When will I reach puberty?

Q: Dear Doctor,

I am 19 years old, but I have not yet experienced puberty or changes that adolescents go through such as increase in penis size and testicles, voice, hair growth or wet dreams.

What is the problem and its solution?

Stephen

A: Dear Stephen,

Boys can start puberty at a wide range of ages, with 95% starting between the ages of nine and 14, so puberty delays are considered delayed when it has not started by age 14.

The earliest sign of puberty is enlargement of the testis, followed by growth of the penis and pubic hair. Puberty can be delayed for several reasons.

Most often it is simply a pattern of growth and development in a family.

This is called constitutional delay, or being a late bloomer and it usually does not require any kind of treatment.

These teens will eventually develop normally, just later than most of their peers.

Medical problems also can cause delays in puberty, some people with chronic illnesses like diabetes, or even asthma may go through puberty at an older age because their illnesses can make it harder for their bodies to grow and develop.

Proper treatment and control of many of these conditions can help make delayed puberty less likely to occur. A malnourished person may also develop later than peers who eat a healthy, balanced diet. For example, teens with eating disorder anorexia nervosa often lose so much weight that their bodies cannot develop properly.

Therefore, delays require investigation to determine the cause and offer appropriate treatment.