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Boys in puberty. Most people think of teen boys eating them out of house and home, needing new clothes because they outgrow them every two weeks, and interesting smells. Well, there's more than that, and I'll help you navigate puberty in boys on today's Scope.

I've got a teenager at my house and one who is about to be a teenager. I can definitely say that all of those things that I just mentioned are absolutely true. But what exactly is going on in their bodies? There's going to be a lot of changes that they may come to you as parents to ask questions about. Puberty in boys can start as early as 9 but really hits between 11 and 14 and lasts for 3 to 4 years. Boys can continue to grow until they are 18 or even 20.

The first thing your boy will notice is that his private area will be changing. His testicles will get bigger, his penis will grow, and he will get pubic hair. Then comes hair under the arms and on his body, and that's usually when the body odor starts too. And you'll need to make sure to get your son some deodorant and you'll probably also need to stress the importance of hygiene.

Voice changes are next. Often boys get pretty embarrassed about how their voice cracks as it gets deeper. At our house, we pretty much just laugh about it because my boys know it's normal and it's happening to all their friends as well.

Their bodies will also start to bulk up, and their muscles will be getting bigger and stronger thanks to testosterone. Testosterone is also what triggers some mood changes in boys, especially the anger issues. So be prepared.

This is also when romances start to blossom so be sure you have the talk with your boys about your family's view on sex, birth control, and protection against sexually transmitted diseases.

Something else that testosterone causes is acne. Acne is not caused by not washing your face or by what you eat but by changing hormones. There is a lot of treatments for acne, including many that are over the counter.

Like I said, boys can continue to grow until they are 18 years old. They will usually have a growth spurt of about four to six inches towards the end of puberty. That's also when more body and facial hair shows up and boys need to learn about shaving beards and mustaches.

What about some of the more uncomfortable things that you may need to talk to your teen boy about? Well, boys start getting erections more, and sometimes they happen at embarrassing times like in the hall at school. They also start having nocturnal emissions, otherwise known as wet dreams. This is when they have erections and ejaculations during their sleep. It's normal. They have no control over it, and it can happen up to a few times per week.

Remember, puberty happens to all of us who make it to adulthood. While things change from each generation to generation, some things are constant, like the changes that happen to a boy's body as they go from being a little kid to being a man. It's a tricky time for kids, and if you or your child have any questions about what's going on in their bodies, be sure to ask your child's pediatrician for help.

So your daughter just had her first period. What's normal, what's not, and what to expect now.

A girl's first period marks her entry into womanhood. It's called menarche. And many parents, especially moms, seem to have a lot of anxiety and questions about it. Many moms readily admit to me that they have forgotten what periods were like when they started. So if something doesn't seem right, they get incredibly nervous that something is wrong with their daughter. Some worry that their daughter has started too early or too late. Actually, any time between ages 9 and 15 is normal.

Some worry that their daughter doesn't have a period every month like clockwork and that they need their hormone levels checked or some sort of treatment to make their periods regular. Well, it is hormones to blame for this. However, it's because hormones are still settling themselves out. It can take two to three years before periods become regular. If there is a family history of irregular periods, they might never be regular. And that's okay too. Parents really worry if their daughter's periods are not regular. But unless their daughter is sexually active or they go months between periods after having them for about a year, there really isn't anything to worry about. Irregular periods by definition happen either less than three weeks apart or more than five weeks between periods. Otherwise, they're normal.

Moms also get concerned about cramps. Sorry, but cramps are part of periods. Your daughter should not miss school or stop being physically active because of cramps. Being physically active has been shown to decrease cramps. I have parents wanting me to write letters so that every month their daughter can miss school during her period. Periods normally last 3 to 10 days. So that's a lot of school missed. I try not to do these letters and instead discuss ways to help their cramps. Over-the-counter naproxen really helps and so does a heating pad.

Some girls will even have nausea or vomiting with their periods due to hormone fluctuations. Treating them supportively with anti-nausea medicines can help.

Moms also get concerned about their daughter's becoming anemic. This does not happen usually. Girls normally lose between 30 to 40 milliliters per period. This is six to eight teaspoons of blood. So while it looks like a lot of blood during a period, it's not as much as it seems. If your daughter has something called menorrhagia, that is excessive blood loss and that is 80 milliliters or more of blood loss per period. And these girls normally pass blood clots that are larger than a quarter. These girls will usually soak through a pad or tampon every hour for several hours during the heaviest portions of their periods. They may also need double maxi pads for protection. If this is the case, then you should talk to your daughter's pediatrician about ways to help.

I often get asked by moms if their daughters could have endometriosis or fibroids or other gynecological issues. As a pediatrician, I can do basic period management and gynecology. I can do oral or injectable birth control to help with periods. But often the best thing for me to do is to refer my patient to a gynecologist if it's more than I can address. They are much better at diagnosing and managing female concerns.

Finally, moms also ask me if their daughters need Pap smears now that they have started their periods. No. That used to be the case, and it's pretty traumatic for a young girl. The current guidelines are if a girl is 21 or has been sexually active for three years, then they get a Pap smear, and that would be done by a gynecologist, not a pediatrician.

Bottom line, most period concerns are actually part of normal development. Your pediatrician can let you know when something is not normal and refer you to a gynecologist who sees teenagers for additional help when needed.

Dr. Gellner: Puberty is one of those awkward times for teens and parents. So how does one talk to their daughter about a certain monthly change that's going to start around now? I've got some advice for that. I'm Dr. Cindy Gellner on The Scope.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Many parents of girls get very apprehensive around the time of puberty. They start pulling out books like "Are you there, God? It's me, Margaret" and secretly stashing feminine protection products for that big day when a girl has their first period.

It can be a challenge to talk to girls about the changes in their body. But if you are honest and open about what is going on, they will be more comfortable with this milestone. Let them know that puberty is the time when a girl's body grows into a woman's body. The physical changes are necessary for a girl to have babies. Puberty may begin as early eight years old or as late as 14 years old. For girls, the start of puberty is officially marked by the first period, which usually happens anywhere from two to two and half years after breast development occurs. The average for a girl's first period to start is 12 years old. Some girls start to get their periods as early as eight or as late as 16. If your child gets their period before age eight or after age 16, you need to talk to your child's pediatrician about that.

Once puberty has begun, the hormones from the brain signal the ovaries to start developing numerous eggs that have been present since birth. After puberty, an egg fully develops and is released from the ovary about once a month. After the period stops, the monthly cycle starts again. And the entire menstrual cycle takes 22 to 35 days. Periods come at the end of this monthly hormonal menstrual cycle and lasts about three to seven days.

There is a whole host of products out there specifically designed for teens to help with protection. A variety of pads and tampons to help absorb the blood that comes out. And though it seems like a lot of blood, it's usually only about two to five tablespoons over the entire period for most girls. Some girls can have heavy periods. Some can have lighter. For the first year or two, a girl's periods are usually irregular. That means they can happen anywhere from twice a month to three times a year. During this time, the body's hormones are not yet fine-tuned so the ovaries may not release an egg once every month.

Periods start coming on a regular schedule once the body starts releasing eggs. Ovulation usually begins one to two years after your daughter's periods start, but it can happen with the first period. Most girl's menstrual cycles become fairly regular as their hormone levels mature and synchronize. If your child has been having periods for less than two years and their physical exam is normal, irregular periods may be part of their normal development. Some women will continue to have irregular cycles as their normal pattern. It's always good for girls to carry an extra tampon or pad in case her period starts unexpectedly.

Some girls have lower abdominal pain and cramping during ovulation or during their period. The pain can be mild or severe. If this happens before a period starts, usually in the middle of the menstrual cycle, the pain is caused by ovulation and usually lasts a short time. It is called mittelschmerz and it feels like a stabbing pain on one side. It's nothing to worry about. Cramps most often happen during a period. They are caused by the hormones that cause the shedding of the lining of the uterus. Some girls have pain for only a day or others, it may last your entire period. Taking ibuprofen or naproxen usually helps.

Remember, your child needs you during this time of transition. Don't make her feel more awkward than she already does. Remind her of the beautiful woman she is becoming.

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