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Dicky Moch Rizal, Dept of Physiology,

Fac. Of Medicine GMU,


dickymd@yahoo.com
Definition of adolescence
Adolescence (Latin:adolescere meaning "to
grow up")
is a transitional stage of physical and
mental human development generally
occurring between puberty and
legal adulthood (age of majority),but largely
characterized as beginning and ending with
the teenage stage

Early adolescence corresponds to ages
10 to 15 years, when most youth are
entering high school
Middle adolescence, typically ages 14 to
18 years
Late adolescence refers to the years past
high school, from age 17 to 18 into the
early twenties
Historically, puberty has been heavily
associated with teenagers and the onset
of adolescent development
An individual is considered to be
(chronologically and legally) mature
enough to be entrusted by society with
certain tasks
Driving a vehicle, having legal sexual
relations, serving in the armed forces or
on a jury, purchasing and drinking
alcohol, voting, entering into contracts,
completing certain levels of education,
and marrying.

LEGACY of LAW
Physical maturity by Tanner
Adolescence is characterized by a number
of cognitive, emotional, physical and attitudinal
changes, which can be a cause of conflict on
one hand and positive personality development
on the other.
A huge proportion of the world's population -
more than 1.75 billion - is young, aged
between 10 and 24 years.
http://www.who.int/features/factfiles/adolescent_health/en/index.ht
ml
Adolescents who have a good
relationship with their parents are less
likely to engage in various risk behaviors,
such as smoking, drinking, fighting,
and/or unprotected sexual intercourse
http://www.childtrends.org/Files/FamilyEnvironmentRB.pdf
Adolescents are frequently confused
about what is 'right' and what is 'wrong
A combination of behavioural and fMRI studies
have demonstrated development of executive
functions, that is, cognitive skills that enable
the control and coordination of thoughts and
behaviour, which are generally associated with
the prefrontal cortex. The thoughts, ideas and
concepts developed at this period of life greatly
influence one's future life, playing a major role
in character and personality formation Choudhury, S.;
Blakemore, S.-J.; Charman, T. (2006). "Social cognitive development during
adolescence". Social Cognitive and Affective Neuroscience 1: 165.
In females, oestrogenization decreases the
susceptibility of the vulva and anterior vagina
to most infections and alters vaginal flora and
pH

Until several years after menarche, the
squamocolumnar junction is located on the
exposed vaginal surface of the cervix,
gradually progressing to the endocervical canal
as thin columnar cells are transformed to
layers of thick squamous cells
The exposed columnar epithelium is especially
likely to become infected with gonorrhoea or
chlamydia if there is contact with infected
partners.
The transition zone itself is susceptible to
carcinogenic factors, including various
infectious organisms
Epidemiological evidence that early age of first
intercourse correlates with precancerous and
cancerous changes to the cervix.

Within the framework of WHO's definition
of health as a state of complete physical,
mental and social well-being, and not
merely the absence of disease or
infirmity, reproductive health addresses
the reproductive processes, functions
and system at all stages of life
Reproductive health, therefore, implies
that people are able to have a
responsible, satisfying and safe sex life
and that they have the capability to
reproduce and the freedom to decide if,
when and how often to do so.
http://www.who.int/topics/reproductive_health/en/
Reproductive health care is defined as
the constellation of methods, techniques,
and services that contribute to
reproductive health and well-being by
preventing and solving reproductive
health problems.
It also includes sexual health, the
purpose of which is the enhancement of
life and personal relations, and not
merely counseling and care related to
reproduction and sexually transmitted
infections.

Reproductive health includes a variety of
topics, such as:
Menstruation and menopause
Pregnancy and preconception care
Fertility/Infertility
Contraception
Sexually transmitted diseases and AIDS/HIV
Health and function of the male and female
reproductive systems
http://www.nichd.nih.gov/health/topics/reproductive_health.cfm

Adolescence Reproductive Health
Unwanted pregnancy
Sexually transmitted diseases and AIDS/HIV
Health and function of the male and female
reproductive systems
Fertility/Infertility
Sex education

Adolescent Reproductive Health Issues
around Pregnancy
According to populationaction.org, every
year, almost 80 million
unintended/unplanned pregnancies occur
around the world. More than half end in
abortion.
Abstinence
`While some methods may lower the chance
of becoming pregnant or contracting an
STD, the only sure way is through
abstinence. Teens can make more
responsible choices when they realize this.
Teen Sex
Almost half of United States teenagers have
had sex at least once; 13 percent of teens
reported having sex by the age of 15

Contraception Use
One-third of teen girls and just under one-third of teen boys
said they do not use contraception consistently. Many teens do
not think they will get pregnant or contract an STD by skipping
contraception occasionally.
STDs and HIV/AIDS
In 2006, almost one million young adults contracted an STD
and 25 percent of sexually active teens get an STD yearly. 13
percent of people who receive an HIV/AIDS diagnosis are
teens.
Pregnancy
Over 400,000 teen girls became pregnant in 2006, and the
majority of these teen parents were underage.


Teen pregnancy accounts for more than
$9 billion per year in costs to U.S.
taxpayers for increased health care and
foster care, increased incarceration rates
among children of teen parents, and lost
tax revenue because of lower
educational attainment and income
among teen mothers
Pregnancy and birth are significant
contributors to high school drop out rates
among girls. Only about 50% of teen
mothers receive a high school diploma by
age 22, versus nearly 90% of women
who had not given birth during
adolescence
The children of teenage mothers are
more likely to have lower school
achievement and drop out of high school,
have more health problems, be
incarcerated at some time during
adolescence, give birth as a teenager,
and face unemployment as a young adult
http://www.cdc.gov/TeenPregnancy/AboutTeenPreg.ht
m
CDC programme : Reducing Teen
Pregnancy and Promoting Health Equity
Among Youth

Knowledge of sexual issues, HIV, other STDs, and
pregnancy (including methods of prevention).
Perception of HIV risk.

Attitudes toward condoms (pro and con). Intent to
use a condom (for pro)
Perception of peer norms and behavior about sex.
Communication with parents or other adults about
sex, condoms, and contraception.
Individual ability to avoid HIV/STD risk and risk
behaviors.
Avoidance of places and situations that might lead to
sex.


Personal values about sex and abstinence,
Individual ability to refuse sex and/or to use
condoms.
Intent to abstain from sex, or limit number of
partners.










Target in 2000 : 400 HIV
patient/100.000
HIV prevalence
increased by
approximately 112,000
(or 11%) from 2003 to
2006 (from 994,000 to
1,106,400 total persons)



Endometriosis and adolescence
Endometriosis is
confirmed in 50% to
70% of adolescents
whose pelvic pain
fails to respond to
NSAIDs and OCs.


Bad behavior related
adolescent reproductive
health