Female puberty
Puberty timeline
When should you expect changes to start? Or are you worried that you’re falling behind? Don’t worry — everyone is a bit different. Things can happen out of sequence and at different ages. Changes normally start anywhere from the age of 8 through 12, with the average start age of 9.5 to 10. Specifically, Black females (timeline below) tend to be about 6 months ahead of White females (add 6 months to values below):
Ages 9.5-13.5: breasts grow
Ages 10-13.5: pubic hair
Age 11: growth spurt
Age 11.5: vaginal discharge starts
Age 12: period starts
Help! I have a lump in my breast!
What I’m about to say only applies if you’re an adolescent…
Breast cancer is super rare in young people! Like SUPER rare. Not to say it doesn’t happen, but if you find a lump in your breast, it’s most likely due to fluctuations in your estrogen and progesterone. Specifically, hormone changes during puberty and during your menstrual cycle can cause something called fibrocystic changes in the breast tissue. How do you know if that’s what it is? Here are a couple of clues:
There are multiple lumps.
The location, size and/or number change depending on where you are in your menstrual cycle, and they may actually go away after your period.
They may be tender.
They can be wiggled or moved around.
There are a few other things that cause lumps in the teenage breast, specifically infections or clogged ducts. Signs include redness, tenderness or bloody/pus-like discharge from the nipple. If this sounds like what you have, warm compresses (simply a washcloth that has been soaked in warm water) can be applied a few times a day to help with drainage, but a visit to the doctor may also be necessary to provide antibiotics.
At the end of the day, what I’m telling you is to NOT PANIC. There are many things that can cause breast lumps in a teen, and the best way to figure out what it is is by visiting the doctor.
Breasts
Guess what’s normal! Basically, everything. Breasts develop differently for different people, so here are a few things that should NOT cause you to worry:
Lopsided breasts (one is larger than the other)
Inverted nipples (on one or both breasts)
Little bumps in the areola (around the nipple itself); these are glands
Little hairs in the areola
Large areola
During development (and around the time of your period) it’s also common for breasts to be tender. It’s also a good idea to get to know what your breast tissue feels like when you’re young so that you can pick up on changes as you age.
Is there anything I can do about my stretch marks?
First, did you know there are actually 2 different kinds of stretch marks? Striae alba (white) and striae rubra (red). Not only are they different colors, but they’re caused by different changes in the skin. Between these two types, stretch marks are actually SUPER COMMON. They generally worsen during times of rapid skin stretching (like growth spurts or pregnancy) but other things, like genetics, also contribute to stretch mark formation.
They generally get better and less noticeable with time, and protection from the sun (with sunscreen) usually helps reduce the discoloration. However, if you find yourself really bothered by them you can talk with your doctor about some options for improvement. There’s a topical medication option as well as dermatology procedures for both types of stretch marks. But remember, they are incredibly common and a natural part of body growth!
Body hair and skin changes
It happens to EVERYONE who goes through puberty — pubic hair. While shaving or waxing is NEVER necessary, many wish to do so. See the link below for shaving tips that reduce skin irritation and ingrown hairs.
There are a few other hair and skin changes that you MIGHT not know are also super common:
Facial hair (like a thin mustache) can happen in females! This is usually more noticeable in those whose family members also have it (meaning it’s genetic) but it’s usually nothing concerning. If you notice it getting thicker or if you notice strange hair patterns on other parts of the body (like chest or back) then it’s worth talking to your doc.
Stretch marks happen to most people to varying degrees. They happen because of the HUGE growth that our bodies experience during puberty. Keep scrolling for a little more information.
Cellulite is also incredibly common. It happens more in females than males, and it’s estimated that it occurs in almost 90% of those with female anatomy! Carrying extra weight CAN make it more pronounced, but even thin people get cellulite. It’s just a way our bodies store fat below the skin.
What’s this bump on the inside of my vagina?
This is very likely a Bartholin gland cyst. Vaginas have two little glands close to the vaginal opening, and their purpose is to release good, healthy mucus that lubricates your vagina and the vulva. However, sometimes these glands get plugged up, which can just happen naturally OR happen when there is irritation or trauma to the area (like penetrative sex or use of a menstrual cup). The result is the feeling of a little ball or nodule at the opening of the vagina.
To help unplug your glands, try soaking in a warm bath a couple of times a day. If the gland(s) starts to hurt, interferes with sex or inserting your menstrual cup, causes discomfort or starts leaking pus you should see a doctor (because it might be infected).
Vaginas vs vulvas
Starting with a quick anatomy lesson, the vulva describes the area surrounding the vaginal opening and includes the inner and outer labia. Lots of stuff starts happening in the vulva during puberty. Here’s what’s important to know about a healthy vulva:
Skin can be darker
Skin can be lighter
Labia minora (the inner folds of skin) can be longer or shorter
Labia minora can be wrinkly
Labia minora can be lopsided
Labia can have little dots that look like white pimples—these are sweat glands (Fordyce spots) and are totally normal
Clear-white vaginal discharge every day is normal
Discharge may smell a little sour or vinegary
These changes (like discharge and odor) can make some people feel uncomfortable. However, the vagina actually works very hard to keep things safe and clean — which is why it’s important to never clean INSIDE the vagina. It’s okay to use a gentle soap on the labia and other folds of the vulva (especially because oil and dead skin cells can build up and cause smegma) but never use soap or water inside of the vagina. It’s got its own self-cleaning system.
There are a few reasons why a vagina might have an especially strong odor, including STIs and BV. However, an easy first step to controlling odor is to improve airflow down there. Check out the link below for “breathable” cotton underwear and talk with a doctor if things still smell (or feel) abnormal.
(Wanna learn more about the hymen? Check this out.)
What are these pimples around my vagina?
There are many reasons you might get pimple-like growths on the vulva. The most likely causes are ingrown hairs, Fordyce spots (little sweat glands) and razor burn. Ten-minute tub soaks can help with ingrown hairs because the water will help loosen the skin and allow the hair to break free. Topical low-dose steroids (like a 1% hydrocortisone ointment) can help relieve the itch and redness caused by razor burn. And finally, there is nothing to do for Fordyce spots, but they are TOTALLY normal and shouldn’t cause you any problems.
Height
The biggest outward sign of puberty is the growth spurt. This is a period of time during which someone’s height increases REALLY FAST. For those with female anatomy, it usually happens right before the first period.
Lots of folks are anxious to know how tall they’re going to be, but there’s only one way to know for sure: wait.
However, if you’re itching to take a guess, look at your parents. Your height will be similar to your mother’s and adjusted up or down depending on your father’s. Here’s an online calculator that can help you make an “educated” guess:
At what age should we start seeing an OB/gyn?
OB/gyn stands for obstetrician and gynecologist. These are doctors that deal exclusively with female anatomy and having a baby. To answer your question, you can start whenever you’re ready, but your first pap smear won’t be until you’re 21 in the US. Until that time, most issues can be managed by your PCP (either a family medicine doctor or your pediatrician).
Periods and more
Menstruation is such a huge topic that it gets a section all its own. And if you want to hear more about the changes that occur during puberty, check out my podcast: