The initial signs of puberty may start to appear among girls between the ages of nine and ten, and menstruation is considered the primary sign of puberty in females approximately two years following the appearance of secondary sexual characteristics.

As for males, changes begin to appear between the ages of twelve and fourteen during which the appearance and emergence of secondary sexual signs occurs, and wet dreams are the main sign of puberty in males. Puberty is preceded by rapid physical growth, especially in height. This rapid growth is not a result of puberty, but rather a precursor to it. Overall, there are a number of factors that affect the date of reaching puberty such as the state of glandular activity, health status, individual readiness, and some other factors such as nutrition. The following table shows the differences in signs of maturity in both males and females. 

Having an Irregular menstrual cycle is not a serious problem and is common among girls. In general, irregularity in the menstrual cycle continues even after two to three years have passed since the beginning of menstruation, and it results from incomplete maturity of the ovaries. In order to ensure the regularity of the menstrual cycle, the date of menstruation must be monitored for a period of three months. If the cycle (from the beginning of the first day of menstruation to the date of the first day of the next menstruation) is between 21-35 days, then it is considered normal and regular. But if it is shorter than 21 days or longer than 35 days, it is considered irregular and requires consultation by a physician.

Among the most common reasons for the irregularity of the cycle are being underweight and below the normal range; unhealthy eating habits, vitamin deficiency, obesity and having excessive weight above the normal range; strenuous exercise, in addition to exhaustion, psychological tension, thyroid gland disorder, hormonal imbalance, polycystic ovaries PCOS.

Menstruation: It is the discharge of blood and tissue from the uterus as a result of the shedding of the endometrium in the absence of fertilization of a mature egg.

Menstrual cycle: It is the natural hormonal changes that occur to a woman’s body every month in preparation for pregnancy, and it begins at puberty and ends at menopause.

Its duration reaches approximately 28 days, and may range between 21-35 days, as the first day of menstruation is the first day of the menstrual cycle and

ends with the beginning of the next menstruation. 

Some mild symptoms associated with menstruation occur due to the sudden drop in levels of (Progesterone and Estrogen), but they disappear within several days after menstruation and hormone levels start to rise again. Girls often feel lower back pain, pain in the lower abdomen, swelling and pain in the breasts, headache, and a change in appetite, and mood swings.

Primary dysmenorrhea, or what is known as menstrual pain, is a very common condition for girls in puberty, and it occurs due to the contraction of the uterine muscles. However, it recedes with age, but is more likely to occur if menstruation begins before the age of 11. Simple analgesics available at home may be recommended for relief of pain.

Do not hesitate to contact the doctor in the following cases:

· If symptoms are severe and may hinder the practice of daily activities.

· Prolonged menstrual flow or more than the usual flow.

· If painkillers do not help relieve menstruation pain.

Adolescent girls need to learn the basics of personal hygiene in general, especially during menstruation, by rinsing the genitals with water more than once a day during menstruation and changing sanitary pads frequently to protect against infections and diseases. The number of times a girl needs to change the sanitary pad depends on the heaviness of the blood flow, taking care not to leave the same pad for a long time, which may cause unpleasant odours and infections.

Myths about menstrual cycle: Avoid hot showers, do not make any effort, hot water increases menstrual pain, irregular periods harm fertility, menstrual blood is different from normal blood, avoid drinking soft drinks or eating fatty substance. 

Polycystic ovaries is not a disease in the known sense. Rather, it is a number of symptoms that occur due to an imbalance in the hormonal system in the body (pituitary gland, ovaries, and others) that leads to inhibition of natural ovulation and an increase in male hormone.

Among its symptoms are irregular menstruation (periods are spaced apart, that is, once every two months or more), weight gain, particularly in the abdomen area, acne on the face, more facial and bodily hair, and delay in pregnancy.

The presence of all or some of the symptoms is sufficient to diagnose this syndrome, and the diagnosis can be confirmed by running hormone tests and by ultrasound.

There is no known treatment to remove the cyst altogether, or to bring it back to its normal state. Therefore, the treatment is administered to the existing symptoms.

Unfortunately, many girls’ resort to the use of certain unnecessary medications, or they follow what their friends do, which may lead to health problem later on. 

It is normal to have discharges during puberty, as the secretions help maintain the cleanliness and viscosity of the female genitalia, and also keep it free from germs and bacteria. There are several natural characteristics for this type of secretion, such as being odourless, transparent or milky and dries on clothes; in certain cases, these secretions become thin and sticky, but some factors lead to a change in their characteristics, such as microbial infections, pregnancy, diabetes, and some beauty care products.

Genitalia discharge is normal if it is white in colour and not accompanied by any other symptoms. If discharge turns yellow or brown, it is an indication of infections that require medical treatment by a physician. 

Sexually transmitted diseases or sexually transmitted infections are diseases transmitted from one person to another, generally through sexual contact, bacteria, viruses, or parasites causing sexually transmitted diseases that can be passed from one person to another through blood, semen, or genitalia and other body secretions.

In some cases, infection can be transmitted in a non-sexual way such as transmission from mother to foetus during pregnancy or childbirth, blood transfusions or use of shared syringes. Moreover, it may be transmitted from apparently healthy people who may not know of their infection.

Sexually transmitted infections STIs don't always show any symptoms but may cause a range of signs and symptoms. On the other hand, STIs may not cause any signs, which is why they may go unnoticed until complications develop or when diagnosed.

Symptoms that may indicate an STI include Sores or blisters on the genitals, mouth, or rectal area, pain or burning during urination, discharge from the male genitalia, unusual or foul-smelling genitalia discharge, unusual female genitalia bleeding, lower abdominal pain, rash on the abdomen, hands or feet.

Signs and symptoms of illness may appear several days after infection, but it may be years before any noticeable problems appear, depending on the organism causing the sexually transmitted infection.

In the event of the appearance of the previous symptoms, you need to consult your doctor immediately. 

AIDS is a chronic disease caused by a virus called the Human Immunodeficiency Virus (HIV) that infects and destroys CD4 cells, a type of white blood cells responsible for the immune system.

Symptoms of the disease vary according to the stage of infection, but the following common symptoms are observed in all stages: high fever, muscle pain, rash, headache, ulcers in the mouth and genitals, swollen lymph glands, diarrhoea and difficulty in breathing.

HIV infection is transmitted through blood and bodily fluids such as semen and female genitalia discharge. HIV is also transmitted through sexual contact and sexual fluids and secretions from an infected person to a healthy person. The virus is also transmitted through blood transfusions and syringes, as well as from a nursing infected mother to her child during breast feeding.

Although the virus exists in other bodily fluids such as saliva, sweat, tears, and urine, it is not transmitted through any of them, nor is it transmitted through hugging, kissing, shaking hands, or using toilets and towels. People most at risk of contracting ‘acquired’ HIV: are people who have sexually transmitted diseases, and inject drug users, and males who have sex with males. Complications: its effect on the immune system, making it easy for people to develop diseases and different types of cancer.

There is no definitive cure for AIDS to date, but some treatments are used to discourage it. 

Onanism, or commonly known asmasturbation does not cause any physical health harm or damage despite the many superstitions associated with it. Itdoes not lead to sterility, blindness, reduction in sperm count, nor does it lead to loss of virginity (if violent means are not used.) Masturbation is a natural behavioural practice related to adolescence and is not limited to one gender only without the other.

However, constant repetition and its practice as a means of pleasure and escape from reality, leads to falling into behavioural addiction as it takes control of the person, leading to a decrease in the ability to focus when studying, working, carrying daily activities or social life. Such a practice deprives one from becoming a social and productive person. Additionally, this addiction prevents people from engaging in work, school, or social events, as well as responsibilities.

Those who practice masturbation may feel guilty because of religious, cultural, and personal beliefs of those who oppose it and describe it as an immoral or bad habit.

Masturbation is the self-stimulation resulting from a person caressing their sexual organs with the aim of obtaining sexual pleasure to reach orgasm. Arousal may occur through such means to organs other than the sexual organs such as the breasts, the inner side of the thigh, or sometimes the anus. 

Taking care of personal hygiene has a major role in one’s physical and psychological health and wellness, as it keeps away many diseases, such as skin diseases, digestive system diseases, and protects against many psychological problems, such as stress.

Some of the most important ways to maintain personal hygiene:

· Taking a shower when necessary and depending on physical exertion, the weather, or changing clothes instead; washing areas that are more likely in need of daily care; using antiperspirants for body odour.

· Brushing the teeth after every meal; changing into clean clothes daily; using absorbent undergarments made of cotton and avoiding synthetic material like nylon and polyester, especially in summer; wash (and keep dry) sensitive areas with water only and avoid scented soap or cosmetics of non-reliable sources. 

Eating a healthy, varied diet supplies the body with many important nutritional elements to maintain good health and energy; the most important of these elements include fats, proteins, carbohydrates, minerals, vitamins, and water. Micronutrients of a balanced and healthy diet differ from one individual to another according to gender, age, physical activity, lifestyle, and other factors.

There are several steps that help make the diet healthier:

· Increase the intake of protein-rich foods as these foods help increase the feeling of satiety and help burn calories more quickly.

· Drink sufficient amounts of water.

· Replace deep fried foods with grilled foods.

· Eat vegetables and stay away from ready-made meals.

· Eat whole fruits rather than fruit juices.

Young people in this age group are greatly influenced by peers and influencers on social media leading to unhealthy eating habits and practices, such as unhealthy dieting, taking medications and others. 

At this age, adolescents reach the stage of their ability to reproduce, their sexual feelings towards the opposite sex develop, bonding between the sexes heightens, sexual feelings deepen, and feelings of sexual desire are mixed with love, appreciation, care, and kindness. Feelings and emotions imposed by this stage are often dominant and affect the adolescent's ability to make a sound, logical decisions. Adolescents need to be shown reason on how to make rational and sound decisions by explaining to them clearly the basis on which marriage is founded and the consequent financial, moral and social responsibilities.

There is no set rule to be applied to males and females to determine the right age and time to go into matrimony. There are many aspects on which the eligibility of a man or woman for marriage depends on, such as reaching a certain level of maturity, and the ability to deal with the radical changes that follow the transition into married life in a positive manner, in addition to individuals’ aspirations for academic achievement. Moreover, the determining factors of the right age for marriage differ according to lifestyles, the environment and communities where individuals live.

Marriage before eighteen, according to the law in countries parties with the Convention on the Rights of Woman and Child, is considered ‘early marriage’, where most countries have established strict laws and regulations for this ‘early marriage’ for many considerations, the most important of which are: the psychological, social and health impact on spouses, such as depriving the girl of the opportunity and the right to continue her education leading to her inability to form her own independent personality; exposing the girl to many health crisis because of her frail young body; immaturity of the spouses where they will be unable to hold responsibility, start a family, raise children and bear the psychological and economic burdens; undermining their prospects and potential, deprivation of the right to development and building a well-balanced personality as a result of the violation of the right to education, denial to the right to protection, as the girl may be subjected to abuse or exploitation. Lastly, the negative impact of early marriage on family relations in the future, as the chances of divorce increase and the multiplicity of family problems spike.

"When a girl, still a child herself, is coerced into marriage, she faces immediate and long-lasting consequences. Chances of continuing her studies diminish while the odds of being abused by the husband and complications during pregnancy increase."

According to UNICEF evidence indicates that girls who marry at an early age drop out of formal education and more often than not end pregnant. Also, childbirth and pregnancy-related deaths are important factors of deaths of girls between the ages of 15 and 19 worldwide, in addition to the risk of death of babies born to young mothers, or their exposure to several diseases if they survive.

UNICEF recognizes that “child marriage separates them from family and friends, and curtails their freedom to participate in community activities, which can have significant impacts on girls' mental and physical wellness.”

The Jordanian Personal Status Law (No. 36 for the year 2010) stipulated provisional completion of eighteen years of age and kept the exception for those who have completed fifteen years of age. For the eligibility of marriage, the Law stipulated that the engaged couple be of sound mind and that each of them had completed eighteen years of age. The Law, however, allowed the judge, with the approval of the Chief Justice, to authorize in special cases the marriage of a person who has completed fifteen years of age ‘According to instructions issued for this purpose, if the situation necessitates marriage for the general interest, and according to that, whoever gets married acquires full capacity in all what is related to marriage and separation and their effects. 

Acne: It is a chronic skin disease resulting from clogging of the hair follicle with dead skin cells and skin oil. Acne is characterized by the appearance of blackheads or whiteheads, pimples, oily skin, and potential scarring. Acne primarily affects areas of the skin where there is a relatively large number of sebaceous glands, including the face, upper chest, and the back.

Most adolescents suffer from acne during puberty as one of the effects of growth. At most times, effects are minor and can be dealt with by following healthy lifestyles, such as personal hygiene and a balanced diet.

There are several ways to prevent the re-emergence of acne, including washing the affected areas twice daily, using anti-acne medications that can be acquired without a prescription so as to reduce excess sebum secretions in the skin. Another way is to avoid excessive use of cosmetics (make-up) and remove and cleanse the skin before bedtime. Also recommended is not to borrow or use beauty and healthcare products from others. 

Why is there a difference in physical appearance between me and my friends? (height and size, hair appearance, breast size and shape)?

The signs of growth and change associated with puberty differ from one person to another, especially with regard to the timing of puberty, acceleration of growth, changes in height, hair growth, etc. The emergence of these changes is affected by many factors, the most important of which are heredity, gender, race, climate, chronic diseases, and others. 

Puberty begins in females between the ages of nine and ten, and for males between the ages of twelve and fourteen.

The process of growing up in the physique (especially height) slows down (and often stops completely) in females when menstruation occurs, while in males the growth process in the physical structure continues until the age of eighteen. Figure shows signs of puberty in both males and females.