Going through puberty

Puberty is an important time when you grow quickly and also other things start to grow like your testicles and your penis! Testosterone also has other jobs like keeping your bones healthy, keeping you strong and making you feel good including giving you sex drive.  Testosterone is produced throughout your life.

Why can some young people have a problem going through puberty?

Two of the hormones, called gonadotrophins, Luteinizing hormone and follicle stimulating hormone, LH and FSH for short, from the pituitary gland control whether you go into puberty or not. These hormones drive the testicles to make the hormone testosterone and it is this hormone that causes the changes to your body seen in puberty.

This means that if the pituitary gland starts producing the hormones too early driving your testicles to make testosterone you have an early puberty and if the pituitary gland cannot produce the hormones to drive your testicles to make testosterone you will not go into puberty by yourself.

Mostly your testicles are healthy it is just the hormones from the pituitary gland that are wrong. One possible exception to this is in young people who have had treatment for leukaemia or a tumour with radiation treatment or chemotherapy which might have damaged the testicles as well as the hypothalamus and the pituitary gland.

How will I know if I am going to have a problem with my puberty?

Boys go into puberty at different times so you may notice that other boys at school are developing even from the age of 9. The first sign in boys is testicles getting larger, you might also notice hairs around your penis and your penis getting bigger and you growing taller quickly. If you develop any of these signs before the age of 9 that is too early. Most boys have started puberty by the age of 13 so if there are no signs by the age of 13 the doctors may do some blood tests to see if it shows any signs of going into puberty.

What if my puberty starts too early?

There are two reasons to stop puberty if it starts too early. The first is you won’t be developing at the same time as other boys at school which might make you feel a bit different and uncomfortable. The second reason is that towards the end of puberty you stop growing so if you start early the earlier you will stop growing. The easiest way to stop puberty is to have an injection that puts the hormones (LH and FSH) from your pituitary gland back to sleep until the right time which is usually just before you are a teenager.

What will help me go through puberty?

The easiest way is to give you the testosterone back that your testicles aren’t making to help you go through puberty, it often comes as an injection that you have every month. The doctors try and do exactly what the body would do and start at low doses and increase them very gradually over several years until you are mostly through puberty. Try and find ways to make it easy for you to remember. Your doctor will check the dose is right for you by seeing how you are progressing through puberty and how you feel (so tell them). Later on they may check with a scan that your bones are healthy.

How long will I need to take testosterone medication for?

Testosterone is also important for keeping your bones healthy and stopping you breaking bones as well as keeping you strong and making you feel good including giving you sex drive. Therefore as your testicles won’t start working if your pituitary gland doesn’t make gonadotrophins you need to stay on testosterone medication probably for life. At some point when you are on a higher dose of testosterone the doctors may offer you different ways of taking it like an injection that lasts 3 months or a gel that you have to put on every day. 

Questions you could ask your doctor or nurse

  • Do you think I will have problems going into puberty?
  • What different sorts of testosterone medication are there?
  • I have had chemotherapy and/or radiotherapy as part of my treatment – could that have damaged my testicles as well as my pituitary gland?