MENARCHE , NATURAL PHENOMENON..!!

            Girls experience menarche at different ages. The timing of menarche is influenced by female biology as well as genetic  and environmental factors , especially nutritional factors. The average age of menarche has declined over the last century but the magnitude of the decline and the factors responsible remain subjects of contention. The average age of menarche is 11.75 years.

           Menarche is the culmination of a series of  physiological  and anatomic processes of puberty :

• Attainment of a sufficient body mass ( typically 20 % body fat).
• Dis inhibition of the GnRH pulse generator in the arcuate nucleus  of the hypothalamus.
• Secretion of oestrogen  by the ovaries in response to pitutary hormone. 
• Over an interval of about 2 to 3 years, estrogen stimulates growth of the uterus (as well as height growth, breast  growth, widening of the pelvis , and increased regional adipose tissue).
• Estrogen stimulates growth and vascularity of the endometrium , the lining of the uterus.
• Fluctuations of hormone levels can result in changes of adequacy of blood supply to parts of the endometrium.
• Death of some of the endometrial tissue from these hormone or blood supply fluctuations leads to deciduation, a sloughing of part of the lining with some blood flow from the vagina .

         A specific hormonal signal for menarche is not known; menarche as a discrete event is thought to be the relatively chance result of the gradual thickening of the endometrium induced by rising but fluctuating pubertal estrogen.

             The menstration , or "flow," consists of a combination of fresh and clotted blood with endometrial tissue. The initial flow of menarche is usually brighter red than mature menstrual flow. It is often scanty in amount and may be very brief, even a single instance of "spotting." Like other menses, menarche may be accompanied by abdominal cramping .

             In most girls, menarche does not signal that ovulation has occurred. In postmenarchal girls, about 80% of the cycles were anovulatory in the first year after menarche, 50% in the third and 10% in the sixth year. Regular ovulation is usually indicated by predictable and consistent intervals between menses, predictable and consistent durations of menses, and predictable and consistent patterns of flow (e.g., heaviness or cramping). Continuing ovulation typically requires a body fat content of at least 22%. An anthropological term for this state of potential fertility is nubility .

              On the other hand, not every girl follows the typical pattern, and some girls ovulate before the first menstruation. Although unlikely, it is possible for a girl who has engaged in sexual intercourse  shortly before her menarche to conceive and become pregnant , which would delay her menarche until after the birth. This goes against the widely held assumption that a woman cannot become pregnant until after menarche.   

                          When menarche occurs, it confirms that the girl has had a gradual oestrogen -induced growth of the uterus , especially the endometrium , and that the "outflow tract" from the uterus, through the cervix to the vagina , is open.

                    In very rare instances, menarche may occur at an unusually early age, preceding thelarche  and other signs of puberty. This is termed isolated premature menarche, but other causes of bleeding must be investigated and excluded. Growth is usually normal. Isolated premature menarche is rarely the first manifestation of precocious puberty .

          When menarche has failed to occur for more than 3 years after thelarche, or beyond 16 years of age, the delay is referred to as primary amenorrhea.

                 Some of the least understood environmental influences on timing of puberty are social and psychological. Nearly all of the research on these effects has concerned girls, partly because female puberty requires greater physiological resources and partly because it involves a unique event (menarche) that makes survey research into female puberty much simpler than male. In most of these studies menarche was specifically examined, assuming it to be a valid "proxy" for the more general process of puberty.

               In comparison with the effects of genetics, nutrition, and general health, social influences are small, shifting timing by a few months rather than years. The most important part of a child's psychosocial environment is the family., hence at public place such happening must not be repeated., take precautions.

 

SAY " NO" FOR  NEXT TIME 

            Some of the aspects of family structure and function reported to be independently associated with earlier menarche:

•  The increased incidence of childhood obesity (both estrogen and progesterone molecules are derived from cholesterol).
• Absence of father from the home from early childhood
• High-conflict family relationships
• Had a low birth weight
• Are singletons
• Are non-white
• Were exposed to smoking
• Were not breast-fed
• Lacked exercise in childhood

Some of the aspects of family structure and function reported to be independently associated with later menarche:

• Larger family size.
• Warmer, closer or more positive relationship with biological father.
• Warmer, more supportive, low-stress family environment
• Have a number of older siblings

The understanding of these environmental effects is incomplete and the following observations and cautions are relevant:

• Mechanisms of these social effects are unknown, though a variety of physiological processes.

        The main anxiety to a young girl is a new thing , and worrying thing is to whom she should tell. I think the young girls must never hide the natural process from Mother.

       Mother after taking the daughter in confidence , should explain everything in details , so that the girl will develope confidence and will welcome this natural phenomenon ., and do not come in the Non sense talks of friends. If at all She has a query ., Mother must give liberty to solve her queries , with a very peace and without any kind of pressure. 

EXERCISE IS MUST FOR KEEPING BODY FIT AND FINE.

         Exercise is must for keeping body physically fit particularly in woman , who in general avoids the exercise. Exercise must in routine to be done daily , regularly and a good diet , keeps the body fit and fine ., then why not to start from today., and remain healthy. Mind it ...! ! " Health is wealth."

                  Always Remember :

·      Fitness, Not Fatness,Predicts a Longer Life.

·        Fitness Begins at Home .

·       Fitness at any age .

·        Get Motivated to Exercise.

                Precaution to be taken are :

      Good technique is a must for a safe, effective workout. If you're new to exercise, over 40, have a health problem, or take regular medication, check with your doctor before starting a fitness program.

       Once your doctor has given you a clean chit , start exercising from simpler one, as -

·       Walking

      You can walk anywhere, anytime, either on a treadmill or with no equipment other than a good pair of shoes.
     You should start by walking five to 10 minutes at a time, gradually moving up to at least 30 minutes per session. As you progress, lengthen the time of your walks before boosting your speed or incline.

·       Push ups

        Adding interval training to your cardio workout can boost fitness, burn more calories, and help you lose weight. The basic idea , Vary the intensity of your aerobic workout to challenge your body instead of loafing in your comfort zone.
       Push up the pace for a minute or two, then back off for 2-10 minutes, depending on the length of your workout and how much time you need to recover.

·       Squats

     Squats work multiple muscle groups - the quadriceps, hamstrings, and gluteals - at the same time.
      Keep your feet shoulder-width apart and your back straight. Bend your knees and lower your rear as if you were sitting down in a chair, keeping your knees over your ankles.

Practice with a real chair to master this move. First, sit all the way down in the chair and stand back up. Next, don't sit all the way down; barely touch the chair's seat before standing back up. Lastly, graduate to doing squats without a chair.

·       Lunges

         Like squats, lunges work all the major muscles of the lower body. Lunges also help improve your balance.
      Take a big step forward, keeping your spine straight. Bend your front knee to approximately 90 degrees. Keep weight on your back toes and drop the back knee toward the floor - but don't let it touch the floor.

        Try stepping not just forward, but back and out to each side, with each lunge.

·       Push-ups

       Push-ups strengthen the chest, shoulders, triceps, and core muscles.
How to: Face-down, place hands slightly wider than shoulder-width apart. Place toes or knees on the floor, creating a smooth line with your body, from shoulders to knees or feet. Keeping rear-end muscles and abdominals engaged, lower and lift your body by bending and straightening your elbows, keeping your torso stable throughout the move.

          Beginners may start doing push-ups leaning into their kitchen counters, then working their way down to a desk or chair, onto the floor with knees bent, and on the floor on their toes. To make it harder, put your feet on a stair, bench, or couch while maintaining good form.

·       Abdominal Crunches

        Begin by lying on your back with feet flat on the floor and palms supporting your head. Press your low back down. Contract abdominals and raise first your head (tucking your chin slightly), then your neck, shoulders, and upper back off the floor.

          Secondly it can very well be performed as - Do crunches with your feet off the floor and knees bent. This technique may help you avoid arching your back; it also engages your hip flexors.

Keep your neck in line with your spine. Don't stick your chin out. Don't hold your breath. To keep chest and shoulders open, keep your elbows out of your line of vision.

·       Bent-Over Row

The bent-over row works all the major muscles of the upper back, as well as the biceps.
        Stand with feet shoulder-width apart, bend knees, and flex forward at the hips, then engage the abdominals and extend spine to add support. Hold weights beneath the shoulders with hands shoulder-width apart. Flex elbows and lift both hands toward the sides of body. Pause, then slowly lower hands

        Otherwise , to start with You should perform the move without weights. If you have trouble doing this exercise standing up, support your weight by sitting on an incline bench, facing backward.

DO EXERCISE REGULARLY AND STAY FIT AND FINE ! !

Adolescence to womanhood ...! !

               Adolescence is the period in which , a child undergoes a number of physical , mental and social changes, thus completing the transformation from childhood to adulthood. The growth changes at this age are very dramatic, almost giving the impression that the child is growing overnight. From the long legged , flat chested, awkward school girl, the transformation into a shapely and graceful young woman is almost like the metamorphosis from the caterpillar to the butterfly.

                   Growing up is there fore, a strange blend of pleasure with a complex mixture of fears and hopes, aspiration and disappointments ,love and hate. It is for the elders around them to help these growing girls to accept their emergence into womanhood with pride and a sense of joyous anticipation of taking their place in the society as working woman , wives and mothers.

               As each phase of life has it’s own peculiar health problems, adolescence is not without these. One of the most important event in life of a girl is the onset of menstruation or the menarche, with all it’s attendant physical and emotional changes.

             The appearance of the sign of womanhood can be a terrifying experience for a girl who is utterly unprepared. This is often associated with disgust and shame. Much can be done to avoid this by simply teaching her the anatomy and physiology of reproductive system and by explaining to her about menstruation and ovulation. It is also necessary to teach them about the need to use clean sanitary pads and menstrual hygiene.

                    The age of menarche normally varies from 12 to 15 years, but occasionally menses may occur earlier or later. Ina group or class where some girls are menstruating and those who have not yet reached menarche, are often worried that they are abnormal. Reassurance to the girls that it is a normal physical changes , and balanced diet, rich in iron and vitamin B-12 , are all that is necessary.

                  In young girls, menses may be accompanied by pain in the lower back or abdomen. Pain occurs at the time of the commencement of the period; sometime pain may be dull and associated with a feeling of malaise. Pelvic pains can be relieved by using Anti spasmodic. If the pain is not relieved , doctor should be consulted at the earliest.

              Adolescent girls usually complain of a white discharge. This is particularly disturbing to older girls from more educated groups, as they have heard that this might be caused by cancer. This symptom usually disappears with treatment by heamatinics; otherwise, a doctor should be consulted.

                A rapid physical growth at this time drains the body reserve of minerals, especially calcium. If this is not supplied in diet, the depletion of body stores may result in manifestations, such as dental caries, falling hair, leg cramps, etc. There is also a need for additional protein for the growing tissue, as well as to cope with the wear and tear associated with adolescent activities.

               At the time of menarche, the breasts also develop, and the rate of development varies from individual to individual. Some girls get worried or become self-conscious when the breast begins to develop and in their effort to conceal them, they develop a stoop. Some adolescent girls Complain of pain or tenderness in the breast prior to menses. This may be relieved by reducing the salt and fluid intake or may need treatment by hormones, so a doctor must be consulted.

              Adolescent girls tend to put on weight, specially around the waist and hips. In most cases, this can be controlled by cutting down on starchy foods like rice, potatoes, cakes and sweets and simultaneously eating fruits and green vegetables. In a few cases of adiposity, hormonal imbalance is there and therefore, a doctor must be consulted.

              There are many factors during the adolescence that can upset the mental balance. Along with the development of sexual organs, the girl becomes conscious of her attraction towards the opposite sex. At the same time she has also developed certain moral and social values, which control her to become shy and withdrawn. It is essential that parents and teachers should try to understand their children better and encourage them to express freely.

        Adolescent girls are very conscious of their physical appearance and are very unhappy about acne on their face, shiny nose, gaining weight and hair on their faces. Their own friends add to their self-consciousness by giving them nicknames, etc. Parents can help these girls to accept their defects and gain self-confidence by commending the special qualities present in them.

        They often fuss about eating wholesome, nutritious food at home. They relish unwholesome eatable outside and thus expose themselves to infection.

        Girls of this age enjoy eating pickles, and sour foods and no amount of persuasion, that pickles are bad or the complexion, will make them swap pickles for salads and fruit juices.

        The adolescent girls are often moody. At times , they can be extremely loving and helpful, while at other times, they become rude and inconsiderate. It is then that parents usually complain, “ We never behaved like this when we were of your age.” Adults tend to forget that they also went through  a stage of uncertainty about themselves. The only difference is that more strictness was imposed upon them, whereas the adolescents of today have greater freedom.

        Anyhow, the period of adolescence is one of explorations & experimentation. There is a rapid fluctuation in their activities and enthusiasm, until they are able to find where their real aptitudes and interests lie. Adults fail to recognize that this is a natural process of development which needs to be encouraged.

        An unsympathetic or condemnatory attitude on the part of parents and the imposition of undue restrictions are likely to create resentment and hostility leading to rebellion or feelings of guilt and inadequacy. This may lead the adolescents to feel that they are not understood and become withdrawn and apathetic.