Caring for Kids…at Billings Clinic

4 things your tween needs to know about puberty but is too afraid to ask

Girls tend to hold the spotlight on adolescent hormonal angst, but sometimes boys go through the pubertal stage just as dramatically.  For many boys, puberty occurs rather suddenly and when changes do occur, they seem to happen all at once. In some instances, a boy will come back from summer break 6 inches taller and look like a man-child, while others struggle with still being offered a kid’s menu at 14.

When does it start?

Male puberty usually starts somewhere between the ages of 9-14, and in the case of some late bloomers, significant changes will not be noticeable until 15-16.  If a boy is well into 14 and shows absolutely no signs of puberty (ie, enlarged testicles), then there may be cause for concern and a visit with your pediatrician is probably a good idea.  For similar reasons, you may want to see the doctor if your 7-8 year old is developing pubic hair or genital enlargement.

How will I change physically?

Male puberty is fraught with concerns about voice changes, body image (hair and muscles), nocturnal emissions (“wet dreams”), breast enlargement, acne, penis size and shape. The onset of boys’ pubertal development is marked by an increase in testicular size and darkening of the scrotum’s skin. These changes are followed by light downy pubic hair at the base of the penis.  Another change happening during this time is an increase in the growth of hands and feet, giving boys that awkward “all arms and legs” look.  Some boys may get a little peach fuzz mustache as facial features get a bit coarser and pimples start to arise on the nose and forehead.  Others may develop a hard button of breast tissue under one or both of their nipples; this is totally normal and does not mean they will grow full breasts.

Why are these embarrassing things happening?

When the voice box starts to grow and the vocal cords stretch, it often leads to cracks and screeches with speech. While this is embarrassing, it is completely normal and will not last long. Boys also start getting “wet dreams,” which are just spontaneous ejaculations that occur at night.  Wet dreams are not directly linked to dreams about sex.  In fact, it is normal for wet dreams to happen without cause.  Also, boys can get sudden and random erections that occur for no reason (and usually happen at the most awkward moments).

Is this normal?

Most boys need reassurance that all of these changes are normal and part of becoming a full adult male.  While some boys may not actively seek out biology lessons from their parents, a couple of well-timed conversations about normal body changes may be secretly welcomed (even when met with sighs and eye-rolling).  Let them know that men come in all different shapes and sizes. A 6-foot tall muscular body type may not be attainable by all boys, and that is okay.  Average adult male height in the U.S. is only 5’9”!  Boys often compare themselves to the guys that started shaving in sixth grade and wonder why they still look like a little kid.  Give it some time, and lots of food (try and keep it healthy and nutritious), and they will get there too!


Michelle Pierson, MD

Hi! My name is Michelle Pierson and I am a wife, mom, and general pediatrician at the Billings Clinic. I am excited about this blog and the opportunity to reach out to parents in my hometown of Billings. Growing up here and raising my own kiddos in this community gives me some perspective on how we can take care of our children's health with the resources we have in the region. I get great joy from my family and job, and a good piece of chocolate cake! A good book and "cuddle time" with my kids on the couch rank up there pretty high too.

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