they have not yet had sexual intercourse. This is okay because the “pill” not only prevents contraception, but also stabilizes the cycle and alters the body's own hormone production. Both of these lead to menstrual periods becoming easier to bear and shorter. By the way: The previously suspected risk that taking the pill early on would reduce fertility in later years has not been confirmed. In addition to the pill, there are also other alternative medical therapy options. The menstrual pain almost always improves after six months, but no later than 1–2 years after the menstrual period has started. So if you can endure the pain, you can initially forego medical advice and wait.

Increased menstrual bleeding (Hypermenorrhoea) are not infrequently associated with menstrual pain (dysmenorrhea), but they also have their own special causes that correspond to those in adult women. More often than previously thought, a coagulation disorder of the blood is the basis, z. B. a (Willebrand-Jürgens syndrome)

Prolonged menstrual bleeding

When to the gynecologist

A visit to the gynecologist is advisable:

  • For severe menstrual pain or heavy discharge
  • For very irregular periods (e.g. if the period is missing for 60-90 days)
  • For inflammation in the vagina and the external genital organs
  • With spotting outside of the norm
  • For unclear pelvic pain
  • If the menstrual period has not started at the age of 16.

Authors

Dr. med. Herbert Renz-Polster in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 11:43 am