Am I Normal?
by Dr. Leela Francisco
The Physical and Hormonal Aspects of Adolescence
Almost every person going through puberty anxiously awaits the changes in their bodies. There would hardly be anyone who did not wonder if what was happening to them was normal or not!
The changes that happen during puberty are slow. It takes many years for the process to follow through completely. You are not going to wake up one morning and suddenly discover you have become an adult overnight. Each of you will go through this in your life; some of you may have already started it, and some of you may start a little later. But all of you will go through it.
So let's talk about some of the 'normal' developmental changes and their effects before we discuss how one can deal with any related problems.
Acne (or what's that zit doing on my face?)
Acne is a skin problem that usually begins in the young teenage years in both boys and girls and can last until the early 20s or even later. It consists of mild to severe outbreaks of pimples and cysts - mainly on the face, but also on the back, arms and chest. Cysts are lumps under the skin that have pus and other tissue in them, but do not erupt like pimples do. These can sometimes cause scarring and blotchy, uneven skin colour.
At the start of puberty, a whole lot of hormones are released into the body. One of these hormones is androgen. Both boys and girls have androgen, but boys have more of it. Androgen affects oil glands in the skin of the face, neck, back, shoulders and chest. When the balance of this hormone along with other hormones is affected, it makes the glands grow bigger and produce more oil (sebum). Bacteria on the skin make this oil thicken so that the pores become blocked, resulting in blackheads, pimples and cysts. Some people have skin types that have a tendency to produce acne with hormonal imbalances.
So how does one deal with this as a youth?
- Keep your face clean, washing it often with clean water, so as to keep the pores free of oil and dust.
- Avoid makeup and other applications on the face.
- For those with severe acne problems, there are various medical treatments available that work on a shortterm basis (for cosmetic effect) and those that work on healing you from within.
Most conventional medicines work on making you look cosmetically better. But the way to be 'healed' is to have treatment that restores the imbalance in hormones to normal and helps you deal with the reason why these hormones are imbalanced in the first place. This will be discussed in more detail later.
The Menstrual Cycle
Menstrual cycles occur over about one month (28 to 32 days). At first, the menstrual periods typically are irregular. The girl may go two months between periods, or may have 2 periods in one month. Over time, these will become more regular. The girl may want to keep track of when she has a menstrual period, and how long the period lasts, on a calendar. This can help her to see what her individual pattern is, and can help her predict when she will have the next menstrual period. Secondary sexual characteristics usually develop before the onset of menstruation.
Hormones and the menstrual cycle: The menstrual cycle is complex, controlled by a variety of glands and their associated hormones. A brain structure called the hypothalamus influences the nearby pituitary gland to secrete special chemicals, which prompt the ovaries to secrete their sex hormones, principally oestrogen and progesterone. The menstrual cycle is a biofeedback system, which means all of the structures and glands are influenced by the activity of the others. There are four main phases of the menstrual cycle:
- Menstruation - the elimination of the thickened uterine lining from the body via the vagina. Menstrual fluid contains blood, cells from the uterine lining (endometrial cells) and mucus. The average length of a period is between three days and one week, depending on the individual.
- The follicular phase - when the follicle is growing in the ovaries. This is helped by hormones like estrogen and FSH (follicular stimulating hormone) which are at a higher level than other female hormones in this phase. This phase is flexible and can last for 10 days up to even 30 days before ovulation occurs in the same woman. But the normal average time period is 12 to 19 days.
- Ovulation - this is when the follicle has matured to the size of being able to rupture and the ovum is released for fertilization by sperm. The normal time for this process to be complete is about 24 to 48 hours.
- The luteal phase - if the ovum is fertilized by sperm, this phase helps in the maturation of the fertilized egg and its embedding in the uterus for pregnancy. If the ovum is not fertilized, it dies about in 48 hours. This phase ends in menstruation. The predominant hormones in this phase are progesterone and LH (leutinizing hormone). It is also always a fixed time period in a woman, of between 14 to 16 days.
The different phases of the menstrual cycle are largely not uncomfortable, and the majority of girls will not notice any problems. A few get a mild form of cramping.
PMS (premenstrual syndrome): There may be other cyclic changes too -- for example, just before or during a menstrual period the girl may feel "moody" or emotional, and may feel puffy or swollen. It usually develops as the girl gets older.
Vaginal secretions: There are also different types of normal vaginal secretions that can be easily interpreted to explain the different phases of the menstrual cycle.
Many teenagers will however also be introduced to some of the more severe symptoms of their bodily change, more recently referred to as 'dysfunctional uterine bleeding' or DUB:
- severe cramping or dysmenorrhea
- excessive bleeding or menorrhagia
- irregular bleeding or
- no bleeding or amenorrhea
All problems relating to the menstrual cycle are therefore hormone related. It is an imbalance in the level of hormones which results in various physical symptoms.
In boys, the testes constantly manufacture sperm, unlike ovaries, their female counterpart. While some sperm can be stored in a structure called the epididymis, the stored sperm must be occasionally released as part of the normal process to make room for new sperm. This can occur automatically during sleep (known as a nocturnal emission or "wet dream") or following sexual intercourse. Nocturnal emissions may be a common concern for young men entering puberty but they should be reassured that it is a normal part of maturation. Often the high surge of male hormones as well as muscular development increases energy and sexual feelings in young boys.
There is always a choice in what a boy seeks to do during this stage. One of the best outlets is to take an active interest in physical sports (eg. football, hockey, tennis,) or physical group activities of interest (eg. hiking, cycling, exercising).
God made each of us to be healthy men and women. God did not want for mankind to be sick or in pain especially in normal bodily functions. So if this has occurred, there are reasons that preceded the actual physical manifestation of symptoms other than other more serious physical diseases. These include emotional problems and maladjustments due to the various circumstances around us, that we have to face daily in our inter-relationships (family, friends, school) or our experiences as children.
How we deal with these and the choices we make, determines the future of our physical health in the long term. Often we are not completely aware of how deeply this affects us and we think we are 'coping well' with our difficulties and sorrows. If we are dealing with life in a healthy, faith-filled way, emotional as well as physical problems can be healed, including apparently 'incurable' problems and diseases.
Conventional medicine offers medicines to deal with physical symptoms and occasionally emotional problems and there is much short term relief, which is helpful especially when there is no other alternative.
But if one seeks a deeper long-term healing, then there are two ways of going about it and both need to go hand in hand:
- An alternative form of treatment, especially when conventional medicine has no answer, like homeopathy or ayurveda. Here one needs to see good practitioners of these systems of healing who follow the correct principles of practice. Any system of healing if misused or abused, with blatant disregard for the principles that have to be followed will not heal and can instead produce more problems.
- Following the right Spiritual path. Correct Spiritual instruction especially as our Catholic Church provides, is for healing of the heart and soul by the Holy Spirit, who is always life giving. It does not produce guilt or condemnation, but instead helps us gently to realise what is not according to the commandments of God in our life and that we need to do the right thing if we love Jesus. Then we need to make the choice for "life in abundance" in the name of Jesus. If we do this, healing occurs not only emotionally and spiritually, but even physically and great miracles can be witnessed with the Grace and Power of the Holy Spirit.
We are the temples of the Holy Spirit, and God has given us the power of this Holy Spirit within us for strength and grace to live our lives, make the right choices and have complete healing even in physical illnesses. Every Catholic Sacrament we have, (Baptism, Holy Eucharist, Confirmation, etc) are the external signs of Grace and Power within us and should lead us to balance out every area of our lives.
I encourage you to write in with any questions you have with regard to all aspects of development mentioned above and in subsequent articles, so that they can be furthur discussed and elaborated for the benefit of all.
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© 2004 Dr. Leela Francisco. All rights reserved.