Page 36 - كتاب تمريض نسا الاكتروني

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You probably know that menarche (the first menstruation) starts on average
between the ages of 12 to15 years. But in some cases, it can start as late as 17 to 20 years,
or as early as 8 to 9 years. Some of the factors that affect the age of menarche are
biological, and some are cultural.

Menarche begins when the hypothalamus in the brain is sensitized to begin producing
GnRH at around the age of 12 to15 years. But evidence suggests that GnRH may begin at
an earlier age in girls who are well nourished and exposed to sexual motivating factors,

such as watching sexual films and talking about sex. In malnourished girls, who have little
exposure to sexual motivating factors, menarche may be delayed until the age of 17 to 20
years. Disease conditions that affect the hypothalamus and pituitary gland, or the ovaries

and uterus, can also affect the age of first menarche.

Around the age of the menarche, the female sex hormones, estrogen and progesterone, are
responsible for the development of secondary sexual characteristics in the female.

These include:

• The development of the breasts

• The broadening of the pelvis

• Increased activity of sweat glands and sebaceous glands (oil glands in the skin)

• The growth of pubic and armpit hair.

Together with the menarche, the appearance of the secondary sexual characteristics marks
the period known as puberty — the period of life (typically between the ages of 10 to15
years) during which the reproductive organs grow to adult size and become functional.

The secondary sexual characteristics are termed ‘secondary’ because they develop after
the primary sexual characteristics, which distinguish females from males.

Menstruation continues every month, except during pregnancy, until the woman reaches
the menopause at around the age of 48 to 50 years, when menstruation ceases.

Summary of study module

In Study module 2, you have learned that:

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