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Discussing Puberty

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q: How do I explain the monthly cycle to my 11-year-old niece, who still believes in Santa? While washing her hair last night, I noticed small breasts and pubic hair. I use a razor for my underarm hair, but what does an 11-year-old use? Would the library have any books on this subject?

A: I do not know your family's situation, but the first thing I would suggest is that you make sure it is all right with your niece's mother for you to begin discussing this topic with her. She may have other plans in place! It sounds like you are very close to your niece, and if you are the major adult female that she relates to, then it would be a good idea to start talking with her about this now.

It is important to present the changes of puberty and menstruation in a calm and clear manner, and in a positive way. You do not want to scare young girls, and you want them to see it as a natural part of growing up.

Fortunately, there are a lot of good books available that can help you get started with it. One of my favorites is The Period Book: Everything You Don't Want to Ask, But Need to Know by Karen Graevelle. This is written for girls, and you can read it together as a way to begin discussing the topic.

Other good books are: What's Happening to my Body Book for Girls (there is one for boys too), by Linda Maderas, and It's Perfectly Normal, by Robie Harris. There are a lot of other books on puberty, and you should visit your local library and scan through a few to see which ones appeal to you.

As far as underarm hair goes, I recommend leaving it alone for as long as possible. In the first year or so of puberty, it is often not very noticeable. For girls with very thick underarm hair, or problems with excessive underarm odor, removing the hair may be helpful. I would not use hair removal products, as they can be very irritating to the skin. It would be preferable to clip the hair or use a gentle razor, with supervision by an adult.

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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.

Please note: This "Expert Advice" area of should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

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