50% of the population in Turkey is 20 years and under
• REPRODUCTIVE HEALTH IN ADOLESCENTS
• Infancy: “I am what was given to me”
• Childhood: “I am what I create”
• Adolescence: “I am an independent thing that can choose freely”
• Young adulthood: “We are all of our loved ones”
• Adulthood: “I am everything I produce”
. Old age: “I am what I leave behind
• REPRODUCTIVE HEALTH
• The World Health Organization defines reproductive health as:
• It is not only the absence of disease and disability related to reproductive system functions and processes, but also the completion of reproduction in a state of complete physical, mental and social well-being.
• adolescence It is the physical, sexual, cognitive and psychosocial transition process of the individual from childhood to adulthood. Physical and sexual development seen during this period puberty is called. Basic physical and sexual changes; your primary sexual characteristicsmaturation, the appearance of secondary sexual characteristics(sexual hair growth, breast development in girls, deepening of the voice in boys), changes in body fat distribution, skeletal development and height increase, and the onset of menstruation in girls and sperm production in boys.
• In Adolescent Girls
Breasts get bigger first
• Then the hairiness increases,
• The last menstrual bleeding occurs.
• The first menstruation can happen at any age between 9 and 16.
• It usually starts one year after the breasts start to grow.
• The first menstruation begins before the egg cells are fully matured and before ovulation.
• After the first menstruation, there may be irregularity for 1-2 years or even no menstruation.
There will be an increase in physiological discharge before puberty in girls. If there is no sign of infection, it is unnecessary to take a vagina culture. The first menstrual bleeding may be delayed or early for several years, too long and irregular. Menstrual bleeding is not painful. Regular ovulation has not started yet. After a few years, menstruation and ovulation will be regulated, a slight pain in menstruation, tension in the chest before menstruation and other symptoms that we call premenstrual syndrome may appear.
• The period between two periods is between 21 and 35 days.
• It is normal to have different amounts of bleeding between 2-7 days*.
Girls enter puberty about two years earlier than boys.
At puberty, the body acquires the ability to reproduce. Accordingly, if the changes that begin in the body begin before the age of 10, it should raise the possibility of a disease.
Young girls who do not menstruate despite completing the age of 16,
Boys who do not show any signs of puberty until the age of 19 should also be referred to a specialist because of the possibility of the disease.
Adolescence is a period in which many psychosocial changes are experienced. This process can be divided into periods.
Early Adolescence (12-14 years): Teenagers deal with their bodies, establish strong friendships with the same sex, think about abstract concepts, worry about the future, and therefore show emotional fluctuations. Consistently limiting attitudes of families and teachers towards adolescents will reduce the anxiety of young people.
Middle Adolescence Period (15-18 years): Pubertal changes and cognitive development have been completed. Adolescents can make generalizations, think abstractly, and develop an insight that can be combined with their experiences. He is interested in the opposite sex, tries to establish friendships and get to know them. They experience separation from the family and efforts to gain independence, and they give more importance to groups of friends. Sports and various social activities are very helpful to adolescents in order to direct the increased impulsive intensity during this period and to find appropriate ways to cope with impulses.
Late Adolescence (Above 18): How long it takes varies from person to person. It ends with the adolescent being able to give an answer that shows the sameness and continuity by trusting the questions of who he is and what he will be. Adolescents have gained the ability to establish close relationships and to choose a job and spouse. He has the responsibility to assume the adult role in society.
• WHEN I WAS FOURTEEN YEARS OF AGE, MY FATHER WAS SO IGNORANT THAT I CANNOT SUGGEST HIM BEING NEAR. BUT WHEN I REACHED TWENTY ONE, HE KNOW SO MUCH THAT I WAS STARTED HOW HE LEARNED IN SEVEN YEARS. MARK TWAIN
In the pre-adolescent period, the perception of sexual identity, masculinity and femininity has developed. There are myths and information about sexuality from friends, school, and family. In early adolescence, curiosity, sexual fantasies and masturbation begin to take place in their own bodies and those of their peers. Sexual activities are usually nonphysical. Dating is common in middle adolescence. There may be relationships with or without coitus. Physical, social and legal maturation is completed in late adolescence. Sexual behaviors can move from being individual to more meaningful and shared relationships.
It is the individual’s self-fulfillment of sexual satisfaction.
Masturbation is a normal act in every period of life.
It is not true that it causes a physical or mental illness or habit*.
Confused between childhood and adulthood, adolescents and their parents experience anxiety about distinguishing between normal and abnormal.
The developmental process of the adolescent includes the return from family dependent to independent personality formation. The adolescent’s efforts to establish an independent identity, possible changes in gender roles and unresolved parent-child conflicts of parents increase the stress of parents in this period. Adolescent sexuality can be even more threatening to adults with unresolved issues with it. Increased stress can reduce a parent’s self-confidence, making them more inconsiderate, reactive, over-controlling, and rigid. A high level of anxiety can cause communication interruption. Lack of parental rules and discipline may result in the adolescent being sexually active, similar to situations where discipline is too strict. Adolescents with self-consistent parents who can supervise their child’s appointments, set reasonable curfew hours, rarely display irresponsible sexual behavior. Because many parents are not comfortable talking about sexuality with their children, their physicians should ensure that the issue is brought up and discussed.
A great majority of adolescents face the dangers posed by their risky behaviors during this period of their lives.
Disruptions in the adolescent’s psychological development process lead to mental health problems. Common mental health problems in young people (alcohol and drug addiction, anorexia nervosa, anxiety, hyperactivity, bipolar disease, bulimianervosa, behavioral disorder, depression,
learning difficulties, obsessive-compulsive disorder, physical and sexual abuse, post-traumatic stress disorder, psychosis, schizophrenia, suicide)
There is a difference between boys and girls in height and weight gain.
Throughout puberty, girls measure 18-23 cm. men are 25-30 cm. elongates.
Structural-familial short stature seen in adolescence should be differentiated from those with pathological length (Skeletal dysplasia, Turner Syndrome, hypothyroidism and growth hormone deficiency, Celiac Disease).
Nutritional problems are very common in adolescence.
Weakness, obesity, short stature, anemia, other vitamin and mineral deficiencies can be counted among these. Obesity has started to be seen above 10% in young people in recent years. Changes in eating habits and rapid weight gain in adolescence, gaining 50% of adult weight in approximately 2-3 years, and the change in body shape according to gender require one and a half times more adiposity in girls than boys, and two times increase in muscle tissue in boys compared to girls. . Supporting young people with diet, exercise and psychologically are the steps that need to be done in treatment.
The frequency of Anorexia Nervosa and Bulimia Nervosa is increasing day by day. Eating disorders are disorders of adolescence and should be considered in association with weight changes, fatigue, menstrual irregularities and various psychological complaints in young people. Gluttony, evening eating syndrome and nonspecific eating disorders are other conditions that should be considered as diagnosis. Mental problems in obesity, weakness and eating disorders should also be considered.
PERSONAL HYGIENE, SKIN, HAIR, HAND, FOOT, MOUTH AND DENTAL CARE AND GENITAL CLEANING ARE IMPORTANT IN Adolescence.
Acne and skin infections, Genital tract infections, Tooth decay, Hepatitis B are common health problems in adolescence.
Underwear should be changed frequently and cotton underwear should be preferred.
Reproductive organs should be kept dry and clean
Toilet cleaning should be done from front to back
Acne : The image of young people is the most important issue for them in this period. Acne is one of the most common complaints in applying to health institutions. If it is not treated at an early stage, there is a possibility of scarring.
girl adolescents excess hair growth The reason must be revealed. Only genetic and environmental factors can cause this, as well as problems caused by the ovaries or adrenal glands.
breast problems : The most common breast problems in girls are fibroadenomas and fibrocysts. Adolescence is a distant period for the detection of breast cancer. The problems that most preoccupy girls during adolescence are breast asymmetry, breast smallness, breast size, excess or absence of nipple and tissue, breast pain, breast mass and nipple discharge.
In male adolescents, the most common breast problem is gynecomastia, which is the size of the breast tissue. Breast size, which is temporary due to the effect of reproductive hormones, can be permanent in young people up to 10%, which will continue in adult life. Treatment may be required to prevent gynecomastia from being permanent and whether it develops due to the medication used or the previous diseases.
Health education to be given to adolescents
• 1- Physical and psychological changes in adolescents
• 2-Reproductive health, sexually transmitted diseases, methods of contraception
• 3- Consanguineous marriages, genetic counseling
• 4-The harms of cigarettes, alcohol and drugs
• 5-Making use of free time, sports and social activities
• 6-Nutrition should be among the subjects.