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PUBERTY AND SEXUAL DEVELOPMENT

Puberty is the process of a child growing and maturing into an adult. When puberty starts is different for everyone; it can start as early as age 8 and go until age 20. Females tend to start puberty earlier and males tend to finish puberty later. However, everyone is unique and will follow the timeline set by their own body. Puberty changes happen slowly and take several years to complete.

 

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 enhance their health and the skills and strategies to avoid negative outcomes.

REMMY’S STORY…

 

Why does it all have to be so hard? I have enough on my plate right now after leaving home and now problems down there! I’m just not sure that everything is normal. I know I’m circumcised so I guess that may affect my size. What is the right size penis anyway? I’m going to have to talk to someone but who will even listen?

JEN’S STORY…

 

Still no period! I know I’m not pregnant ‘cause I haven’t had sex in six months. So what’s going on? I’ve been getting my periods since I was 12, so you’d think that they would come regularly by now. One of the girls at the shelter said that stress and even not eating well can affect your period, so I guess that could be the reason. But what if there’s something really wrong with me?

PUBERTY CHANGES

Many of the changes that happen during puberty are physical changes that happen to the body. Although they are the easiest to recognize, puberty also has social and emotional changes. The table below presents all of these changes.

Puberty Changes at a Glance

Puberty ChangePhysicalSocialEmotional
Grow taller
Thinks more about looks (clothes, hair)
Voice changes
Skin gets oily
Mood swings
Acne (pimples)
Hair grows on face (males)
Hair gets oily
Start having sexual thoughts and feelings
Hair grows in underarms
Hair grows on genitals (pubic hair)
Start to sweat (body odour)
Breasts develop*
May become interested in having a boyfriend or girlfriend
Hips get bigger (females)
Shoulders gets wider (males)
Start producing sperm (males)
Penis grows bigger (males)
Friendship become more important
Brain starts sending sex hormones around the body
Wet dreams (males)
Unexpected erections (males)
Sometimes feel lonely and confused
Start making sperm (males)
Stronger feelings of wanting to be liked and “fit” in
Testicles get bigger (males)
Want more independence
Sperm can be released through the penis – ejaculation (males)
Start making vaginal discharge (females)
Start releasing eggs from the ovaries – ovulation (females)
Start having periods – menstruation (females)
Thinking about the future

*The rise in sex hormones can lead to young males developing enlarged breasts. Nearly one in two males experience temporary enlargement of the breasts during puberty which can cause some embarrassment.


 

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Transgender youth (people whose gender identity, outward appearance, expression and/or anatomy do not fit with conventional expectations of male or female) may find puberty very difficult. They will need support recognizing that their changing body needs care no matter which gender they identify with. Talking with a professional may be helpful. The information below outlines changes that can happen to a male body or female body in relation to reproduction and anatomy.

MALES AND PUBERTY

Puberty for males can start any time between the ages of 9 and 14 and last until around age 20.

Some of the physical changes of puberty that are unique to (biological) males include:

 

  • Developing broader shoulders.
  • Growing hair on the face.
  • Growth of the penis and testicles. Penis length varies from male to male. The average penis is 5 inches when it is erect (hard), and 3 ½ to 4 inches when flaccid (soft).  Everyone is different, so a penis that is larger or smaller is still normal.
  • Unexpected erections. Erections (when the penis fills with blood) happen since birth. But during puberty, they happen more often, and may happen out of nowhere. Males can sit down if this happens, so that the erection is less noticeable.
  • Sperm production. Sex hormones are released into the body leading to the production of sperm.
  • Ejaculation is when sperm are released from the penis in the form of semen. Semen is a sticky, whitish fluid. It is made up of water, mucous, sugar, acids and bases and carries sperm cells. A typical quantity of semen in an ejaculation is about 3 to 5 millimeters (a teaspoon). Most males can ejaculate semen by the time they are 15.
  • Wet dreams. Wet dreams are where small amounts of semen are released during sleep.


 

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Young men may be concerned about penis size. It is important to emphasize that everyone goes through puberty at different rates and some do not finish growing until they are in their late teens. It is important to note that penis size does not affect a male’s ability to give or receive sexual pleasure or to create a pregnancy. Using pills or creams to enlarge the penis is not recommended as these products do not have medical research to support that they are safe.

 


 

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Testicular cancer can affect males at any age; it occurs most often in males aged 15-35 and is the most common cancer in this age group. Testicular self-exam (TSE) help teach what feels normal so that a change can be found early and treated. There may or may not be swelling or pain. If testicular cancer is found early, there is a greater chance that it can be cured.

 

To learn more about testicular health and testicular self-exam (TSE), see testicularcancercanada.ca

MAINTAINING GOOD SEXUAL HEALTH FOR MALES

To maintain good sexual health it is important to recognize changes and talk to a healthcare provider if there are concerns. Any changes of the penis such as unusual discharge, sores, lumps, or painful urination should be reported to a healthcare provider. It is important to:

 

  • Check the penis and testicles regularly for lumps, sores, rashes or any unusual discharge, which may be a sign of infection.
  • Wash the penis and testicles daily with mild soap and water. In uncircumcised males, the foreskin of the penis needs to be pulled back gently so that the skin underneath can be washed. This helps to lessen the chance of skin irritation and possible infection.


 

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If uncircumcised, some males find that the foreskin does not pull back until after they have finished puberty. Keeping the penis clean by pulling back the foreskin is important, but the foreskin should not be forced back. It is important to see a healthcare provider if there is discomfort with foreskin.

FEMALES AND PUBERTY

Puberty for females can start any time between the ages of 8 and 13. Some of the physical changes of puberty that are unique to (biological) females include:

 

  • The hips begin to widen.
  • Breasts begin to develop.

Some young females experience breast tenderness as their breasts grow, which is normal. It is also common for one breast to be larger or a different shape than the other.

 

Other physical changes occurring for females during puberty include the making of vaginal discharge, and menstruation and ovulation.

Vaginal discharge:

 

Vaginal discharge is a normal puberty change, it starts anywhere from 6 months to a year before menstruation begins.  It is a normal process that helps the body to remove dead cells and bacteria from the vagina.  Vaginal discharge is normally clear or whitish in color.   It may change slightly in amount or consistency at different times of the month, which is normal.  Any significant change in color, smell, amount or texture, could be a sign of infection, and should be discussed with a health care provider.

 

Menstruation and ovulation:

 

As females go through puberty they experience their first period or menstrual bleeding, signaling that the ovaries are releasing eggs and the body is now capable of conceiving a pregnancy. A menstrual cycle is the length of time it takes the body to go through the process of:

 

  • Maturating and releasing an egg (ovulation).
  • Thickening the lining of the uterus and preparing for a fertilized egg.
  • Shedding the thickened lining (period or menstrual bleeding) when there has not been a fertilized egg implanted to create a pregnancy.

The average age a female goes through her first menstrual cycle and gets a period is about age 12. However, some females get their first period as early as 8 or as late as 16 years old.

 

The length of a cycle is counted from the first day of bleeding in one month to the first day of bleeding in the next month. When a female first starts getting a period the cycle will probably not be regular. This is normal.

 

A menstrual cycle is approximately 28 days, but normal cycles can vary from as short as 20 days to as long as 40 days. The number of days that a female will bleed also varies. It is normal to bleed for approximately 2-7 days.

Having a period is a normal and healthy part of growing up. However, for some, periods can be painful and difficult to manage. Menstruation continues throughout a female’s reproductive life until around age 50. Menopause, the time when menstruation stops, can happen anytime between age 40 and 58 years.

 

Reasons to talk to a healthcare provider include:

 

  • Having the first period before age 8 or not having a period by age 16.
  • Having a lot of pain or cramping with periods.
  • Bleeding that often lasts for more than 7 days.
  • Bleeding that is really heavy (e.g., changing a pad or tampon every 1 or 2 hours or passing lots of clots).
  • Bleeding between periods.
  • Missing a period (if participating in sexual activity) or missing several periods (only if the female has NEVER been sexually active).


 

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Stress, diet, weight loss or gain, birth control and pregnancy can all affect the menstrual cycle. It is important to talk to a healthcare provider if there is concern about the menstrual cycle.


 

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It is recommended that everyone have a complete health check-up at least once a year. This may not be possible for those who may not have access to healthcare or may not feel comfortable talking to a healthcare provider.

How can you support youth to feel more comfortable using healthcare services?

MAINTAINING GOOD SEXUAL HEALTH FOR FEMALES

To maintain good sexual health it is important to recognize changes and talk to a healthcare provider if there are concerns. It is important for females to monitor both breast health and cervical health.

 

Breast Health:

  • All breasts have a certain amount of ‘lumpiness’ so females should know what feels normal for them and if something does not feel right, talk to a healthcare provider. A clinical breast exam performed by a healthcare provider can help detect changes early.
  • For more information on breast cancer, see ScreeningForLife.ca

Cervical Health:

  • Healthcare providers may perform a pelvic exam to examine a female’s reproductive organs. To learn more about having a first pelvic exam, see SexualityAndU.ca
  • A Pap test checks for changes in the cells of the cervix. If any cell changes are found, they should be followed closely. If needed, cell changes can be treated so that cancer does not develop.
  • A Pap test does not test for infections and is not an STI test. A female should talk to a healthcare provider if she would like to be tested for STIs.
  • For more information about cervical screening, see ScreeningForLife.ca


 

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Current guidelines recommend a Pap test for females who are 25 years of age or 3 years after first sexual activity, whichever is later. Sexual activity includes any intimate sexual contact in the genital area. This includes touching, oral sexual activity or intercourse with a partner of either sex.

RESOURCES

Alberta Health Services – Teaching Sexual Health:  www.teachingsexualhealth.ca

 

Alberta Health Services – Screening for Life: www.screeningforlife.ca

 

KidsHealth from Nemours:  www.kidshealth.org