What it means

For most people with testes, the sequence is roughly:

  1. The testes grow. This is usually the earliest sign, often before anything else noticeable. The scrotum darkens, stretches and loosens.
  2. Pubic hair appears, generally around the same period.
  3. The penis grows, usually a year or more after the testes. It also changes shape and becomes more erect-looking at rest.
  4. Erections and spontaneous emissions become more frequent.
  5. The voice begins to deepen, usually later, as the larynx grows.

What can vary

A great deal, and none of it is a problem in itself.

  • Sequence and timing vary. Penis growth can begin before testes in some people. Testicular growth can be the only sign for a long while.
  • Penis size varies enormously across adults, and a penis that is smaller before puberty may still end up above average. Puberty is not a reliable predictor of adult size, and early worrying about it is usually wasted effort.
  • Uncircumcised development is slower to become visible, because the glans stays covered. This is normal.
  • Development is uneven. One side may be slightly larger, which is very common.
  • Some people develop very little. Minimal change with normal hormone levels is a variation, not a deficiency, and there is no treatment anyone should offer a healthy teenager for it.

Possible explanations

If development seems absent, a clinician considers: it has not started yet; a hormone condition; or a condition affecting the testes. These need history, examination and sometimes blood tests.

Warning signs

  • Sudden severe testicular pain. This is an emergency. It may be testicular torsion, where the blood supply is cut off, and saving the testicle depends on hours, not days.
  • A hard testicular lump, or one that suddenly feels different. Most are not serious; only examination can confirm that.
  • Testicular enlargement before age 9, or none by about age 14.
  • Persistent pain or swelling that lasts more than a few days.
  • An erection lasting hours with severe pain is an emergency.

What to do next

If development is proceeding and nothing hurts, there is nothing to do.

If you have found a lump, book an appointment rather than waiting. If you have sudden severe pain, do not wait at all.

You can also ask a doctor anything about this. It is routine work for them, and you will not be the first person of your age in the room.

Self-care

  • Do not try to “make it grow”. Nothing topical, oral or exercise-based changes normal development, and attempts frequently cause irritation or injury.
  • Foreskin care: do not forcibly retract it. Retraction is not necessary for cleaning, and forced retraction is a common cause of pain, scarring and infection.
  • General washing is enough. See genital hygiene.
  • Shaving: read hair removal safety first. Ingrown hairs and folliculitis are the main avoidable harms.

When to seek help

Routine: any development question, however embarrassing it feels.

Prompt: a new or hard lump, ongoing pain, swelling, or a development pattern outside the ranges above.

Emergency: sudden severe testicular pain, or a painful erection lasting more than four hours.

How to talk about it

“I noticed my testicles have changed and I wanted to check it was normal.”

“I’ve found a lump and I’m worried about it.”

“Nothing seems to be happening and I want to know if that’s worth checking.”

Say “testicle” or “balls”, whichever you would say out loud. Clinicians understand both. What matters is that you say it.

Sources

Public sources are linked so you can read the detail rather than take this site’s word for it. None of this has yet been reviewed by a qualified clinician — see how we handle medical review.

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References

Where this comes from

Linked so you can check it against a recognised public health source rather than take this site's word for it.

  1. Puberty and adolescence — American Academy of Pediatrics American Academy of Pediatrics (opens in a new tab)
  2. Adolescent health — World Health Organization World Health Organization (opens in a new tab)

These are public sources from recognised health organisations, linked so you can read the detail rather than take this site's word for it. Reading them does not tell you whether any of it applies to you, and none of these articles has yet been reviewed by a qualified clinician. How we handle sourcing and review.