Puberty
Between the ages of nine and 15 years (on average, at 12 to 13 years), the vagina and uterus (womb) become bigger. The uterus is the organ in which a baby grows. The vagina is a tube leading from the uterus to the outside of the body. The opening of the vagina is inside the vulva, in between the legs. A clear or whitish fluid may start to flow out of the vagina to keep it clean. Then, about two years after the breasts start to grow, when a girl is between ten and 16 years old (on average, at 13 to 14 years), hormones made by her ovaries cause the ovaries to release an ovum, which moves into the uterus. Usually, only one ovum is released at a time. The hormones also tell the uterus to get ready for a baby, in case the ovum meets a sperm cell and gets fertilized. The walls of the uterus become thicker with extra tissue. Inside the thick part of the uterus are blood vessels and other nutrients that a baby will need to grow. If an ovum in the uterus gets fertilized, it sticks to the wall of the uterus and starts to grow. However, if the ovum is not fertilized, it does not stick. The uterus then gets rid of the ovum and the extra tissue by releasing it from the body. The tissue and blood flows out of the uterus through the vagina. This is called menstruation or having a period. The bleeding normally lasts for about three to five days, though some girls may bleed for longer or have a bit of bleeding between periods. The uterus then starts preparing for another ovum. For most girls, the time between their periods is about one month. For about two years after menstruation starts, the time between periods is not always the same. Some girls may skip a month, or have two periods close to each other. It is also normal to have cramps (rather painful squeezing feelings) or to feel bloated (swollen up) in the abdomen during periods. When many girls start having periods, they begin using sanitary napkins (also called sanitary pads) or tampons to soak up the blood and tissue. A sanitary napkin is a piece of material that is absorbent (able to take in liquids) and is worn between the vulva and underpants. A tampon is a stick of absorbent material that is placed inside the vagina.