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Ask Dr. K: Puberty brings physical, emotional changes

DEAR DOCTOR K: What can I expect when my son goes through puberty?

DEAR READER: I’m tempted to reply: “You don’t want to know.” Then again, you wrote me expecting an answer, so here goes.

There are hormonal changes during puberty. In addition, the brain still is growing and developing; it is not yet the adult brain. There are things the adult brain does that the adolescent brain often does not do — like think twice before doing something.

Puberty usually starts between the ages of 9 and 14 for boys. It typically lasts four or five years. The first sign of puberty in a boy is usually that the testicles and scrotum get bigger, due to changes in male sex hormones. Then the penis starts to grow, at first longer and then wider. The scrotum also gets darker, or redder, and more wrinkled.

Boys gain a lot of weight and develop muscles during puberty. Their shoulders get wider and they grow taller. The peak growth period occurs about two years after puberty has begun.

Hair grows under the arms, on the legs and face, in the pubic area and sometimes on the chest. Glands in the skin make more oil and sweat. Body odor and acne might become noticeable.

Another change is that a boy’s voice becomes lower or deeper than it was during childhood. This may start with squeaking or cracking of the voice.

As hormone levels increase during puberty, boys have more frequent erections. The body starts making sperm, and boys start to ejaculate during an erection. Boys sometimes ejaculate while they are sleeping. This so-called wet dream, or nocturnal emission, is perfectly normal, and it usually goes away as a boy gets older.

Puberty also brings many emotional changes. Your son is developing intense friendships. He cares deeply about what other people think, and he wants to be liked and accepted by his friends.

Respect your son’s growing need for independence from you and desire to keep many things private — at least from you. At the same time that he is becoming more independent from you, your son is becoming much more dependent on his friends. And, particularly in the age of smartphones and online social networks, he is revealing many more personal thoughts, feelings and events to his friends.

During puberty, a child’s moods change quickly and often. Although it can be frustrating, these mood swings are normal and are probably related to changes in hormone levels in the body. Do your best to support, encourage and guide your child though this time.

It’s a good idea to talk to your son about puberty before his development begins. Teenage boys are aware of how emotionally turbulent and impulsive they can be. They often recognize that their behavior is different from when they were younger. They sometimes even feel “possessed” — as though some greater force is influencing their behavior. They can worry that they may be losing their mind. Discussing the changes that come with puberty can help them to know what to expect.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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