Puberty Changes

 Healthy sexuality includes an understanding of how the body works, and how to take care of it. When youth understand their sexual development they can build the confidence and motivation to learn skills and strategies that enhance their health.

 Puberty is the process of a child becoming an adult. Puberty changes are triggered by the increase in the production of hormones. It can start as early as age 8 and go until age 20. Everyone is unique and will follow the timeline set by their own body.

REMMY’S STORY…

Why does it all have to be so hard? I have so much on my plate right now after leaving home that it feels like I just can’t cope with all these other changes. My mood is still all over the place, my so-called friends are ignoring me and, to be honest, I’m just not sure everything is normal down there! I’m going to have to talk to someone but who will even listen?

Puberty Changes

When people think about puberty, they often focus on the changes that happen to the body. Though these may be easiest to recognize, the social and emotional changes are often the changes that youth need the most help understanding and the most support coping with.

Social and Emotional Changes

 These changes are triggered by both physical development of the brain and body as well as changes in socio-cultural expectations. For example, mood swings might be caused by hormone changes, but they are also affected by changing parental expectations and changes in friendships. Some social and emotional changes include:

  •  Wanting more independence
  •  Having stronger feelings of wanting to feel liked and fit in
  • Friendships become more important
  •  Friends and friendship groups may change
  •  Peers and media have greater influence on values and behaviors
  •  Sometimes feeling lonely and confused
  • Thinking more about appearance
  • Becoming more self-conscious
  •  Mood swings
  •  May get crushes and become interested in having a romantic partner (boyfriend, girlfriend)
  •  Expectations from and about parents and school may change
  •  Thinking more about the future

 Managing Social and Emotional Changes

Because of the connection between mind and body, social and emotional health is supported by healthy living choices such as getting enough rest, good nutrition, regular exercise, avoiding substance use, and adequate hydration. The following skills can help youth successfully manage the social and emotional changes of puberty:

  • Self-care and healthy living
  • How to build healthy self-esteem and body image
  • Relationships, communication and boundaries
  • Values and identity development
  • Emotional management and healthy thoughts
  • Safer risk taking
  •  Connecting to community and health supports

Physical Changes

Physical changes often impact the social and emotional well-being of youth so healthy management is important. As with the social and emotional changes of puberty, most of the physical changes happen to everyone, regardless of their assigned sex. These changes include:

  • Growing taller
  • Having temporary period of increased awkwardness/clumsiness
  • Voice changes
  • Skin and hair getting oily
  • Pimples, blackheads, acne
  • Increase in the amount and courseness of body hair (legs, underarms, chest, back)
  • Genital hair growth (pubic hair)
  • Increase in sweating, especially feet and armpits
  • Changes to body odor
  • Breasts changes (may include swelling, tenderness, temporary or permanent development)

Good to know

 Hormone fluctuations cause everyone to have some breast changes during puberty. For youth assigned male at birth, these changes are typically temporary. For those assigned female, some of the changes are temporary (tenderness, hardness under the areola) while breast size and shape changes are lasting. Both during and after development, it can be common for one breast to be a different size or shape from the other.

Some physical changes don’t happen to everyone but are based on a person’s reproductive anatomy.

People assigned male at birth will generally experience these changes in puberty:

  • Increase in the amount and coarseness of facial hair
  • Widening of shoulders
  • Sperm production
  • Penis and testicle growth
  • Increase in erections, including unexpected erections
  • Ejaculation of Sperm

People assigned female at birth will generally experience these changes in puberty:

  • Lasting breast development
  • Hip widening
  • Increase in vaginal fluid
  • Vaginal development
  • Ovulation

Good to know

Youth who identify as a gender other than their assigned sex may find some puberty changes especially challenging. Before puberty, children’s bodies don’t have publicly visible differences based on assigned sex. Puberty changes can make gender expression and self-acceptance more challenging for some trans or non-binary youth. Some youth who are transgender may benefit from medical interventions that can delay puberty changes. Transitioning can be more difficult after the physical changes of puberty. All youth, including trans, non-binary and gender creative youth need support accessing the services they need to feel great about, and take care of, their body.

Managing physical changes

Managing the physical changes of puberty tends to be about understanding anatomy and physiology, acquiring hygiene skills and learning about one’s own body.

Self-Care and Screenings:

As the body matures, it becomes more important for youth to get to know what is normal for all parts of their body and where to go if they notice changes. This includes getting to know what their breasts and genitals look like and checking them regularly. It is important to see a health care provider if a person has pain, unusual discharge, foul smell, sores, irritation, lumps or other concerning symptoms.

Yearly check-ups continue to be an important part of healthy development throughout life. Puberty is a good time for parents and professionals to teach youth about:

  • How to find health care services like a doctor, counselor, optometrist, and dentist.
  • When and how to make an appointment.
  • How to prepare for a health care appointment.
  • How to ask questions and remember information at a health care appointment.

Good to know

 It’s recommended that a person have their first Cervical Screening (Pap test) at age 25 or 3 years after first sexual contact with another person, whichever comes later. Youth are encouraged to get to know what their testicles and breasts look and feel like, reporting any changes to a health care provider.

For ideas and suggestion on how to talk to a health care provider about sexual health, see: 

How to Talk about Sexual Health with Health Care Providers
 

Skin, Hair and Body Odor Changes:

Increased sweat and oil production as well as changing hormones can cause body, skin and hair changes. For adolescents to look and feel their best, it is important that they develop a healthy hygiene routine. Click here for more information about hygiene.

Tip

 Having a complete health-check up at least once a year can be a challenge for youth who have barriers to health care. One way you can reduce barriers to health care is to help youth get access to a copy of their provincial and other health insurance cards and encourage them to carry it with them at all times.

Penis and Testicular Changes:

Sperm Production: During puberty, testicles grow and begin to make to sperm. Sperm is stored in the epididymis, a tube-like structure at the back of the testicles.

Penis Growth: The penis also grows during puberty and has an average size around 5” erect in adulthood. Many people wonder about penis size. Penises come in many shapes and sizes. Everyone is different, so a penis that is larger or smaller is still normal. Size isn’t related to sexual pleasure or fertility. Using pills, creams, or devices to enlarge the penis can cause serious harm and aren’t recommended for anyone, especially youth.

Erections: An erection is when the penis fills with blood and becomes hard, allowing for some types of sex. Sometimes erections happen when a person has a sexual feeling, or the genital area is touched. Sometimes they happen unexpectedly, like at school or during sports. Baggy clothes, sitting down and wearing appropriate sports equipment can all help hide an erection. Staying calm and thinking about other things can help it go away.

Ejaculation: Sometimes when a person has an erection, if they masturbate or have sex, they may ejaculate about a teaspoon of whitish fluid called semen from the penis.

Wet dreams: People often get erections at night when they are sleeping. Many people have an erection when they wake up and will have to wait for the erection to go away before they can urinate (pee). Sometimes people ejaculate when they are sleeping. This is called having a wet dream or a nocturnal emission. If semen gets on bedding or pajamas during a wet dream, it’s important to wash them the next day. Learning how to do laundry can help with this.

Good to know

Circumcision is when the foreskin is removed from the penis. Some people are circumcised, others are not. Circumcision is a personal choice that parents make and is generally not considered medically necessary for health or hygiene. Circumcision is an important part of traditional practice or ceremony of some cultures and faiths.

Vaginal, Uterine and Ovary Changes:

Vaginal fluid: When puberty starts, the vagina starts to make more vaginal fluid. This normal body process helps the body keep the vagina clean and healthy. Vaginal fluid can be clear or whitish; slippery, sticky or a bit creamy. The amount and consistency changes slightly throughout the month. It’s important to talk to a health care provider if someone notices significant changes in color, smell, amount or texture because that can be the sign of a problem. When a person is having a sexual feelings, vaginal fluid increases. 

Ovulation: People are born with all the eggs they’ll ever have stored in the ovaries. During puberty, hormones trigger the ovaries to mature a few of the eggs. While this is happening, the lining of the uterus builds up with blood and tissue. Once mature, the ovaries release one or more mature eggs into the fallopian tube. This is called ovulation.

Menstruation: If the released egg is fertilized by a sperm, the fertilized egg travels to the uterus and implants into the built up lining, creating a pregnancy. If the egg isn’t fertilized, it dissolves in the fallopian tube and the uterine lining sheds and comes out the vagina. This is called having a period, or menstruation. From the first day of one period to the first day of the next is usually around 20-40 days. Each period lasts about 3-7 days. Increased vaginal discharge, breast changes and pubic hair growth mean someone is getting close to having their first period, so it’s a good idea to have a pad handy.

Having a period is a normal part of growing up. Most people feel and act the same when they have their period as when they don’t have their period. People can exercise, shower/bathe, and go to school when they have their period. If they use a tampon or menstrual cup instead of a pad, they can swim during their period.

Good to know

A youth can get pregnant before their first period. If someone is sexually active around the time of their first ovulation and a sperm fertilizes that first egg, it could result in a pregnancy instead of a first period. Some people ovulate a month or two before their first period.

Tip

 Youth may worry that they will get their period at school or that when they get their period, blood will suddenly come rushing out. It can be helpful to let youth know that periods usually start slow, with their first sign being a small smear of blood on toilet tissue or underwear. They need to know where and how to get menstrual products, how to use them, what to do if they don’t have one handy and to not flush them down the toilet. For more information on menstrual products, go to the Menstrual Supplies section of the “Puberty Kit.”

Healthy living strategies like getting enough rest, stress management and regular exercise can reduce uncomfortable symptoms of periods. For some people, periods can be painful and more difficult to manage. Painful periods can be a sign of a problem. Talk to a health care about periods if:

  • Someone has severe headaches or nausea with periods.
  • Periods last more than 7 days or are very heavy (need to change pad or tampon every hour or have lots of clots).
  • There’s bleeding between periods.
  • A sexually active person missed a period or someone who is not sexually active. missed several or missing several periods when not sexually active.
  • Someone got their first period before age 8 or not having a period by age 16.

Good to know

Some youth use over the counter pain medication to manage menstrual cramps. It is very important to use any medication exactly as instructed by a health care professional or on the package. Over the counter pain medications are not always effective for some people. If a pain medication does not work at the recommended dose, increasing the dose doesn’t usually help and can cause serious health problems.