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
Everyone goes through puberty, but not always at the same time or in exactly the same way. It is the time 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 does puberty begin?
There's no "right" time for puberty to begin. But girls start a little earlier than 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?
Chemicals called hormones will cause many changes in your body.
Soft hair starts to grow in the pubic area (the area between your legs and around your genitals [around your vagina or penis]). This hair will become thick and very curly. It is not necessary to shave your pubic hair. It is a normal change as you become an adult.
You may also notice hair under your arms and on your legs. Boys start to get hair on their face or chest. You may choose to shave or trim unwanted hair.
During puberty, your skin gets oilier. This can cause acne (also called pimples). Acne is not caused by dirt or eating certain foods, and you can't catch acne from or give acne to another person.
Talk with your doctor about how to treat and control mild or severe acne. A few tips on how to care for your skin include
Do wash your face twice a day. In general, milder soaps and cleansers are better for your skin.
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—it irritates the skin.
You may begin to sweat more. Most people use a deodorant or an antiperspirant to keep underarm odor and wetness under control.
Other Changes (Girls Only)
Breasts. The first sign of puberty in most girls is breast development (small, tender lumps under one or both nipples). There may be soreness, which will go 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 your mom or another trusted adult about your feelings and get advice on tank tops and bras.
Curves. As you go through puberty, you'll get taller, your hips will get wider, and your body begins to build up fat in your belly, hips, thighs, buttocks, and legs. This is normal and gives your body a curvier shape.
Periods. Your menstrual cycle, or "period," starts during puberty. Most girls get their periods 2 to 2 1/2 years after their breasts start to grow (between 10 and 15 years old). It can take up to 2 years for periods to occur every month. A girl who has started having periods is able to get pregnant, even if she doesn't have a period every month.
During puberty, your ovaries begin to release eggs. If an egg connects with sperm from a man's penis (fertilization), it will grow inside your uterus and develop into a baby. 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 a sperm, the body does not need this tissue or these cells. They turn into a blood-like fluid and flow out of your vagina. Your period is the monthly discharge of this fluid out of the body.
You will need to wear some kind of menstrual pad or tampon, or both, to absorb this fluid and keep it from getting on your clothes. Most periods last from 3 to 7 days. It may be helpful to track your periods on a calendar or smartphone app.
Having your period does not mean you have to avoid normal activities such as swimming, horseback riding, or physical education class. Exercise can even help get rid of cramps and other discomforts you may feel during your period.
Other Changes (Boys Only)
Height. Around 13 to 15 years old you will have a growth spurt, meaning large growth in height and shoe size. During this time, you may feel hungrier and eat more. Because you are growing quickly, you won't be very muscular until the growth spurt stops.
Muscles. As you go through puberty, you'll get taller, your shoulders will get broader, and, as your muscles get bigger, your weight will increase. This usually occurs 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 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 it, most people won't notice your erection. Also, everyone's penis is different, and if your size or shape compared to another boy is different, it doesn't mean there is anything wrong with you.
Wet dreams. During puberty, your testes begin to produce sperm. This means that during an erection, you may also ejaculate. This 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 your sheets or clothes are wet. This is called a nocturnal emission, or wet dream. This is normal and will stop as you get older.
Voice cracking. Your voice will get deeper, but it doesn't happen all at once. It usually starts with your voice cracking. As you keep growing, the cracking will stop and your voice will stay at the lower range.
Breasts? You may have swelling under your nipples; this is common between 11 and 14 years old. 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. But if you're worried, talk with your doctor.
Along with all the physical changes you will go through during puberty, there are many emotional changes. For example
You may start to care more about what other people think about you because you want to be accepted and liked.
Your relationships with others may begin to change. Some 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 their parents don't understand them; this is a normal feeling. 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 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. You may be surprised at how much better you will feel.
Sex and Sexuality
During this time, many teens also become more aware of their sexual 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 if you are attracted to boys, girls, or both. That's OK and you shouldn't feel worried about it.
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?
If I am attracted to a same-sex friend, does that mean I am gay or lesbian?
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 and it won't harm you. Some boys and girls masturbate; 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 hear many warnings and dangers about having sex. On the other hand, movies, TV, magazines, and the lyrics in songs 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. About half of all teens in the United States have never had sex. Many teens believe 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 are ever forced or pressured to have sex, 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 ahead how you are going to say no so you are clearly understood. Stay away from situations that can lead to sex, such as being alone with someone who has been pressuring you to have sex, using drugs or alcohol, or going to a party where people will be drinking alcohol or using drugs. 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 to 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 the way 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 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.
Visit HealthyChildren.org for more information.
Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. 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.