Medical Q&As

Puberty - small testicles?

I have a 14-year-old son who entered puberty a number of years ago. He has come to me, worried, informing me that while his penis has grown, his testicles remain small. He is looking for an answer, and I'd be grateful if you could reassure us that all is normal.

Puberty is a gradual process of change. In the case of boys the first sign of puberty is enlargement of the testicles and penis. This is followed by growth of hair in the armpits and pubic area. Then the voice deepens in response to structural changes in the larynx and the muscles increase in bulk. Finally the skin tends to become oilier, which can contribute to the development of acne and the facial hair begins to sprout. It is important to emphasise that not every young person exhibits the exact same pattern of development that I have just described. For example, some young people may display pubic or armpit hair before any other signs of sexual development occurs. Also, the testicles can vary in size and yet function absolutely normally. It is quite likely that your son is normal but it might be best for him to attend your GP for added reassurance.