FAQ | The Family Planning Association of Sri Lanka


Adolescence and Puberty


1. What is adolescence?


Adolescence is the period between 10 -19 years. It is a unique period during which you transform from a child into an adult.


2. What is puberty?


Physical, emotional and sexual growths are the hallmark of puberty. These changes are controlled by the sex hormones.


3. When will I go through puberty?

Girls start puberty earlier (between 9 to 13 years) than boys (between 9.5 to 14 years). However, everyone goes through puberty at his /her own pace. There is no need to distress yourself by comparing yourself with others.


4. What are pre-pubertal signs?

Pre-pubertal signs show that puberty could be expected to happen after 2 years. In a girl the area round the nipple starts to swell a little (breast buds) around 9-11 years; in a boy, the skin of the scrotum will start getting dark around 10-11 years.


5. How does puberty begin?

Puberty starts when impulses in your brain trigger the hormones of the pituitary gland (the main endocrine gland in your body and situated in the brain) to act on the ovaries (girl) and the testes (boy) to release the sex hormones.


6. What causes these changes to my body during puberty?

The male (testosterone) and female (oestrogen/progesterone) sex hormones are responsible for the appearance of the secondary sexual characteristics, the growth of the reproductive systems and influence the emotional and psychological development as well.


7. What’s Menarche?

Menarche is the first menstruation that marks the start of puberty in girls. In Sri Lanka, menarche usually occurs around 11-13 years.


8. What is Spermarche?

Spermache is the beginning of development of sperm in boys' testicles at puberty, equivalent of menarche in girls.


9. What is menstruation?

Menstruation — aka having your period — is when blood and tissue from your uterus comes out of your vagina. It usually happens once every month


10. Is menstruation normal?

Menstruation is a normal physiological event and not an illness. The event will occur every month and means that she can get pregnant.


11. What is the menstrual cycle?

The menstrual cycle is controlled by the female sex hormones and prepares the body each month for a pregnancy. The average menstrual cycle (counted from first day of one period to the first day of the next period) is 28 days long. 


12. What happens during menstruation?                                         

The womb (uterus) gets ready to receive a fertilized ovum. The female sex hormone (oestrogen) thickens the lining of the womb and matures an egg (ovum) in one of the ovaries. Around the 14th day, the mature egg gets released and enters the fallopian tube to travel to the womb. When you menstruate, your body sheds the lining of the uterus (womb). Menstrual blood flows from the uterus through the small opening in the cervix and passes out of the body through the vagina.


13. What happens when you have sex during menstruation?

If there is sexual intercourse during menstruation, sperm get deposited in the vagina and travels to the fallopian tube. The egg and sperm unite in the fallopian tube. The fertilized egg enters the womb and attaches itself to the lining and starts growing. i.e. a pregnancy has occurred. If the egg is not fertilized, it breaks down, the hormone levels drop. The thickened lining of the uterus also breaks down and is passed out through the vagina with more blood and mucous as menstrual blood.


14. How long does menstrual bleeding last?

The menstrual period may be as short as 2 days or extend up to 7 days. Usually bleeding lasts for 3 to 4 days.


15. How much am I supposed to bleed during menstruation?

About half a cup of blood is lost at every period, but this can vary.


16. When does a woman stop menstruating?

The cycle of events in menstruation is repeated for many years till the production of female sex hormone stops at menopause (stopping of menstruation).


17. How long is the menstrual cycle?

The length of the menstrual cycle and the number of days of bleeding can vary. This is normal. The cycle may happen every 21 to 35 days in adults and every 21 to 45 days in young adolescents. 


18. In which part of the menstrual cycle can one get pregnant?

In a 28 day cycle, the fertile period (the time when pregnancy is most likely to happen if there is sexual intercourse) is between the 11th and 17th day. But a pregnancy may happen outside this period though it is less likely. The day of ovulation depends on the length of the cycle. If periods are not regular, it is difficult to calculate the day of ovulation.


19. Why is menarche celebrated?

In many Asian countries including Sri Lanka rituals, taboos and celebrations show the cultural and social significance of menarche. These events announce to the community that the girl has ‘grown up’ and is ready for marriage and motherhood. After menarche, girls may find that their behavior, dress, opportunities to socialize with boys and other personal choices are controlled after menarche.


20. What pubertal changes do Adolescent girls experience?

The breasts first start to develop and are followed by the appearance of hair in the pubic area and under the arms. The labia (folds around the vagina) may change colour and grow bigger. There may be whitish vaginal discharge. Fat starts getting deposited along the upper arms, thighs and upper back, breasts and hips.


21. What pubertal changes do Adolescent boys experience?

As the testicles grow, the skin of the scrotum darkens, enlarges and hangs down. Enlargement of the penis and the appearing of pubic hair also takes place and nocturnal emissions (or "wet dreams") start. There is growth of hair under the arms, on the face, chest and back, the voice “cracks” and deepens, the Adam’s apple gets larger and there is a tendency for increased sweating. The chest and shoulders get broader. Height and weight may increase and acne may appear.


22. Why do one of my testicles hang lower than the other?

In most males, one testicle (usually the left) hangs lower than the other and this is normal.


23. What is an erection?

An erection happens due to blood flowing into the cavities of the corpora cavernosa of the penis. The pressure of the blood inside the cavities causes the penis to expand and get hard. The erection ends after ejaculation (release of semen) or it may go away on its own.


24. Why do I get spontaneous erections?

Erections may also occur suddenly without any obvious reason (spontaneous) and during sleep (nocturnal). Spontaneous erections are common during puberty and can be very embarrassing. This problem lessens as boys get older.


25. Why is my menarche delayed?

If your menarche is delayed it may be due to a family pattern, or a chronic illness in childhood or being underweight. Generally, a girl is likely to grow up around the same age that her mother and grandmother did.  If menarche has not taken place by 16 or 17 years you should be seen by a doctor.


26. Why are my periods irregular?

There is no need to get alarmed if your periods suddenly stop after menarche or doesn’t come on a regular day. Variation in the length of the period is quite a common occurrence in among girls who have just started menstruating. This is because your body is still maturing. Generally within 2 years or so the periods will start to happen monthly.


27. Can I delay or postpone a period?

You may suddenly find that your period is happening at an inconvenient time. For example you are taking part in a swimming meet, attending a family function, facing an examination etc. A doctor will advise you on postponing or delaying the period to a convenient time.


28. Is menstruation painful?

Early menstrual cycles generally have little or no pain. As cycles become regular it is normal to feel some pain and discomfort in the breasts and abdomen and some mild change in the mood. These end when the period is over.


29. What is Premenstrual tension (PMT) or PMT Syndrome (PMTS)?

Premenstrual tension (PMT) or PMT Syndrome (PMTS) is a highly distressing condition that requires treatment.


30. When do the symptoms for Premenstrual tension (PMT) or PMT Syndrome (PMTS) start?

The symptoms usually start about one to two weeks before the period and are severe.


31. What are the symptoms of Premenstrual tension (PMT) or PMT Syndrome (PMTS)

Girls may be very irritable, anxious, weepy and withdrawn; complain of tenderness in the breasts and feeling easily tired and bloated. The symptoms are usually due to retention of water in the body.


32. How is Premenstrual tension (PMT) or PMT Syndrome (PMTS) treated?

Avoiding the high sugar high carbohydrate diets popular among teenagers is beneficial. Treatment is with hormones commonly the oral contraceptive pill.


33. How do I maintain sanitary protection during menstruation?

Body odour is embarrassing at any time but is more so during menstruation. Personal cleanliness during these days is very important. Regular bathing, and changing of sanitary napkins (pads) and clean underwear will prevent body odour. 


34. Should I use pads or tampons?

Whether to use pads or tampons is a personal choice.


35. Why do some parents discourage the use of tampons?

The use of tampons is usually discouraged by most parents for fear of damaging the hymen.


36. What do I need to remember if I use tampons?

Girls who use tampons should use a sanitary towel at night rather than a tampon and must be especially careful not to leave a tampon unforgotten after the end of the period.


37. What’s the toxic shock syndrome?

Forgotten tampons are one of the reasons for toxic shock syndrome. It causes a dangerous infection that leads to this condition and may even be fatal.


38. Should I change my diet after menstruation?

The loss of blood every month means that girls lose iron and protein. Eating a balanced diet, rich in iron, protein and minerals, and having regular meals is important to replace the monthly loss of blood and prevent anaemia.


39. Do I have to stop my day to day activities when I am menstruating?

There is no need to stop sports, swimming, dancing, partying etc. just because you are having your periods. Menstruation is not an illness and should not be a barrier to doing what you usually do and what you like to do.


40. Can girls get body hair?

Teenage girls worry that they have noticeable amounts of hair on the upper lip, and arms and legs. The presence of visible amounts of hair on the body is not abnormal and can vary.


41. Can a girl have a hoarse voice?

A doctor should be consulted if there are changes in the voice of a girl during puberty (a hoarse voice).


42. What is acne?

Acne is due to hormones especially androgens (testosterone) a small amount of which is also secreted in girls. This is why so many teenagers get acne during puberty and girls find that they get it before their periods. The hormones stimulate the sebaceous (oil) glands in your skin to make more oil which blocks the ducts. This gives rise to blackheads and whiteheads.


43. Do oily foods and chocolates cause acne?

There is no proof that oily foods and chocolates cause acne as is commonly believed. However stress can make existing acne worse.


44. How do I treat acne?

Meddling with the lesions including always touching and squeezing them as well as and excessive washing of the face with strong soaps and lotions can cause permanent scarring and disfigurement. Acne is best treated by a dermatologist (skin specialist). Acne takes a minimum of 4 to 6 weeks to improve and but can occur again.


45. Can I catch acne from another person?

Acne is not an infection and you cannot “catch” it from another person.


46. Why does my height and weight increase during adolescence?

Both boys and girls increase in height and weight during adolescence.


47. Why do girls grow before boys?

Girls start (10 years) and end (16 years) their growth earlier than boys. Boys start growing about 2 years later than girls but continue to grow until 18 years. Therefore although a girl of 10 years may be taller than a boy of 10 years, by the time they are 18 years, the boy will be taller as he has grown for longer. Weight gain in girls is more due to fat while in boys it is due to increase in muscle.


48. What are growing pains?

Adolescence is the final period of growth. The rapid increase in height (due to the combined effect of growth hormones, thyroid hormones, and male sex hormone) may cause some teenagers to complain of ‘growing pains’ in their arms and legs. The height of parents (heredity), diet/nutrition, exercise and sleep are important factors that determine the final height achieved.


49. Why is one of my breasts bigger than the other?

In girls, one breast bud may develop before the other, or the breasts may develop at different rates.  This is normal and the difference in size becomes less noticeable as growth continues. In many adult women too one breast may be just slightly bigger than the other, or have a slightly different shape.


50. Why do my breasts hurt before the menstrual period?

Pain in the breasts before the menstrual period is a common complaint of teenage girls.  The breasts may feel swollen and uncomfortable. These sensations pass once the period is over. This is due to the action of the female hormones and is normal


51. Can exercise make breasts bigger?

Exercise won't make breasts bigger because breasts don't have any muscles; but it will strengthen the chest muscles underneath the breasts and make them ‘look larger.


52. What about breasts and boys? 

The false appearance of ‘breasts” in boys is due to swelling of the tissues around the nipple. It is a normal happening and seen in quite a proportion of teenage boys. It is due to hormonal influences, needs no treatment and usually disappears within a few months. If it persists after one year however it is best to consult a doctor.


53. Does the size of the penis matter?

Penises vary in size when flaccid (not erect), but these differences usually disappear in the erect state ; and the giving and receiving of sexual pleasure is not dependent on the size of the erect penis.


54. Does the size of the breasts matter?

Teenage girls will vary greatly as to when and how much their breast develop. Breast size is largely determined by your genes. Breasts increase in size during puberty due to deposition of fat. Breasts grow to full maturity only during pregnancy. The size and shape of the breasts have no relationship at all to the ability to respond to sexual stimulation, produce milk or feed babies.


55. Why are there lumps in my breasts?

One or more small lumps or lumpy areas in your breast are not unusual during puberty. A lump that moves is often called a ‘breast mouse” and it is painless. The lumpy areas don’t move about but become painful close to the period. This condition is called fibroadenosis. These are not cancers. It is best to remove the breast mouse surgically.


56. What are fibroids?

Fibroids are non-cancerous growths that develop in or around the womb (uterus). The growths are made up of muscle and fibrous tissue and vary in size. They're sometimes known as uterine myomas or leiomyomas


57. Are fibroadenosis cancers?

Fibroadenosis are not cancers but it is best to remove them surgically.


58. Why do I sometimes have an erection when I wake up in the morning?

Morning erections are present when waking up and are usually associated with a full bladder. They are common in men of all ages.


59. What is a nocturnal orgasm?

Nocturnal orgasms are a very normal and natural part of growing up for both boys and girls. The orgasm is due to stimulation of the genitals during sleep by the bedclothes or unknowingly by the person, or by a pleasurable sex dream. Nocturnal orgasms in boys are often but not always associated with release of semen (ejaculation). In girls there is no emission but there is wetness in the vagina. 


60. What is a wet dream?

Nocturnal emissions or wet dreams is when a male ejaculates during sleep.  During puberty the male hormones cause sperms to be produced. The semen builds up in the body and is released during masturbation or through a wet dream. Wet dreams generally start happening in boys around 14 years but the age can vary.  Having wet dreams often does not mean you are a sex maniac or that you will not be able to have a normal happy sex life when you are older. 


61. Does having wet dreams harm my health?

Contrary to a popular myth, loss of semen from the body during wet dreams does not harm your health. Neither will it prevent you having children when you marry. Men continue to produce sperms even in old age.


62. Why do I sometimes feel out of control of my emotions?

The hormones that control puberty also affect your feelings and emotions.  You also start thinking about sex, feel sexual urges and become attracted to girls, boys or sometime both. You might masturbate but feel guilty about it later. This is all normal.


63. Is fitting in in peer groups important?

Being in the group gives you an image and identity. The powerful desire and need to be accepted by them may lead you to imitate them or do things to win their approval. This may be different from what your parents think is right for you! Choosing your friends correctly is very important to avoid getting into risky behaviours. Having hobbies, taking up sports, having caring friends who will not pressure you into risky behaviours will build your confidence and make you feel good about yourself.


64. Why am I so impulsive?

The areas of the brain responsible for controlling decision-making, organization, impulse control and planning for the future (executive functions) mature at different rates in adolescents. In some, this process completes only in their late twenties. This is why adolescents are likely to “act first and think later” and are impulsive, have poor control of emotions and poor judgment.


65. What is romantic love?

Romantic love is an emotional response where deep feelings develop towards another person. You constantly think of the person, and want to be with the person. You are exhilarated and happy when you are with the person and feel sad and depressed when you are not. Your parents suspect you are “having an affair”. The emotions may or may not get coloured by sexual feelings.


66. How do I deal with the end of a love affair?

Generally, most teenage affairs are brief. When a love affair ends for whatever reasons you will be miserable but the feelings of intense sadness, rejection, and pain will definitely pass away. Some teenagers take longer than others to recover from a broken relationship. People fall in love more than once. Your past love affair or affairs will be a memory you will remember with a smile of nostalgia when you are old!  


67. What is necking?

Necking is the kissing and caressing of the neck, ears, lips and other sexual activity between partners that does not involve  touching and caressing of the breasts and genitals ( i.e. little or no sexual arousal) , or sexual intercourse. Continued or prolonged necking leads to petting (touching each other in a sexual way).


68. What is petting?

Petting includes prolonged and deep kissing, caressing of the breasts and the genital organs (heavy petting). Necking and petting cause sexual arousal.


69. What happens when you are sexually aroused?

Boys will get erection of the penis and girls will feel wetness in the vagina. Mutual petting (partners caress each other) causes strong sexual arousal and the couple may end up having sex even though they had not planned to so.


70. How does a girl get pregnant?

Sex, when it happens is usually sudden, unplanned and unprotected (i.e. without a condom), and there is a risk of pregnancy.


71. I am pressured to have sex

One may be pressured, threatened or emotionally blackmailed into having sex by their boyfriends/girlfriends. Both girls and boys have the duty to behave responsibly. If you genuinely care about each other, your relationship will be built on mutual trust and respect and there will be no pressure to have sex. Remember that no one has the right to force another person to have sex and everyone has the right to refuse to have sex. 


72. How do I avoid having sex?

Knowing how your bodies behave allows you to set limits and avoid problems. Limiting necking and petting to acts that will not cause sexual arousal in the girl reduces the risk of being drawn to have sexual intercourse after mutual petting. Being in a crowd and avoiding lonely places reduces the opportunities and temptation to become sexually involved.


73.  What happens if a girl gets pregnant between 16 and 18 years?

It is well worth remembering that the legal age of marriage is 18 years. So if a girl gets pregnant between the ages of 16 and 18 years she will not be able to marry. Instead she will be traumatised by the many health and social problems of a teenage pregnancy.


74. What is a Teenage pregnancy?

Teenage pregnancy is defined as a teenage girl, usually within the ages of 13-19, becoming pregnant. It is usually an “accident” i.e. unplanned.


75. What are the health risks of a teenage pregnancy?

The pregnancy is a burden to a teenage girl’s body as it is still growing and maturing from a child into an adult and it’s difficult to provide all the nourishment to the baby. Babies born to teenage girls are likely to be smaller and weigh less than the average normal baby. They fall ill easily and often. Complications are common during pregnancy and delivery. The girl does not have the emotional maturity and the skills needed to be a mother.


76. Why I am always fighting with my parents ?

There is usually strong difference in opinion between parents and teenagers about their clothes, behavior, friends and studies. Your parents worry that you maybe “getting out of control” because you are becoming more independent and making your own decisions. This is all part of normal growing up. Good communication is the key to solving these issues.

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