Hot Topics in Adolescent Health

A Practical Manual for Working with Young People

Sarah Bekaert, Dame Lesley Southgate

• Publisher: CRC Press
• Year: 2018
• eBook ISBN:
  9781315346731
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

What do young people need to know about their health - and how can you help them learn it? This practical guide will help you to broach health subjects (ranging from the banal to the embarrassing to the deadly serious) with the adolescents you encounter in your professional life. Drawing on research and collaboration with specialists in areas such as dietetics, mental health, drugs and alcohol, fitness, education and careers, along with young people themselves, Hot Topics in Adolescent Health provides a range of support mechanisms for professionals working with young people. Using interactive methods of delivery, this practical guide and complimentary CD provide figures, diagrams and suggested activities to explore each topic within a group setting and point to other resources for further information. The book covers both the basic and more detailed issues beginning with an introduction to adolescence and puberty before exploring key issues such as body image, diet and exercise, mental health, drugs, alcohol, relationships and sex (including contraception, sexual health, pregnancy and abortion) - giving lots of inspiration on how to confidently answer those tricky questions. Sections on consent and confidentiality when working with young people, as well as a vital summary of child protection policy and procedure, will also prove useful. It is highly recommended for healthcare professionals, teachers, therapists, counsellors, community group leaders and all people working with adolescents.

CHAPTER 1

Puberty

Remember Harry Enfield’s character Kevin? The time when the delightful, chatty 12 year old turns into a disgruntled, grumpy teen? For those working with this age group, it can be difficult to accommodate the varying needs of a young person—each enters puberty at different times; each working through his or her relationship with a “new self” as well as relationships with peers, adults and family. In addition, the transition doesn’t happen overnight and mood and communication can vary dramatically from minute to minute!

Puberty is the time when a child physically develops into an adult. For example, girls develop breasts and boys broaden out, and hair sprouts in all sorts of new places! Usually, puberty starts between the ages of 8–13 in girls and 10–15 in boys. Hence, in this age group there can be a wide range of shapes and sizes.

There are emotional changes too as a developing sense of self leads young people to a reshaping of relationships with peers, adults and family. The development of sexual feelings alongside the physical changes can cause embarrassment and confusion too.

This section will look at the physical changes that happen to boys and girls and offer advice on topics like body odour and acne to help boost self-esteem during this time. It will also look at the emotional changes that take place and how they influence social interaction.

Finally, we will look at areas where, as if puberty isn’t complicated enough, other factors can make the journey even more complicated, e.g. disability, sexuality.

What Happens in Puberty?

Draw two androgynous figures on large pieces of paper. Get the group to tell you about the changes that occur in puberty and draw these changes onto the picture. According to the level of the group, bring out discussion on what might cause these changes, how they may happen at different times for different young people and the possible consequences of these changes.

Biology

Hormones

For boys, hormones travel through the blood and tell the testes, the two egg-shaped glands in the scrotum (the sac that hangs under the penis), to begin making testosterone and sperm. Testosterone is the hormone that causes most of the changes in a boy’s body during puberty.

In girls, FSH (follicle stimulating hormone) and LH (luteinising hormone) target the ovaries, which contain eggs that have been there since birth. The hormones stimulate the ovaries to begin producing another hormone called oestrogen. Oestrogen, along with FSH and LH, causes a girl’s body to mature and prepare her for pregnancy.

Boys and girls both begin to grow hair under their arms and their pubic areas (on and around the genitals). It starts out looking light and thin. Then, as they go through puberty, it becomes longer, thicker, heavier, curlier and darker. Eventually, boys also start to grow hair on their faces.

Growth spurt

Both boys and girls undergo a growth spurt during this time; some can grow up to four inches in one year. Naturally their appetite will reflect this; they need lots of food, ideally representing all food groups, in order to develop good bone strength, muscle and skin tone. The classic “teenager sleeping until midday”, while annoying for parents, is a natural reflection of the sleep teenagers typically need for all this growth! (See Chapter 4 for more information on nutrition needs during this growth spurt.)

Changing shape

Boys’ and girls’ bodies fill out and change shape during puberty. A boy’s shoulders grow wider and his body will become more muscular. There may be a bit of breast growth for boys; this is normal—it goes away for most by the end of puberty. In addition, boys’ voices crack and eventually become deeper, their penises grow longer and wider and their testes get bigger.

Girls’ bodies usually become curvier. Their hips get wider and their breasts develop. Sometimes one breast grows more quickly than the other, but most of the time they even out. Girls may start wearing bras around this time, especially if they are involved in sports or exercise classes.

Male reproductive organs

Figure 1.1 The male reproductive organs

The main function of the male reproductive organs is to make sperm and pass them to the female. The organs consist of two round glands called testes that lie in a special sac (scrotum) outside the body. Within the testes are tubules and ducts where sperm are produced. A duct, called the vas deferens, comes out of each testis and up into the pelvis. At this point, the seminal vesicle joins the vas deferens. The seminal vesicles add seminal fluid to the sperm. The duct then becomes the ejaculatory duct, which fuses with the urethra at the prostate gland. The duct is then called the prostatic urethra and carries both urine and semen through the penis. The penis is made up of vascular spaces and erectile tissue.

Figure 1.2 The female reproductive organs

The female reproductive system is designed to make eggs, to favour fertilisation and to house the growing foetus during pregnancy. The ovaries produce eggs (or ova) from follicles. The egg travels down the fallopian/uterine tubes to the uterus, where a fertilised egg will implant and the foetus develops. At the base of the uterus is the cervix, leading to the vagina where sperm can be introduced from the penis.

Fertilisation

Fertilisation takes place when a sperm and egg fuse. Once a month an egg is released from the ovaries (ovulation) and travels down the uterine tubes. If it meets sperm in the uterine tubes it may be fertilised. The fertilised egg then travels to the uterus and implants in the uterine wall, where the foetus develops.

Periods

Before contraception can be understood it is helpful to have an understanding of the menstrual cycle, as most hormonal contraceptive methods interrupt this cycle in some way. (See Chapter 9 for more information about contraception.)

The menstrual cycle is calculated from the first day of a period until the day before the next period starts. The length of the menstrual cycle varies for each individual and often from one period to the next. It can be as short as 21 days and as long as 40 days.

The menstrual cycle is controlled by hormones. The chemical messenger follicle stimulating hormone releasing factor (FSH-RF) is released by the hypothalamus, a gland in the brain. This hormone tells the pituitary, also in the brain, to secrete follicle stimulating hormone (FSH) and luteinising hormone (LH) into the bloodstream. These hormones cause the follicles in the ovaries to begin to mature.

The maturing follicles release the hormone oestrogen. Oestrogen causes the lining of the uterus to thicken. When the oestrogen level reaches a certain point it causes the hypothalamus to release luteinising hormone releasing factor (LHRF), causing the pituitary to release a large amount of luteinising hormone (LH). This surge of LH triggers the most mature follicle to burst open and release an egg. This is called ovulation.

Inside the uterine tube, the egg is carried toward the uterus. Fertilisation occurs if sperm are present as the live egg reaches the uterus.

The follicle from which the egg burst becomes the corpus luteum (yellow body). As it heals, it produces the hormones oestrogen and, in larger amounts, progesterone, which is necessary for the maintenance of a pregnancy. Progesterone causes the surface of the uterine lining, the endometrium, to become covered with mucous, secreted from glands within the lining itself. If fertilisation and implantation do not occur, the arteries of the lining close off, stopping blood flow to the surface of the lining. The endometrium lining comes away as a period.

The drop in hormones from the ovaries stimulates the hypothalamus and pituitary gland to begin to release FSH and start the next cycle.

Figure 1.3 The menstrual cycle

The Consequences

Nocturnal ejaculation or ‘wet dreams’

A wet dream is when a boy ejaculates semen in his sleep. It’s normal, unavoidable, and totally natural. Apparently the average teenager has four erections every night and a wet dream about every three weeks. A boy may wake up remembering the dream or may sleep through it. It is more likely to happen at the weekend, as teenagers sleep longer and are more likely to dream!

Masturbation

Masturbation is the touching or stimulating of your own or someone else’s genitals for sexual pleasure. Masturbation is a natural and normal way of exploring your own body. Naturally this is something that s...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• About the author
• Dedication Page
• Figures and diagrams
• CD contents
• Introduction
• 1 Puberty
• 2 How do I look? Body image during adolescence
• 3 Mental health
• 4 Healthy eating
• 5 Exercise
• 6 What’s your poison? Smoking, alcohol and drugs
• 7 Consent, confidentiality and the law
• 8 Relationships and sex
• 9 Contraception and young people
• 10 Sexual health
• 11 L8r baby! Teenage pregnancy
• 12 Gangs
• Glossary
• Index