Although adolescent males have as many health issues and concerns as adolescent females, they are much less likely to be seen in a clinical setting. This is related to both individual factors and the health care system itself, which is not always encouraging and set up to provide comprehensive male health care.
Working with adolescent boys involves gaining the knowledge and skills to address concerns such as puberty and sexuality, substance use, violence, risk-taking behaviours and mental health issues. The ability to engage the young male patient is critical, and the professional must be comfortable in initiating conversation about a wide array of topics with the teen boy, who may be reluctant to discuss his concerns. It is important to take every opportunity with adolescent boys to talk about issues beyond the presenting complain, and let them know about confidential care.
The physician can educate teens about the importance of regular checkups, and that they are welcome to contact the physician if they are experiencing any concerns about their health or well-being. Parents of preadolescent and adolescent boys should be educated on the value of regular health maintenance visits for their sons beginning in their early teen years.
This is likely related to both individual factors and the health care system itself, which is not always encouraging and set up to provide comprehensive "Premature ejaculation in teens" health care. There is increasing interest in addressing the needs of young men, as evidenced by the fact that there have been a number of recent publications to draw attention to issues of adolescent male health 1 — 4. The majority of adolescents seeking health care are female, particularly in adolescent health clinic settings.
Teenage girls have many reasons for seeking health care, such as gynecological concerns menstrual problems, contraception and pregnancyeating disorders and mental health issues adjustment difficulties, anxiety and depression. The present paper provides an overview of the common health problems and concerns of adolescent males, and offers ways to improve their access to health care. Sexual maturity rating SMR in boys assesses genitalia development and pubic hair patterns from stage I to stage V 56.
Pubertal development follows a fairly consistent and predictable sequence of events, although the onset and duration vary depending on genetics, Premature ejaculation in teens, health status and psychological factors 7. It is important to understand this process to be able to answer concerns about growth and puberty.
For males, there are notable events during this sequence:. Adolescents can experience many concerns or worries about growth and Premature ejaculation in teens 89. They rarely consult a physician, and during a medical visit for other conditions, they do not always feel comfortable bringing up these issues. It is important that health care professionals ask boys questions about growth and pubertal development starting in the early teen years or even in the prepubertal years.
One way to introduce these topics is to ask the teen whether he has any concerns about topics such as athletic performance, strength or endurance.
These topics can naturally lead to questions about how the young man is feeling about his changing body. Opening up discussions around these topics serves many purposes — it lets the young teen know that doctors are interested and are available to talk to about these topics; it is a way to introduce preventive issues in the area of sexual health, and it opens the door to future counselling on nutrition and exercise patterns, sexuality, contraception and sexually transmitted infections STIs.
It is important to remember that teens may not always be direct in their questions for the doctor. For example, teens worried about their development
Premature ejaculation in teens express this through general complaints or indirect questions about body function. Delayed puberty is defined as no evidence of an increase in testicular volume greater than or equal to 4 mL or length greater than or equal to 2.
In most cases of delayed puberty for adolescent males, there is no evidence of organic pathology accounting for this; they have constitutional delay of puberty. This condition is eight times more common in boys than in girls, and there is often a positive family history. The psychological consequences of pubertal delay in boys are noteworthy because there is evidence of emotional distress, poor body image and low self-esteem 9.
These boys are also more likely to be teased or bullied. Precocious puberty in males is defined as testicular enlargement before 8. The condition always requires investigation because an underlying organic condition is far more likely particularly intracranial pathology in boys than "Premature ejaculation in teens" is in girls. The psychological consequences for early maturing boys are also significant. Because they appear older than their peers, they may face increased social pressure to conform to adult norms; society may view them as more emotionally advanced However, their cognitive and social development may lag far behind their appearance.
Studies have also shown that early maturing boys are more likely to be sexually active and are more likely to participate in risky behaviours Gynecomastia is a frequent concern of boys who may find their breast development embarrassing or worry that there is something wrong with them. is usually mild, less than 3 cm to 4 cm.
Boys can be reassured that most of their friends also have or will have the same condition, and that it will resolve in one to two years without intervention.
Premature ejaculation in teens, the condition may be worsened by pseudogynecomastia Genital development is a concern of many boys who may wonder about the size or shape of their penis, but they are unlikely to bring it up without some prompting by "Premature ejaculation in teens" care provider. Adolescents may have an unfounded Premature ejaculation in teens of normal or desirable penis size, particularly if they have been exposed to pornography or have encountered commercial products reported to change the size of the penis.
The physician should emphasize that young men come in all shapes and sizes, as do their penises, and should point out the relative unimportance of penis size for sexual function and satisfaction 9. If necessary, the physician should strongly caution against the use of any chemical or mechanical interventions claiming to change penis size. The mean penile flaccid length is 8. The mean erect length is There is no predictable relationship between the size of the flaccid penis and erect length.
Physical differences and abnormalities of the genitals can be very distressing to the developing young man Pearly, grayish-white penile papules are small, 1 mm to 3 mm in size, and found along the corona of the penis base of the glans.
They are relevant only because the young man can be concerned about them or because they could be mistaken for condyloma — which differ because they are not shiny, are usually bigger and of varying size.
Adolescents with congenital abnormalities of the genitals such as hypospadias should be given the opportunity to discuss the situation. With their evolving sexuality, new questions or concerns about physical appearance or sexual functioning may arise. Adolescents with hypospadias should be asked about the possible curvature of their penis when in the erect state chordee.
Small varicoceles are not of concern. Larger ones may need to be referred for urological opinion because they may interfere with spermatogenesis. A hydrocele is a fluctuant, transluminating cystic mass surrounding the testicle. The history and physical examination should exclude an inguinal hernia. If the testicle is normal in consistency and contour, ultrasonography is not needed to detect a testicular tumour.
Surgical intervention is based on the size of the lesions, which can cause discomfort or embarrassment to the adolescent. A young male patient with phimosis is unlikely to discuss it with the physician because topics relating to erection are particularly uncomfortable for boys to talk about.
If the foreskin is tight on the glans during examination, the physician should ask about possible paraphimosis, a condition in which, during an erection, the foreskin is retracted behind the glans and restricts blood flow, leading to pain, edema and possible vascular compromise.
It is a surgical emergency if the foreskin cannot be brought back to the normal position by pressing firmly on the glans with fingers to release the pressure of the blood flow coming in, with countertraction on the foreskin.
The adolescent boy with phimosis should told to retract the foreskin often to increase its elasticity and allow it to be retracted behind the glans.
Erections, ejaculation and masturbation are topics that are rarely brought up by adolescent boys; however, that should not be taken to mean the topics are not of interest. During puberty, particularly early puberty, spontaneous erections are common, which Premature ejaculation in teens be very embarrassing for the young man Normalizing this for the teen, coupled with reassurance that over time this will improve, can be helpful.
The vast majority of young males will experience masturbation and nocturnal emissions before 18 years of age. It is appropriate to tell teenagers that masturbation is common and normal, and that it does not lead to any physical or mental illness. Although it is unusual, some boys need reassurance that spontaneous erections and masturbation are not signs that Premature ejaculation in teens are perverted or have an unhealthy mind.
Both should be considered to be aspects of normal sexuality for adolescents. Very rarely, masturbation can become a compulsive behaviour that the teen is concerned about or a parent becomes aware of. In this situation, an underlying mental health problem or past trauma should be investigated. The most common form of sexual dysfunction in young men is premature ejaculation.