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Johns Hopkins Health - Girl Talk

Summer 2011
Issue No. 13

Girl Talk

Date: July 22, 2011

two african american women mother daughter

Making puberty’s bumpy ride go smoother for your tween daughter

Holy hormones! You’ve seen the signs—wispy hair peeks out from under her freckled arms, her slim, tomboyish hips form new curves, and breasts begin to bud. Day by day, your little girl’s body is transforming into a young woman’s—and you just don’t know how to handle it.

Relax. Johns Hopkins pediatric and adolescent gynecologist Delese LaCour, M.D., reveals the truth about tweens—their body angst, daunting social pressures, monthly cycles and menstrual pain. Here’s your guide on what to expect, including what’s normal and what isn’t.

What to expect: Struggles with body image.
What’s normal: “It’s normal for tweens to gain weight as they develop a more adult woman’s shape,” LaCour says. “It’s concerning to them as they develop hips and especially breasts. I hear lots of concerns about breast development, especially about asymmetry or size.”
What’s not: Your daughter uses negative language to describe herself based on physical development and attractiveness.

What to expect: Social pressures.

What’s normal: “It’s a time when a girl looks for more acceptance outward, outside the family,” LaCour says. “She’s trying to navigate self-acceptance and the idea that she may be different from others in her peer group.”
What’s not: Your daughter has frequent headaches, stomachaches, chest pains, trouble sleeping, tiredness or lack of energy. These are symptoms of too much stress.

What to expect: Menstrual cycles.
What’s normal: LaCour says it’s normal for menstrual cycles to begin within two years of breast development.
What’s not: Your daughter’s menstrual cycles last longer than seven days, are spaced more than 90 days or fewer than 21 days apart, or are especially heavy (soaking one feminine hygiene product every one to two hours).

What to expect: Menstrual cramps.
What’s normal: Mild cramping pain that can be relieved with a heating pad or hot shower.
What’s not: Your daughter’s cramps stop her from doing her daily activities or if she is absent from school one or more days each month because of pain.

For more information, appointments or consultations, call 877-546-1872 or visit

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