Male Puberty

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The changes in the structure and function of the body that happen during puberty to make sexual reproduction possible.

What is puberty?

Puberty is a stage of development that our bodies go through to reach sexual maturity. The physical and psychological changes that we experience during puberty prepare us for reproduction.

What causes puberty?

Puberty begins when a part of the brain, called the hypothalamus, begins producing pulses of gonadotrophin-releasing hormone (GnRH). GnRH stimulates the pituitary gland (located just underneath the middle of the brain) to produce luteinising hormone (LH), which is released into the bloodstream. When LH reaches the testes, it stimulates the production of testosterone.
The production of testosterone by the testes is what causes the changes in growth and development that happen during puberty.

When does puberty occur?

Puberty usually starts between the ages of nine and 14 years old, and it normally lasts for five to six years. The timing of changes that occur during puberty is different from person to person.

The timing of puberty depends mainly on genetics but undernutrition, chronic diseases and excessive exercise can all cause a delay in puberty onset. Social factors, like where someone lives or their socioeconomic status, can also affect the timing of puberty.

Nutrition in early life affects the timing of puberty in complicated ways. Children with low birthweights (which indicates a lack of nutrients before birth) have earlier puberty than normal birthweight children. Children who are overweight or who have obesity also have earlier puberty onset, whereas severe obesity seems to delay the start of puberty in boys.

What are the signs and symptoms of puberty?

Puberty is a continual process but it can be divided into “Tanner” stages, which go from one (pre-puberty) to five (mature adult).

It’s not just the body that changes during puberty. There are also important changes that occur in the brain. Changes in emotions, thinking and behaviour happen over more than 10 years and continue past 20 years of age.

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What happens during each stage of puberty?

Tanner stage 1

  • Hormones

    This is the pre-puberty stage, before the hypothalamus starts producing pulses of GnRH.

  • Genitals

    The genitals are child-like.

    There is no pubic hair

    The size of the testes is less than 4 ml in volume (the longest measurement along the centre of the testis is less than 2.5 cm).

  • Body shape

    Body shape is child-like.

    Height increases by about one cm every two months.

  • Brain and behaviour

    During this stage, self-awareness develops but thinking is very straightforward and matter of fact.

    There is a basic understanding of others’ thoughts and feelings.

Tanner stage 2

  • Hormones

    Testosterone production by the testes begins.

  • Genitals

    The testes get bigger (about 4 ml in volume; longest measurement along the centre is 2.5-3.2 cm).

    The scrotum starts to grow and its skin becomes thinner and redder.

    The size of the penis has not changed much if at all.

  • Skin and hair

    Fine, soft hair begins to develop at the base of the penis

  • Body shape

    Height increases by around one cm every two months.

    Body shape hasn’t changed much.

  • Brain and behaviour

    The hormonal changes during this time can cause mood swings, and there might be more desire for independence and privacy, and self-consciousness about appearance.

    Problem-solving skills and impulse control begin to develop, along with personal opinions and questioning of authority.

    Risk-taking, thrill-seeking and rule-breaking begins to increase.

Tanner stage 3

  • Hormones

    Testosterone levels increase.

  • Genitals

    Growth of the testes (volume 6-12 ml, longest measurement about 3.6 cm) and scrotum continues.

    The penis begins to grow in length.

  • Skin and hair

    Pubic hair becomes darker, courser and curlier and begins to spread over a wider area.

    Acne may appear.

  • Body shape

    Body growth begins to accelerate.

    Height increases by 1.5 cm every two months.

    The shoulders begin to broaden and muscle mass increases.

    Development of breast tissue (gynaecomastia) may occur (this usually goes away on its own as puberty progresses).

  • Body functions

    The voice might begin to break.

    Spontaneous erections (and ejaculation during sleep) may begin.

    Sperm production begins.

  • Brain and behaviour

    The hormonal changes during this time can cause mood swings, and there might be more desire for independence and privacy, and self-consciousness about appearance.

    Mood swings, emotional outbursts, frustration, irritability and anger are linked to rising testosterone levels during this time.

    The desire to fit in with peers increases and focus shifts from family to friends.

    The frontal lobe of the frontal lobe of the brain is still immature, so judgement, impulse control and planning skills are limited.

    Reasoning skills and use of logic develop.

    Awareness and interest in thinking and the future begins.

    The ability to reason about other people’s thoughts, and infer hidden meanings, increases.

    Risk-taking and thrill-seeking increase.

    Problem-solving skills and impulse control begin to develop, along with personal opinions and questioning of authority.

    Risk-taking, thrill-seeking and rule-breaking begins to increase.

Tanner stage 4

  • Hormones

    Testosterone levels are at their peak.

  • Genitals

    The testes continue to grow (12-20 ml, longest measurement 4.1-4.5 cm).

    The scrotum gets larger and darker.

    The penis grows in length and width.

  • Skin and hair

    Pubic hair is adult-like but has not spread to the inner thighs.

    Hair develops in the armpits.

    Acne may increase.

  • Body shape

    Body growth peaks with height increasing by almost one cm per month, as bone and muscle growth increase.

  • Body functions

    The voice deepens.

    Semen becomes opalescent in appearance.

    Ejaculation volume increases.

  • Brain and behaviour

    Emotional intensity and complexity are at their highest.

    Periods of sadness and confusion may be common.

    Social or sexual anxiety may develop and feelings of rejection may occur.

    Experimentation with identity by changing appearance or behaviour may occur.

    The ability to analyse things develops reasoning skills improve (but might be inconsistent), and systematic thought about the future and planning begins.

    The ability to interpret non-verbal cues (e.g. facial expressions, body language) increases.

    Risk-taking behaviour is greatest during this stage, with potentially negative (substance use, physical recklessness, aggression) and positive (trying new physical, social and academic activities).

Tanner stage 5

  • Hormones

    Maturation of the reproductive system is achieved, including hormonal regulation.

  • Genitals

    The penis, scrotum and testes (volume greater than 20 ml; longest measurement greater than 4.5 cm) are their adult size (there may be some slight changes with age).

  • Skin and hair

    Facial hair develops.

    Acne may disappear.

  • Body shape

    An adult physique is achieved as full height is reached, but muscle growth continues beyond puberty.

    Gynaecomastia may disappear.

  • Brain and behaviour

    As the brain completes maturation, emotional regulation improves and mood swings reduce.

    A stronger sense of identity develops, personal values are established, and relationships with friends and sexual partners become more stable.

    Abstract thought develops, allowing the interpretation of meaning, finding patterns, connecting ideas and seeing the big picture.

    The ability to control and coordinate thoughts and behaviour continues to develop beyond puberty, as do social skills.

    Risk-taking begins to decrease as impulse control increases and reasoning skills improve, leading to better risk-assessment and decision-making.

What to do if you have concerns about puberty

If you have concerns about puberty you should talk to your doctor. They can help to manage problems that might arise during puberty (e.g. acne, changes in mood) and refer you to a specialist for treatment of a medical cause of a problem with the timing of puberty.

Boys who begin puberty early (before nine years of age) may have an underlying medical cause that might need treatment. Early puberty is associated with increased risk of obesity, type 2 diabetes, cardiovascular disease, behavioural and emotional problems, risk-taking and reduced height.

Some conditions – like Klinefelter syndrome – can stop puberty before it finishes.

Using testosterone for performance or image enhancement during puberty will disturb normal development, with possible life-long negative effects on brain and body development.

In rare cases of abnormally early or delayed puberty, it may be necessary for a specialist medical practitioner to investigate hormonal problems. In some cases, a specialist will prescribe hormone treatment to delay or start puberty.

What questions should I ask my doctor about puberty?

  • Are the changes I am experiencing normal?

  • Will the change I am experiencing from puberty be permanent?

  • How long will it be until this effect of puberty changes or goes away?

  • Is there something that I can do to minimise unwanted changes during puberty?

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Male Puberty

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