Health Promotion of the Adolescent and Family

Adolescence starts at the beginning of puberty and lasts until around 18 to 20 years of age. This period represents the transition from childhood to adulthood and encompasses important physical and emotional changes. To promote the health of your adolescent patient, you’ll support them through puberty and psychosexual development. Puberty is a complex physical and emotional process that typically begins between the ages of ages eight and 14.

Now, puberty is under the control of the hypothalamic-pituitary-gonadal axis, which is a system of hormone signaling between the hypothalamus, pituitary gland, and gonads, either the testes or ovaries. During puberty, the hypothalamus begins secreting gonadotropin-releasing hormone, or GnRH, which stimulates the secretion of follicle-stimulating hormone, or FSH, and luteinizing hormone, or LH, from the pituitary. These hormones then travel to the gonads and stimulate ovulation and menarche, or the first menstrual cycle in those assigned female at birth; and the production of sperm in those assigned male at birth. They also stimulate the production of sex-specific hormones, which are estrogen and progesterone in those assigned female at birth and testosterone in those assigned male at birth.

The increased production of these sex hormones drives the development of primary and secondary sex characteristics in both sexes. Primary sex characteristics refers to growth of the genitals, which are the organs directly involved in sexual reproduction. Secondary sex characteristics refers to sex-specific physical characteristics that are not directly involved or necessary in sexual reproduction, like the growth of pubic hair in both sexes, the deepening of the voice in those assigned male at birth, and the development of breasts in those assigned female at birth.

When caring for your adolescent patient, be sure to maintain modesty as much as possible, and give them a choice to speak to you without their caregiver in the room to ensure confidentiality about specific problems, like sexual activity and contraception. Also, be sure to encourage their caregivers to maintain open and honest communication regarding puberty so their child can feel comfortable expressing their feelings and asking questions without judgment.