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TCM Views on Puberty

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TCM Views on Puberty

TCM Views on Puberty

Author: Physician Chan Yee Shuin | August 2021 | Zhongjing TCM 

No parent feels prepared for “being a parent”. From pregnancy, to their child’s first breath on this world, to their first day at school, it was no easy feat. And then comes puberty! Every parent would have gone through puberty, but what is it all about?

What is puberty about?

1 What happens

Puberty refers to the phase when a child starts to mature into a young man or woman. Through this process, they become sexually mature and are capable of reproduction. It is a period of varying physical and emotional changes, and most importantly it is a phase of growth.

The age of onset ranges, but mostly falls between 11-14 for boys, and 11-12 for girls. During puberty, boys will experience an increase in their height and weight, their muscles start to bulge and their shoulders will broaden. There will be hair growth at the genital, armpit, face and chest areas. Their penis and testicles enlarge, erections and ejaculations occur more frequently and their voices start to deepen. For girls, they will also experience an increase in their height and weight, and their hips broaden, buttocks and thigh areas may thicken. There will be hair growth at the genital and armpit region, their breasts start to develop and they will experience their first menstruation - menarche. For both boys and girls, their skin may become oilier and acne may occur. Perspiration will also increase, which may cause body odour. All these changes would take place throughout the adolescent stage, usually from 10 - 19 years of age.

 

What is the medical (TCM/Western) understanding of puberty?

Puberty is a result of a whole series of hormones triggering different biological processes in the body. The hypothalamus in the brain first releases a hormone called Gonadotropin Releasing Hormone, which triggers the Anterior pituitary gland, also in the brain to release two hormones - Luteinizing hormone and Follicle-stimulating hormone. These two in turn affect the gonads - testes in boys and ovaries in girls - to produce hormones that result in the secondary sexual characteristics throughout the body.

2 TCM‘s Understanding’

In TCM, we understand puberty from a different perspective. According to an excerpt from an ancient text called 《黄帝内经》 (Huangdi’s Internal Classic),

“女子......二七天癸至,任脉通,太冲脉盛,月事以时下,故有子”

“男子......二八肾气盛,天癸至,精气溢泻,阴阳和,故能有子”

It says that at the age of about 14 for girls and 16 for boys, they become sexually mature and are able to bear children. A substance called Tian Gui, which is understood to control the growth, maturation and decline of a person’s reproductive abilities, is produced. In girls, Tian Gui directs Qi and Blood to fill the Chong and Ren meridians, and menstruation will take place, leading to the ability to conceive. For boys, Tian Gui controls the accumulation and release of Essence and Qi, and thereafter are also able to conceive.

The production of Tian Gui relies on the abundance of Kidney Qi. During the adolescent stage, Kidney Qi is abundant, resulting in Tian Gui which directs sexual maturation. Tian Gui can be thought of as something similar to the sexual hormones that direct sexual maturity from the biological perspective.

 

Is going through puberty an issue?

Yes, and no. For some, it may have been a breeze. They may not even have any recollection of the presence of such a “phase” in their lives. For others, that is not the case. Not only does the child have to deal with the biological changes in their physical body, they are also becoming socially aware of their self, peer, and community identities. Some common issues that will be addressed in this article are acne, menstrual cramps and mental health.

Skin troubles - Acne

Acne is an inflammatory skin condition. When skin pores are clogged by oil and dead skin cells, these buildups can become infected by bacteria which results in redness and swelling. Acne can affect the face, chest and back. Common causes are inflammation, overgrowth of skin cells clogging pores, production of skin oil, and even acne bacteria.

Acne is often referred to as 粉刺 (fen ci) or “青春痘” (qing chun dou) where “青春” refers to youth or the the youthful age, and “” would refer to the pustules on the skin. Such a name is quite apt, since acne is often most observed in adolescents as puberty begins, and improves after a certain age for most. For others, it may persist further into adulthood. From the TCM perspective, the main pathological agents for acne would be heat, dampness and phlegm. Hence the treatment principle would be to first dispel the heat and remove dampness, and can be complemented with methods of resolving phlegm.

TCM treatment for acne will include oral and external methods. Oral would be the consumption of herbal medication which is best discerned by a professional TCM physician, and medication is best coupled with external treatment methods such as topical application of medication or even acupuncture. When combined, the internal environment of the body, what we refer to as body constitution, can be improved to reduce the occurrence of acne, and external treatments can directly take effect on the skin lesions to also contribute to healing and recovery.While self-medication is not advised and it is best to seek professional medical practitioners, we can still enjoy some simple teas to reduce acne occurrence in mild cases. For those who are facing pimple and acne issues, the following tea and lifestyle changes is advised.

3 Skin troubles

 

Monthly troubles - Menstrual cramps

When a girl begins her menstrual periods, it often takes about 2 years for her menstrual cycle to become regular. A regular menstruation cycle should be about 21 - 35 days, and the menstrual period is usually between 3 - 7 days. There should be little to no discomfort felt during menstruation. However, a common problem when girls start menstruating is having menstrual cramps. They may feel pain in their lower abdomen before, during or after their period. This pain can extend to the hips and lower back, and in severe cases it can even lead to fainting.

Pain can arise from two different causes according to TCM. The first, is pain due to lack of nourishment, “不荣则痛”. Deficiency in essence and blood results in insufficient nourishment for the Chong and Ren meridians as well as the womb leading to pain. The second is pain from the obstruction of flow, “不通则痛”.Obstruction of the flow of Qi and blood to the Chong, Ren meridians and the womb can also lead to pain. The crucial principle for TCM physicians in treating menstrual cramps is to differentiate the two. Menstrual cramps are not only an issue faced by girls going through puberty, but also affecting those in adulthood. Our Physician Quek Yi Yan has spoken on this topic and written an article on it titled “TCM Views On Menstrual Cramps (Dysmenorrhea)”, which includes in-depth explanation on menstrual cramps, and tips on managing it with recipes and acupressure massage!

4 Menstrual troubles CN

 

Worry troubles - Mental health

According to the World Health Organization, mental health conditions account for up to 16% of the global burden of disease and injury in people in the adolescent age group - ages 10 - 19 years. Up to half of mental conditions start by the age of 14, yet the majority are left undetected and untreated. It is an issue that deserves more attention because the consequences of not addressing adolescent mental health conditions actually extend into adulthood. This can impair both physical and mental health of these individuals.

Factors that contribute to stress during adolescence include exploration of their self-identity, quality of home life and relationships with peers. The adolescent period is a trying time for the individual, both mentally and physically. It is a crucial formative period in one’s life. Physical changes can bring about confusion, fear and emotional instability, what we often refer to as “mood swings”. Hence, it is not only important to prepare them with knowledge on the physical changes during puberty and maintaining hygiene, but also to strengthen communication to guide them in learning how to navigate society and handle social relations.

According to TCM, the organ most closely related to emotions would be the Liver. When the Liver Qi is not regulated, our emotions may become unstable. However, the cause of the obstruction and disorder of Liver Qi is very often due to excessive emotions that are harmful for the body or the innate constitution of the body. It can thus become a vicious cycle where unregulated emotions aggravate the obstruction of Liver Qi which in turn destabilize emotions further.

The main principle for TCM treatment of obstructed Liver Qi is to regulate movement of Qi. While medication prescribed by professional TCM practitioners can help with regulation of emotions, it is important to have a multi-pronged approach to such issues. In TCM, emphasis on tackling issues holistically is apparent in the advice on diet and lifestyle changes that comes with virtually every consultation. Other measures we can take in tackling adolescent mental health issues are related to daily habits and the environment in the family. It is good to establish healthy sleep patterns and regular exercise which help in dealing with the stress. A supportive environment in the family and at school is important, where it is not just a one-way communication of just teaching the child what to do, but to maintain healthy mutual conversation to hear them out.

Family bonding activities are one good way to improve the parent-child relationship and establish a safe support system at home. One of the many types of activities can be cooking! Parents can try out the following recipe with their children. Not only can the family spend time together and get comfortable with each other, the main star of the recipe uses rose buds, an ingredient that is great for regulating Liver Qi to help in improving our moods.

5 Worry troubles

While no parent starts off parenting feeling prepared, we can do our part to gear our children up for puberty. It is no easy journey. Hopefully the troubles addressed in this article can help you understand and navigate puberty a little better! It may be tough, but like any other phase, it is transient and will eventually pass.

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