As children enter the teenage years, additional medical topics become more relevant. Please review these articles that cover situations teens and their parents may encounter.
You know your child best. Please contact our office with any concerns about your teen’s wellbeing, mental, or physical health.
Puberty:Ready or Not Expect Some Big Changes
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Everyone goes through puberty but not always at the same time or in the same way. It is when your body starts changing from that of a child to that of an adult. At times, you may feel like your body is out of control.
Compared with your friends, you may feel too tall, too short, or awkward. You may feel self-conscious about these changes, but many of your friends probably do too. In general, here's what you can expect. (When the word
When Does Puberty Begin?
There's no "right" time for puberty to begin. But puberty for girls starts a little earlier than for boys, usually between ages 8 and 13 years. Puberty for boys usually starts at about ages 11 to 14 years.
What Changes Can I Expect?
Soft hair starts to grow in the pubic area (the area between the legs and around the genitals [the vagina or penis]). This hair becomes thick and very curly. It is not necessary to shave your pubic hair. You may also notice hair under your arms and on your legs. Boys start to get hair on their face or chest. Some girls notice that the hair on their legs has become darker. You may choose to shave or trim unwanted hair.
During puberty, your skin gets oilier. This oil can cause acne (also called
Do wash your face twice a day. In general, milder soaps and cleansers are better for your skin.
Do use an oil-free moisturizer on your face after washing.
Don't pop or pinch your zits. All this does is break open the lining of the oil ducts and make them redder and more swollen. This can also cause scars.
Don't scrub your skin too hard. This irritates the skin.
You may begin to sweat more. Most people use a deodorant or an antiperspirant to control underarm odor and wetness.
Other Changes (Girls)
Breasts. In most girls, the first sign of puberty is breast development (small, tender lumps under one or both nipples). There may be soreness, which goes away as your breasts grow. Don't worry if one breast grows a little faster than the other. By the time your breasts are fully developed, they usually end up being the same size. When your breasts get larger, you may want to start wearing a tank top or bra under clothing. Some girls are excited about this. Other girls may feel embarrassed, especially if they are the first of their friends to have breasts. Talk with a parent or another trusted adult to work through your feelings and get advice on tank tops and bras.
Shape. As you go through puberty, you get taller, your hips get wider, and your body begins to build up fat in your belly, hips, thighs, buttocks, and legs. It is normal for girls to develop different body shapes.
Periods. Your menstrual cycle, or "period," starts during puberty. Most girls get their periods 2 to 2½ years after their breasts start to grow (between 10 and 15 years old). After the first period, it can take up to 2 years for periods to occur every month. When you start having periods, you are able to get pregnant—even if you don't have a period every month.
During puberty, your ovaries begin to release eggs. A baby may develop in your uterus if an egg connects with sperm during sexual intercourse. To help your body prepare for this, a thick layer of tissue and blood cells builds up in your uterus. If the egg doesn't connect with sperm, your body does not need these tissues and cells. They turn into a bloodlike fluid and flow out of your vagina. Your period is the monthly discharge of this fluid out of your body.
During your period, wearing a menstrual pad, menstrual cup, or tampon or wearing menstrual underwear protects your clothes. These can be used together and need to be changed every few hours. Most periods last from 3 to 7 days. You may find it helpful to track your periods on a calendar or smartphone app.
Having your period does not mean you have to avoid physical activities like swimming, running, or physical education class. Exercise can even help get rid of cramps and other discomforts you may feel during your period.
Other Changes (Boys)
Height. Around 13 to 15 years old, you will have a
Muscles. As you go through puberty, you get taller, your shoulders get broader, and, as your muscles get bigger, your weight increases. These changes usually occur later in puberty, around 15 to 18 years old.
Penis and testes. During puberty, the penis and testes get larger. There's also an increase in sex hormones. You may notice that you get erections (when the penis gets stiff and hard) more often than before. This is normal. Even though you may feel embarrassed, try to remember that unless you draw attention to your erection, most people won't notice it. Also, everyone's penis is different, so if the size of yours differs from that of another person's, it doesn't mean there is anything wrong with you.
Wet dreams. During puberty, your testes begin to produce sperm. So during an erection, you may also ejaculate. Ejaculation is when semen (made up of sperm and other fluids) is released through the penis. This could happen while you are sleeping. You might wake up to find that your sheets or clothes are wet. This is called a
Voice cracking. Your voice gets deeper, but it doesn't happen all at once. It usually starts with your voice cracking. As you keep growing, the cracking stops and your voice stays at the lower range.
Breasts? You may have swelling under your nipples. If this happens to you, you may worry that you're growing breasts. Don't worry, you're not. This swelling is very common and only temporary. Most common ages for male breasts are 11 to 16 years. But if you're worried, talk with your doctor.
Along with physical changes during puberty, there are many emotional changes. For example,
You may care more about what people think of you because you want to be accepted and liked.
Your relationships with others may begin to change. Some may become more important and some less so. You'll start to separate more from your parents and identify with others your age.
You may not like the attention of your parents and other adults at times. Keep in mind that they are also trying to adjust to the changes you're going through. Many teens feel that their parents don't understand them. This is normal. It's usually best to let them know (politely) how you feel and then talk things out together.
You may lose your temper more easily and may feel that nobody cares about you.
You may begin to make decisions that could affect the rest of your life.
Talk about your feelings with your parents, another trusted adult, or your doctor or other health care provider. You may be surprised by how much better you feel.
Sex and Sexuality
During this time, many teens also become more aware of their romantic feelings. A look, a touch, or just thinking about someone may make your heart beat faster and may produce a warm, tingling feeling all over. You may not be sure who you like. That's OK and you shouldn't feel worried about these changes. You may ask yourself . . .
When should I start dating?
When is it OK to kiss?
How far should I go sexually?
When will I be ready to have sexual intercourse?
Will having sex help my relationship?
Do I have to have sex?
How do I know who I like? How do I know if I'm gay, lesbian, or bisexual?
What is oral sex? Is oral sex really sex?
Is it OK to masturbate (touching your genitals for sexual pleasure)? Masturbation is a normal private activity that won't harm you. Some people masturbate and some don't.
Remember, talking with your parents or doctor is a good way to get information and to help you think about how these changes affect you.
Decisions About Sex
Deciding to become sexually active can be very confusing. On the one hand, you'll receive many warnings and dangers about having sex. Yet movies, TV, social media, and lyrics in songs will all seem to be telling you that having sex is OK.
It's normal for teens to be curious about sex, but deciding to have sex is a big step. There's nothing wrong if you decide to wait to have sex. Not everyone is having sex. Half of all teens in the United States have never had sex. Many teens believe that waiting until they are ready to have sex is important. The right time is different for each person.
No one should be forced or pressured to have sex! If you ever are, it's important to never blame yourself and to tell an adult you trust as soon as possible. Medical and counseling supports are available to help someone who has been forced or pressured to have sex.
Deciding to Wait
If you decide to wait, plan how you are going to say no so you are clearly understood. Stay away from situations that can lead to sex. For example, avoid being alone with someone who has been pressuring you to have sex. Or avoid using drugs or alcohol or going to party where people are using drugs or alcohol. Remember, a person who doesn't support your decision to wait may not be the right person for you.
Making Health Decisions About Sex
If you decide to have sex, it's important that you know the facts about birth control, sexually transmitted infections (STIs), and emotions. Sex increases your chances of becoming pregnant, becoming a teen parent, and getting an STI, and it may affect how you feel about yourself or how others feel about you. These are important decisions and are worth talking about with adults who care about you, including your doctor.
Taking Care of Yourself
As you get older, you will need to make many decisions to ensure that you stay healthy.
Eating right, exercising, and getting enough rest are important during puberty because your body is going through many changes.
It's also important to feel good about yourself and the decisions you make.
Whenever you have questions about your health or your feelings, don't be afraid to share them with your parents and doctor or other health care provider.
Visit HealthyChildren.org for more information.
The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.
In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.
The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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