What is Puberty?

Puberty refers to the time when a child sexually matures hormonally, physically and emotionally, with girls usually reaching this stage before boys.

What is puberty?

Puberty is the name given to the natural process of the body maturing, changing from a child’s body to an adult’s, in both males and females, usually between the ages of 10 and 16. This is to prepare the body for sexual reproduction, and is triggered by hormonal signals sent out by the brain to the reproductive organs. It affects boys’ and girls’ bodies differently, and involves a change in bones, hair, skin, sexual organs and breasts. Puberty further distinguishes the biological nature of each sex.

When do girls begin puberty?

The stages of puberty for girls are as follows:

Stage 1 (10 years old)

In girls, puberty begins when the hypothalamus, which is responsible for releasing hormones, releases the hormone GnRH to the pituitary gland. The pituitary gland is responsible for regulating all the other glands in the body. The release of GnRH triggers the pituitary gland to produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Stage 2 (9–11 years old)

Puberty at this stage includes the following changes:

•  Breasts begin to develop, with tissue growing under the nipple. The skin around the nipple begins to increase in size.
•  The uterus starts to get bigger, in order to prepare the body to be able to carry children.
•  Pubic hair might begin to form on the labia.

Stage 3 (12 years old)

At this stage, the changes in stage 2 continue to develop, but there are new changes too:

•  Breast tissue continues to grow. Breasts can feel painful and sensitive.
•  Armpit hair starts to grow.
•  Pubic hair becomes thicker.
•  Acne may occur, on the face and the back.
•  The child starts to become taller.
•  Fat growth occurs around the hips and the thighs.

Stage 4 (13 years old)

•  Breasts become more developed, and look fuller.
•  Pubic hair thickens even further.
•  The child may have their first period, though it is normal for this to occur up to the age of 14.
•  The child’s height will begin to reach its apex.

Stage 5 (15 years old)

•  Breasts are at their full size, or approaching it.
•  The body’s shape has changed, becoming wider at the hips, thighs and buttocks.
•  Pubic hair grows to the inside thighs.
•  Reproductive organs are developed.
•  Periods usually become regular over a period of 2 years.

What kind of emotions do girls go through during puberty?

Girls can experience a range of emotional changes during puberty, due to the development of the brain during this time, and the sudden changes in hormone levels. These may begin around the time of a girl’s first period, and then may continue throughout puberty, becoming more heightened just before menstruation.

Emotional changes include:

•  Anxiety.
•  Depression.
•  Irritability.
•  Sadness.
•  Sleeplessness.
•  Sudden mood changes.
•  Confusion.

There are other feelings that may be brought on by puberty, which include:

Sensitivity and self-consciousness

It is usual for teenagers to begin to feel sensitive and self-conscious, perhaps about how their body is changing, and more attention may be paid to outward appearance. This is usually more pronounced for girls than it is for boys, as their bodies tend to change before boys, and at a quicker rate.

Peer pressure

Teenagers are more likely to be influenced by their peers, or what they see, and what they like and dislike may change frequently. There may be some friction between the child and authority figures, as either party may feel that the other is out of touch with what is appropriate or important.

Identity issues

At this time, it is common for identity shifts to occur. The child is at the stage of figuring out what it might be to be an adult, though they are not quite there yet. They may perceive themselves as older and more independent, but they may also look for support and guidance.

Sexual feelings

It is normal for changes in thoughts, feelings and sensations surrounding sex to occur during puberty. Teenagers may start to have feelings of sexual excitement, arousal and attraction, which might be scary or confusing at first. It can incur feelings of guilt or shame, which are often not spoken about. There is nothing to feel ashamed of in feeling attraction towards others.

When do boys begin puberty?

Though hormones kick in around the same time as they do for girls, boys tend to start the physical changes of puberty later than girls.

The stages of puberty for girls are as follows:

Stage 1 (10 years old)

In boys, puberty begins in the same way as it does for girls, when the hypothalamus, which is responsible for releasing hormones, releases the hormone GnRH to the pituitary gland. The release of GnRH triggers the pituitary gland to produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Stage 2 (11 years old)

In boys, stage 2 is marked when the testicles start to become larger, including the skin (scrotum) around the testicles. At this stage, pubic hair begins to form around the penis.

Stage 3 (13 years old)

Stage 3 in males is marked by the following changes:

•  Muscles getting bigger.
•  Enlarging of the penis and testicles.
•  Ejaculation during the night, known as ‘wet dreams’.
•  Changes in the voice are marked, with the voice alternating between low and high pitches, as it gradually becomes deeper.
•  Becoming taller in height, which can cause growing pains.

Stage 4 (14 years old)

In males, this stage includes:

•  The colour of the scrotum darkens.
•  Some teenagers may experience acne.
•  Voice levels out at a deeper pitch.
•  Hair may begin to grow in the armpits.

Stage 5 (15 years old)

•  Final size of the penis and testicles.
•  Increased growth of pubic hair.
•  Facial hair may have started to grow.
•  Their height may have reached its apex, or they may continue to grow.

What do both sexes have in common throughout puberty?

Both sexes experience a change in body odour, as the sweat glands become larger. They will need to start using deodorant. Furthermore, acne is a symptom that both sexes may experience, due to hormonal changes causing the pores in the skin to become clogged with excess oil. This may be worse for people who have a history of acne in their family. Mood changes are common throughout puberty, which is normal, though any signs of depression, anxiety or mental health conditions should be discussed with a healthcare professional, as some teenagers can experience severe symptoms of low mood.

What kind of emotions do boys go through during puberty?

Boys experience many of the same feelings and sensations during puberty as girls, and others which may include:

Confusing feelings

Boys can at times feel irritable, and even sad, depressed or angry.

Embarrassment

They may feel embarrassed about the way that their voice is changing, and self-conscious about changes to their skin. Additionally, boys can have unexpected erections, and wet dreams, which may cause embarrassment and feelings of shame.

Can puberty hit really early or late?

Some teenagers see that their peers are going through puberty, which can make them conscious that they haven’t experienced milestone changes in their bodies. For example, a girl might be worried that her friends have had their first period, and she has not seen hers, and a boy may be concerned that he is yet to grow facial hair. This can be a worrying time for teenagers, and they can feel anxious that their bodies will never change. However, only a small minority of people have issues with puberty not occurring by itself. In contrast to this, puberty can come early. It is normal for puberty to begin any time between 8 and 14 for both sexes.

Early puberty

Early puberty, sometimes called precocious puberty, is considered to be when a girl shows signs of puberty before 8 years old, and a boy shows signs of puberty before 9 years old. This does not mean all signs will occur. For most children, there is no known cause for the early onset of puberty.

In some cases, there are medical reasons for early puberty, which can include:

•  A genetic condition.
•  Issues with the ovaries.
•  Issues with the thyroid gland.
•  Damage caused to the brain, perhaps due to trauma or an infection.
•  A brain tumour.

The first signs of early puberty in girls are the growth of breasts and the start of the menstrual cycle. In boys, it is the growth of the penis, the scrotum and the testicles, and the voice breaking. Both sexes may experience growth spurts, acne and a change in body odour. Girls are up to 10 times more likely to experience early puberty than boys.

There are treatments available that may be able to help children to control the symptoms of early puberty:

•  GnRH therapy. This is when the child is given a shot of hormones with the aim of putting the body into a menopausal state until the child is ready to start puberty.
•  Delaying puberty with hormones can also be done via an implant, which is inserted under the skin and releases the hormone over a year, and not through monthly shots.

There are conditions which can appear to be an early onset of puberty, but are separate conditions:

•  Premature pubarche. This is when hair may start to grow early, either in the pubic area or in the armpits, due to the early release of adrenal hormones.
•  Premature thelarche. This is when girls start to develop breasts at a young age, even at a very young age.

Complications of early puberty

Some issues are associated with early puberty, including:

•  Shortness in height. This is not a negative thing; however, the child may end up shorter than they may have been if they had started puberty around the right age. This is because the growth starts earlier than others, but stops prematurely.
•  Early sexual feelings and urges, which can be confusing, and may potentially lead to early sexual activity.
•  Stress and anxiety. Children may be too young to handle their bodily changes.

Late puberty

Late, or delayed, puberty is considered to be when a boy does not experience changes by 15, and girls by 14. Puberty in girls is triggered by oestrogen in the ovaries, and for boys, it is testosterone. Causes of delayed puberty can include:

•  A hormonal delay. If the release of GnRH from the hypothalamus is delayed, the pituitary gland will not release hormones to the ovaries or testicles, thus, puberty is delayed.
•  They may have a condition that could impact growth and maturation, such as cystic fibrosis, and even asthma.
•  Poor nutrition can hinder the development of the body, either through poor diet or eating disorders.
•  Genetic conditions such as Turner syndrome can delay puberty.

There are treatments for delayed puberty, which involves the administration of testosterone in boys, and oestrogen in girls. Hormonal treatment at this stage to trigger puberty is considered to be safe, with signs of puberty becoming apparent in just a few months. The treatment will likely be stopped once the first signs of puberty are seen. Most children who have experienced delayed puberty will reach a normal adult height and maturation.

There are a number of charities and organisations that offer support and advice on puberty:

Who can support with puberty?

• YoungMinds is a charity for children, young people and their parents to support them through challenges to mental health, which is one of the many challenges that can occur throughout puberty.
• Brook is a sexual health and wellbeing service that offers advice, support and online and telephone helplines, as well as in-person consultations.
• SCARF is a charity that provides support for young people, and PSHE support for teachers. They help children to understand their bodies.