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October 10, 2023

Ask Lisa Podcast - Episode 139

This Is So Awkward: Modern Puberty Explained with Dr. Cara Natterson and Vanessa Bennett

Episode 139

So what’s really happening when kids go through puberty? Dr. Cara Natterson and Vanessa Bennett join the Ask Lisa podcast to talk about their new book This is So Awkward: Modern Puberty Explained. The conversation takes a deep dive into the research on puberty and tackles key questions: When does puberty start and end? Why do kids suddenly smell bad, and how do we help? What’s the best way to respond to teens’ surging hormones? How do we support late bloomers? And more!

October 10, 2023 | 57 min

Transcript | This Is So Awkward: Modern Puberty Explained with Dr. Cara Natterson and Vanessa Bennett

TRANSCRIPT | THIS IS SO AWKWARD: MODERN PUBERTY EXPLAINED WITH DR. CARA NATTERSON AND VANESSA BENNETT

Ask Lisa Podcast, Ep. 139: This Is So Awkward: Modern Puberty Explained with Dr. Cara Natterson and Vanessa Bennett

The Ask Lisa Podcast does not constitute medical advice and is not a substitute for professional mental health advice, diagnosis or treatment. If you have concerns about your child’s well-being, consult a physician or mental health professional.

The following transcript has been automatically generated by an AI system and should be used for informational purposes only. We cannot guarantee the accuracy, completeness, or timeliness of the information provided.

——

Reena Ninan
So I wore my Mr. T chains today necklace “What you talking about fool?” Because we’re talking about podcast, or puberty in our podcast today. I’m so anxious I can’t even spit it out. I’m so anxious about this conversation because there’s so many questions, right?

Lisa Damour
Oh, you look great. And can I just tell you, you know, I have a seventh grader.

Reena Ninan
I know.

Lisa Damour
And you know, we do. We’ve been going back to school nights. And you know, I see her classmates. Reena man, it just takes me back. Right. I mean, they are all over the map. There are giant children there at 30 children there are children who have a five o’clock shadow. Oh, it’s just like… I look at it with wonder. And also like, I’m so glad I don’t have to do that again ever in my own life.

Reena Ninan
It’s my idea of hell repeating seventh grade that is the year that I absolutely hate it. But you know what I love about our next two guests are not only are they puberty experts, but they’re actually looking at the science of puberty, which I feel like nobody ever does. So it’s not just parents talking about puberty through their experiences. It’s as you know, you love being grounded in science in this podcast. So without further ado, let me explain. The book is called “This Is So Awkward: Modern Puberty Explained.” And Dr. Cara Natterson is a pediatrician speaker and doctor behind the New York Times Best Selling series “The Care and Keeping of You,” more than 7 million copies in print. And it’s sequel for boys, “Guy Stuff.” Well, we love that book. We got both of them for our kids. And then Vanessa Kroll Bennett is a puberty expert writer and entrepreneur who helps adults navigate uncertainty while supporting the kids with love, which is hard to do. Cara is the co-founder and CEO and Vanessa is the president of content at Order of Magnitude. It’s the leading brand dedicated to flipping puberty positive together, they host also they co-host also The Puberty Podcast. Welcome, guys.

Cara Natterson
Thank you.

Vanessa Kroll Bennett
Thank you, Reena. Thank you, Lisa, we’re so happy to be with you.

Lisa Damour
We are so glad to have you here. And I have to tell you, we put a call out to our listeners, like what questions do you have about puberty? And in response, we got an avalanche. So we’re not even messing around, we are gonna get right down to business. We have questions for you questions for you. Now, as someone who blurbed your book, I’ve read your book, obviously, I am thrilled that we get to be with you here on your publication date for this book. This book has so much in it is so rich, it is so smart. We want people to go check it out for themselves. And then in addition to all the wisdom that you’re gonna give us here today, there’s so so, so much more in that book. So yeah, just start with the questions?

Cara Natterson
Let’s do it.

Lisa Damour
Okay, let’s just start at the beginning. We had a parent ask, How do I prepare my kid for what is happening both emotionally and physically, when it comes to puberty?

Cara Natterson
Vanessa, you start.

Vanessa Kroll Bennett
First of all, I just want to say thank you both for being so supportive of the work that we are doing. And the amazing part of writing this book and putting this book into the world has been the encouragement, the generosity of all the professionals who work with kids and care about kids. So first of all, just thank you guys for being part of this national and global team of people you know, taking care of kids in really thoughtful and caring ways.

Lisa Damour
That is so kind. We are honored.

Cara Natterson
That’s why I wrote a book with her.

Vanessa Kroll Bennett
Okay, now down to the nitty gritty. So the first thing that people need to know is that puberty starts on average two years earlier than it used to. So for adults thinking about when they need to have this conversation when they need to prepare kids. It’s not happening the way it did when we were kids, right? So it’s not the average onset at like 11. And it lasts for a few years, the average onset is between eight and nine for girls, and between nine and 10. For boys, yes, hold on to your seats, folks. That is totally true. And it means that the conversations and the preparation needs to start much earlier than people ever imagined. But I don’t want people to worry that if they haven’t started and they have an 11 year old or 12 year old or a 15 year old in their house, it’s never ever too late to start the conversation, you can always go back and say something like, Hey, kiddo, I’m using Lisa’s favorite phrase, you know, Hey, kiddo, I know that we haven’t really talked about this before. But I just found out that I should be talking to you about puberty and about changes in your body. And I haven’t done it yet. So we’re gonna get started.

Cara Natterson
And I’m gonna jump in with the how, because the house is a little overwhelming. And frankly, it’s why we wrote the book. I mean, the book is a lot of science, but every single bit of science is followed by, okay, how the hell do I approach this with my kid or with my family, right? Or with a kid that I care about with someone who I’m coaching? Or I’m teaching, or I’m mentoring, or for health care providers, a kid who I’m taking care of in the office? So the answer there is an answer. That’s not new, but we’re applying it to a much broader cross section. And the cross section is kids who are in grammar school, not just middle and high school who need the talk. The talk is not one talk. That’s the part of the the advice that’s not new. We’ve known that for a while. The talk. And you guys talked about this is many talks over many years, covering many topics. But now we’re going to ask you to roll those talks back into even smaller, more digestible bites for younger kids. So for parents, or mentors, or grandparents or family members who are looking to broach this subject, one way in, is to ask kids to reflect on how something makes them feel. If they start talking about a physical change, or an emotional change, or a social change, rather than you telling them how you think they should feel about it. You can stop and ask them. Well, how does it make you feel? Lisa, you talked about the beginning of seventh grade picture. In everyone’s mind I Mind’s Eye about seventh grade, early seventh grade, looks like this. There is a massive skew in height, weight, physical dimension, curves, hair, right? Every single one of those kids has feelings about where they sit on that continuum. If you’re early, it can feel awkward. If you’re late, it can feel awkward. And you know what, if you’re smack dab in the middle, it can feel awkward. So starting the conversation by asking them how they feel about something that they point out to you, is a really nice way in to the beginning of conversation that is based in science and fact and information.

Reena Ninan
I love what you say in this book is that it’s about small conversations, what not one long puberty talk that you should be having. But is there an ideal age when you know, idealistically, you should start talking about it? And also we got this question from a listener saying that they think their nine year old daughter is getting breast is it too early? How do you approach that?

Cara Natterson
Yes. So the the perfect age, if you know, if it fits for your family, and this age hasn’t struck yet, is eight, I would say to begin the conversation and interestingly, “The Care and Keeping of You” books, they are aged down to eight, eight and always have been even before all of this conversation started the original “Care and Keeping” book. This is such an interesting history was was written by a woman named Valorie Schaefer actually just joined the title in the early 2000s. Valorie wrote the book in response to a study that was published In 1997, by a nurse named Marsha Herman Giddens, who was the very first one to recognize the puberty was happening earlier and girls and Marsha Herman Giddens identified the puberty was beginning around age 10, in the late 90s. So that is why the Karen keeping hit bookshelves, it was to give kids as young as eight, who may be experiencing body changes, a little conversation starter, right, and a little sort of tiptoeing into information about getting comfortable with your body. So when ideal time is eight, and lest you think that it’s later for boys, because boys tend to go into puberty, a little bit later, but not much, boys, girls, as Vanessa said, are entering now between eight nine boys between nine and 10. Not all but the average for boys, every gender should know about every gender. Like, let’s just get that out there front and center. There is no reason for us to gender, any of this. According to the parts you have. There’s something incredibly empowering and important about, especially about conversations around consent, when everyone understands what’s happening to everyone’s bodies. So my answer is an ideal age is eight, regardless of the gender, but this is not. And this is where I know Vanessa is going to pick up the ball. This is not like, yeah, tell of everything. Is that where you’re going, Vanessa?

Vanessa Kroll Bennett
Yes, so our advice is definitely don’t backup the dump truck and just empty it all over your kid, as tempting as it is, particularly when we’re nervous, like you just want to like, hand them all the information immediately so that you’re like, Oh, I’m done. I’m out of here, I’ve can check that off my to do list as we all love to do. But the other thing Reena is that talking about preparing kids for puberty, like the word sex often doesn’t enter the conversation for years. So with kids in pre K or toddlers, you’re teaching them the correct anatomical terms for their bodies. With kindergarteners, you’re doing a ton about consent, like who can touch your hair, who can hold your hand who can sit in your lap. And as kids get older, you’re just building a foundation for conversations about how does their party feel? What what do you feel like when you get nervous or excited or you feel loved, right? Like you’re doing all these baseline conversations so that by eight or nine, which is it’s totally typical, than a nine year old girl in today’s age would be developing breasts. But it’s not just what’s happening with her physically, it’s about what’s happening with her, as Cara said emotionally and normalizing that and one way to normalize it is that it’s just part of the family conversation since kids can remember. And I will repeat. If you have never used the correct anatomical terminology for kids body parts. It’s never too late to start, don’t beat yourself up. If you have pet names and nicknames for genitals or breasts or any of those things, it’s okay, you can start now and you can admit to your kid, Hey, I just realized I should be using these words and I haven’t been so let’s start now.

Lisa Damour
Okay, we got so much good stuff here. So if the conversation starts around eight, your child may or may not be underway with puberty at that point. How do you know when puberty starting? Like how can you tell? Or can you tell that it’s underway?

Cara Natterson
So we have a friend and a colleague named Louise Greenspan, who’s one of the more important researchers in this field, she wrote a wonderful book called “The New Puberty,” which came out in 2014, and is still incredibly relevant. And Louise says, and we always quote her, the first sign of puberty is usually a slamming door.

Reena Ninan
Whoa!

Cara Natterson
Right? So why? Because the hormones that are in charge of puberty, do not stop at the neck. They circulate around the brain, and they deeply impact moods. And lest you confuse the fact that moods need to be things worn on your sleeve instead of things that can be sort of stuffed down. I know you guys, you know, are are experts in the mood arena. But let’s be clear that silence, especially typical among boys, but can absolutely happen for all genders. Silence is a mood. So sometimes there’s eye rolling, sometimes there’s an yelling sometimes there’s door slamming, sometimes there’s hysterical laughter. Right? Can’t Stop it. Hysterical laughter and sometimes there is mono syllabic grunting and all of it is the moodiness that goes on with initial hormone swings.

Lisa Damour
That is so helpful. I think that is so helpful for people to have that context. Okay, so then just to ask, following up, has it always been this way? Is there something different about today’s puberty versus like, say, like our grandma’s generation? Like, why is this new? What’s the story?

Vanessa Kroll Bennett
We hear from parents all the time: Why is my 10 year old acting like I would have expected a 16 year old to act, or a 12 year old or a 14 year old to act. And so as Cara said, just because the moods circulate, I mean, because the hormones circulate everywhere. The moods that we would have expected to see and an older kid are presenting themselves earlier, because the hormones are presenting themselves earlier. So it’s not just and this may contribute, the media they are consuming and the influences in their lives that sort of show them new ways of behaving that are equal parts, charming, and infuriating. It might also be that they are actually in puberty, and the hormones are circulating, and therefore the moods are presenting themselves much earlier than adults imagined they would.

Cara Natterson
Can we get science nerdy for one second on us, we’d love science nerdy, here’s the science nerdy piece. So the maturation of the brain is entirely chronological. So there is sort of a path, that brain development goes down, that is really marked by time in a way that has not shifted, you know, puberty, the physical, like, we should define some terms, puberty is the path to sexual maturation, that will one day allow someone the capability of potentially having a baby. That’s puberty, adolescence, is generally considered the social and emotional evolution from childhood to adulthood. Those two timeframes used to have no Venn diagram overlap, or very little. And now, frankly, they’re considered almost entirely overlapped, so that the social, emotional and physical shifts all coexist. And that’s because of hormones, because the hormones that are shifting the body, and as puberty has stretched, we haven’t even talked about this. But we can talk about this as puberty has stretched in duration, those hormone surges and drops lasts longer and longer. So as puberty has expanded over a broader period of time, so to have the hormonal influences on social and emotional issues, okay, put a pin in that. Now let’s talk about brain development. The brain, meanwhile, is marching along this very chronological path. And it is doing it is doing two things. It is myelinating, which means neurons in the brain are getting insulated. And it is pruning, which means neurons in the brain that aren’t used are being basically killed off. And the combination of myelination and pruning is what takes a brain from an immature young brain to a mature able to make really good decisions, adult brain. And the point at which kids are in that trajectory on those two on those two fronts, when they are eight, is different than when they are 10. And different than when they’re 12. So when your grandmother went through puberty, arguably, her brain had myelinated more and pruned more before estrogen and testosterone and all the other hormones that are involved in sexual maturation started to flood her brain that looks different, that does look different. But the brain maturation itself. We don’t think it does. And there’s a giant asterisk there, which is your grandmother’s generation never got in an MRI scanner. And there was never documentation of what was happening to their brains. So we’re making some assumptions here.

Reena Ninan
You know, is it too early? I’m just so overwhelmed. This is unbelievab– no one has talked to me about puberty the way you too are talking to me about puberty. And is it too early to ask? I’m so stuck on the slamming doors thing that was like a Whoa, light bulb moment. So what you’re saying is puberty ends at 53? When does it end?

Cara Natterson
I’m 53 and I don’t think it’s over.

Reena Ninan
But when did, how do we know it’s over that it’s ending? Is there a sign?

Vanessa Kroll Bennett
I mean, Reena, it’s like really complicated question because the hormonal shifts in our bodies for those of us who are menstruating errs, or former administrators of a certain age, know that from month to month and year to year if we had pregnancies or, you know, other hormonal experiences, it doesn’t act like art are constant shifting and ebbing and flowing, never ends. When does puberty and well, there are markers and car can go through the specific markers, right, the end of growth, the end of certain body shifts in terms of hip widening, but like breast growth or shrinkage never ends throughout an you know, an entire lifetime. And male bodies also shift and change all the time as well. So I hate to say, a It depends, because that’s the world’s most annoying answer. And also, we give it all the time. And be I’m sorry to all of our listeners. But like, in some ways, we’re always and forever on this journey. And that’s why talking to kids about it is so important because it acknowledges that it is a lifelong process of understanding our bodies, getting to know our bodies, really acknowledging the relationship between our bodies, and our moods and our relationships. And our families like it is this incredible, incredibly interested, dependent world. And if we push it away, then that means we push it away at pregnancy and we push it away menopause and we push it away in all of those moments. And instead we’re saying bring it into the conversation include all these discussions. Cara I don’t know if you want to add the like technical…

Cara Natterson
Dying to add. Yeah. Because Reena, one other piece of the answer is that puberty has all of these different components that Vanessa has listed, right? So you have breast growth, by the way, 50% of of x y individuals, males, genetic males have some breast growth during puberty. So we can talk about that. You have height growth or height gain, you have curviness or stretching, you have shifts in lean muscle mass and body fat deposition, you have voice changes, you have sweating hair and zits which are concurrent with puberty, but not part of puberty, technically. And we can talk about that, because that’s super interesting. But all of these things happen. And all of these things happen in a different order, and at a different time in every body. So it’s impossible for us to give you an absolute endpoint because some kids grow go through a growth spurt, before they gain their weight, and other kids get their curves before their voice drops and other kids. And so the the sort of constellation of puberty elements, will you will see sort of a bow tied at the end of all of these things happening. But there isn’t one thing to look for. I will add that getting a first period is neither the beginning of puberty, nor is it the end. It is a middle marker. And this is very important, because this is what has driven first of all, a lot of miscommunication around puberty. But second of all, a lot of research around puberty is looking at menarche, the first period. It’s an easy, measurable, highly memorable event. There is no male equivalent. So it’s easier for us to talk about and look at certain features of female puberty than male puberty, which is part of the reason that males have been so left in the dust in this conversation.

Lisa Damour
That’s so interesting. All right, here’s another question we got from a listener: Is there a situation where you would recommend hormone injections to slow puberty down?

Cara Natterson
I get this question a lot, a lot. And I’m going to start with the most important piece of the answer, which is you need to talk to your doctor. Because there are certainly cases where kids are entering puberty too quickly. And it needs to be slowed down. It’s called precocious puberty. And it’s a diagnosis. And it used to be when when puberty started on average at age 11. In the 1940s 50s 60s 70s. Then precocious puberty used to be maybe nine or certainly eight, we would we would treat. Now of course we didn’t have the labs that we have now. We couldn’t measure hormones like we can now And we didn’t have the treatments like we have now. But it was that you know, what was considered precocious or early looked very different back then, today, precocious puberty. If I’m telling you the average age of onset is between eight and nine. And in some populations like for black girls, it is not uncommon to see girls enter puberty with breast butting at age seven. Then what is precocious, I mean, precocious is five or six, which feels overwhelming. I mean, that just feels stunning. And now I’m going to tell you that there are some listeners out there whose kids have pubic hair, or axillary underarm hair at the age of five. And those folks rushed to their pediatrician, and they say, oh my gosh, my kid is in puberty. But this is that comment I made a few minutes ago about how hair and zits and sweat, they are not technically puberty. Those three changes are driven by totally different hormones, estrogen, progesterone, and testosterone. They drive sexual maturation, but hair and zits and body odor are largely controlled by hormones that are released from the adrenal gland. So those glands sit on top of your kidneys. And while they happen concurrent with puberty, they don’t mark sexual maturation. So we have to be careful how we use words here, because if we’re using the word puberty to essentially describe the entire journey through the tweens and teens, and a hormonally driven journey at that, guess they need to be talked about. But when you look at the science, a five year old with pubic hair, as alarming as that can be, may not be and is likely not in puberty. So anyone with any question about whether their child is in it too early and needs to take puberty blockers should absolutely talk to a doctor and the flipside is also true. There are late bloomers. Late Bloomers are defined as the last two and a half percent. That’s it. It’s a statistical definition. So there will always be late bloomers.

Reena Ninan
I want to ask you about that, Cara, because we got a lot of questions on on that as well on early and late bloomers and one, a couple of parents wrote in actually talking about their sons one says, you know my son’s a sophomore who turned 16 We’re still waiting for puberty when another one says my son’s almost 13 And he’s 10 to 12 inches shorter than his friends. What advice do you have for oh, the boys who are they have

Cara Natterson
So much advice Reena, I have so much advice because parents Okay, here’s the deal. This is so important for parents of boys to know, girl puberty presents, typically, with more outward moods, and breast spots, those tend to be even though nothing comes in a set order. Those tend to be the earlier signs. You know what boy, puberty presents with quiet, which people don’t recognize as moods, and growing testicles and penises. Okay, so now I want to put a pin in that and tell you about how I’m a pediatrician. And when my son started to hit third and fourth and fifth grade, he did what was very typical of kids his age, he started covering up, he shut the bathroom door. I never saw him naked. And I had no idea what was going on with his penis and testicles.

Lisa Damour
I’m just gonna interrupt and say Cara, like, it’s kind of extraordinary that you can make that sound like a normal thing. You did? You did. And we’re having a good technical adult grown up conversation as we should about puberty. But I just, I just had to say that.

Cara Natterson
Well, here’s why I say it that way. Because sometimes when I say the next sentence, I’m going to say people think I should check my son’s penis and testicles. And what I’m saying is even I didn’t, okay, so No, you shouldn’t. But if the earliest sign is growth of the penis, and testicles, and I’m going to tell you right now, it can be a couple of years between when that growth begins and you see any other changes that look like puberty in boys. I’m here to say sometimes that 13 year old is in puberty, sometimes that 16 year old is in puberty, it’s just that they started later, and no one is taking sort of account of what is happening in their groin and they aren’t frankly there they if they’re not the noticing type, they’re they’re not noticing. So again, the advice is always check in with a physician, a physician is the one or a healthcare provider of some sort is the one who should do a physical exam. And there’s this amazing this is Lisa, you if you thought that was normalized Listen to this one, there’s a necklace called an orchid ometer. It looks like a strand of beads. Each bead represents an increasingly large testicular size, and you go from pre pubescent to fully grown adult, a lot of pediatricians wear one around their neck or keep one in their pocket. And they can show kids where they are along the spectrum of puberty. And that’s important, it’s tangible. But this is all to say that late blooming does happen. The definition of late blooming, I am frustrated by the definition of late blooming is no evidence of pubertal onset before the age of 14, and boys, it’s a little softer. And girls, it’s about 13, and girls. But the reason I’m frustrated by it is often the advices do nothing until they’re 14. And that listener who wrote in to describe being almost a foot shorter than many of the kids in their class, what they’re telling you is doing nothing for a child who is a little bit late to the puberty party can be very emotionally and socially difficult. And so checking in with your doctor earlier, rather than later is appropriate. And I’m gonna add one last detail before I pass the baton to Vanessa, which is late blooming boys tend to slow their height gain. So most kids grow an average of two inches a year, and then they hit their growth spurt, which is faster and less girls, it’s three, two to three inches a year boys, it’s three to four inches, your last couple of years, sometimes up to four years. late blooming boys tend to slow or almost stop their growth between the in that run up to puberty. So they may grow half an inch a year. And now they’re falling further behind their peers. Which I mean, it’s really emotionally and socially it’s very, very challenging.

Reena Ninan
Lisa, so many questions.

Lisa Damour
Okay. So Vanessa, over to you on this one. Pimples. We got questions about pimples.

Vanessa Kroll Bennett
I have one on my chin right now, Lisa.

Lisa Damour
Well then, you’re the perfect person to answer this question.

Vanessa Kroll Bennett
I’m feeling very empathetic.

Lisa Damour
Okay. So what’s a person to do about their own or their teenagers pimples?

Vanessa Kroll Bennett
So the first thing I mean, what I what I’m going to do, I will not share on this podcast because I might have not followed the advice I’m sure, you can all guess what that advice is. Spoiler alert, don’t pop them. So there’s so many aspects to acne, right? There’s the biological aspects. And as Cara mentioned, oilier skin and pimples are related to adrenarche, which are actually governed by the adrenal glands sitting atop the kidneys, so more sweat, oily or skin. So it’s adjacent to puberty, but sometimes kids will get pimples earlier than they’re in puberty, or much later than having gone through much of puberty. So it’s normal to have seen a kid beautifully glide through puberty with clear skin, and then all of a sudden, at 17, the acne appears out of nowhere. The first thing to acknowledge is that it really stinks, like acne is a bummer. And kids feel self conscious. And they feel like things are out of control. And often kids have acne, when they have beautiful hygiene, they are washing their faces twice a day with appropriate sensitive materials or even dermatologically prescribed materials, right? They are wearing sunscreen, they’re using moisturizer, sometimes acne is out of the control of the kid. And other times, they are not doing those things. Right. So what if pimples are appearing? The first thing is to make sure kids are actually taking care of their skin. So you might say to a kid, hey, I want to make sure you’re washing your face. And they might say, Oh yes, I’m washing my face. And then you might want to say, I just want to make sure you’re washing your face with cleanser or soap. And they might say to you, oh, I’m supposed to use so I’m supposed to use cleanser. And I speak from personal experience that this is they are utterly shocked to hear that they’re supposed to actually Use a product to cleanser face. So that’s question number one. It does not sound like you’re disgusting. Like, what is happening? Are you even taking care of yourself? Like, why aren’t you like taking pride in what you look like you? I bought you all these products and you don’t use them. And it’s so disrespectful and I’ve wasted my money, right? Like that is a very shaming approach to the topic of converse of the to the topic of acne, better off to be casual, to be supportive to be curious and just wonder if they’re taking care of things.

Lisa Damour
And if they are, do you take them to a dermatologist?

Vanessa Kroll Bennett
Yeah, so you start with a pediatrician often, many families need referrals to go see specialists and pediatricians may have a specific dermatologist that they like, they might have a specific dermatologist who is particularly sensitive to a kid’s predicament, right? If the acne is really bad, there’s a series of steps that you go through in order to treat that acne. And it’s not a light process. It’s a serious process with serious medication. So you want someone who’s going to be sensitive to not just the physical needs, but also the emotional process of taking on such a big responsibility. So start with a pediatrician, then you can move on to a dermatologist and the dermatologist will walk you through the various options of increasing seriousness.

Lisa Damour
Just to wrap this up, here’s something I feel I’ve seen. And I just want to see if it’s resonates with what’s true. I feel like the options and the treatments are so much better than when we were teenagers. Is that fair?

Vanessa Kroll Bennett
I mean, yes and no. Yeah, Cara, you can you can speak to that pretty easy.

Cara Natterson
Yes and no. There, there are more of them. There is more. You know, the most kids are getting their information about acne treatment through social media actually. And so they’ve heard about a lot of different brands. But the active ingredients are the same as the active ingredients when we were growing up. And one really good we sort of walked through in the book in great detail how health care providers especially dermatologist will tell you to treat acne and why. And one of the most important things to know is when you overdrive the skin, it tells the oil glands below to make more oil. And if your problem is oil that’s congesting your pores, then the drier you make the skin that pimple will go away and 24 hours but five more we’ll be back 48 hours later. So there’s there’s a lot to unearth about acne treatment. I don’t think social media except for our social media is the best way to figure out how to treat it.

Reena Ninan
Yeah, so the toothpaste thing does that still work?

Cara Natterson
Oh, toothpaste is unbelievable.

Reena Ninan
Really? I was joking.

Cara Natterson
Oh no, it’s great.

Lisa Damour
What, putting toothpaste on a pimple is helpful?

Cara Natterson
Oh my god, it’s amazing.

Lisa Damour
I don’t know about this.

Reena Ninan
You don’t known about this, Lisa? This is like before there was anything you put toothpaste on it.

Cara Natterson
Yes. And here’s why. Because it’s very focal, you literally put a tiny.of Toothpaste exactly where the pimple is. And it acts as a local drying agent. So right at that area that’s congested, you dry, but you’re not drying anything else around. I will say though, first of all, sometimes it stings depending on what’s in the toothpaste, so be careful with that. And second of all, it doesn’t work for cystic acne, those deep pimples will not respond to toothpaste. It’s really like a nice juicy whitehead.

Reena Ninan
Okay, all right.

Lisa Damour
New topic.

Reena Ninan
New topic, new topic. You know, one thing I love about your book, guys, it’s like every chapter, whether it’s hygiene or sleep, you’ve got this section that says let’s start with science in this book. And I love that because you’re breaking down the science of it all. So I have to ask you this question. Why do tweens and teens smell so bad? What is happening?

Cara Natterson
Okay, ready for the 20 second version?

Reena Ninan
Yes.

Cara Natterson
Okay. When the adrenal glands pump out their adrenal androgens, those adrenal androgens tell the skin cells to either grow a thicker or curlier or, or darker hair, right like usually pubic hair, and or to make oily or skin wake make the oil thicker, that’s in the sweat. When the oil in the sweat is thicker, especially in the armpits, around the feet in the groin, three really common areas for smelling. There is more protein in that oil. We all have bacteria that lives on our skin normal, appropriate symbiotic great. The bacteria love to eat the proteins in that oily sweat when the bacteria eat those proteins, they metabolize them. And they off gas them. In other words, when you’re talking to a kid, you can say, they fart them out. And the smell is body odor. That’s it.

Reena Ninan
How do we get them to stop farting it out?

Cara Natterson
Okay, Vanessa.

Vanessa Kroll Bennett
Remember how I encouraged people to be really explicit about using things like soap? Go back to the fundamentals. So A, if you tell a kid that they might not even notice their body odor, we notice it, they might not notice it be, they might enjoy their body odor. They might like the way it smells. Kids love the way their farts smell. They also sometimes like the way their body odor smells. I mean, I might have had a 13 year old in my house last night where I was like, Dude, did you use soap? And he was like, Yeah, and I said, stick your nose in your armpit. And tell me that again. And he said, Oh, it smells good in there.

Lisa Damour
Can I just tell you, I feel like I’m in the seventh grade right now. Like, I feel like living seventh grade.

Vanessa Kroll Bennett
Welcome to my life. Lisa. It’s like, I’m always in the seventh grade. So Rena, you have to be really, really explicit with kids about how often they need to do things, what they need to use, with foot stink, so that we hear from a lot of parents about like, eight and nine and 10 year olds with incredibly stinky feet, but like not really anything else going on. So tell kids and young adults to use soap on their feet. They don’t realize that they’re actually supposed to wash their feet. With soap, I might have a 20 year old in my house who looked at me the other day, I was like, wait, what? I’m supposed to wash my feet with soap. And I’m like, oh my god…

Cara Natterson
But here’s why. Here’s why. Because the soap removes the bacteria from your skin. There we go. And if you have fewer bacteria on your skin, then even if you’re making that protein rich, oily sweat, the bacteria are not going to be able to eat it at the same rate, their farting rate goes down, the smell goes down, and those bacteria grow right back. So 24 hours later, right?

Reena Ninan
I have some friends who like swear by Tea Tree lotions, body washes, that they swear makes different for feet and armpits. Do you guys agree?

Cara Natterson
Well, you know, it’s very interesting, because we all have different micro biomes on different parts of our body. And the one we talk about the most in in our society right now is the microbiome inside the gut all the different bacteria that live inside our gut that are important for digestion, and metabolizing food, but we have a teeming microbiome on our skin. And depending upon what the microbiome balance is for you, different types of products are going to work differently. So tea tree oil is one of those products that works really, really well for some people. You just need something that will help debulk the bacteria from the skin and water does not do it. Friction does it? But water does not do it.

Lisa Damour
All right, I got to ask you a question about menstruation. Because we got a lot it’s hard to choose from, but I’m just gonna choose one. My daughter has frequent periods every 18 days. What could this mean?

Cara Natterson
It could mean you need to go see your doctor.

Lisa Damour
Okay, okay.

Cara Natterson
It’s, it’s normal for kids to have irregular periods for the first couple of years. It’s also normal for kids to have completely regular periods that they can set a watch by, for the first couple of years. Irregular Periods are a result of the hormonal signaling between the brain and the ovaries and the uterus, just trying to find their rhythm. And so sometimes people get a period every couple of weeks, and then it might be three months, and then it might be a week, and then it might be six months. But when it’s routinely every couple of weeks, the reason why you want to see a doctor is not that I’m alarmed and worried that something terrible is going on. It’s that sometimes you can have a fair amount of blood loss, and kids can become anemic. And when they become anemic, which means that their hemoglobin, their red blood cell number goes down, their iron levels go down, their ability to carry oxygen to their tissue goes down. They feel bad, they’re tired. They can’t focus the way normally they can focus. They can’t run and play and do sports and all those things. So that is why you want to go see a doctor.

Reena Ninan
So can we talk about sexual development before we go? Wet dreams, boys and wet dreams? Do they all have them? How do we discuss this with them?

Vanessa Kroll Bennett
It’s so interesting when we work with adults and talk to adults, and we ask them for kind of their number one seminal memory. Apologies. So well done, Vanessa, I’ve been working with car too long, I just turned into like such a punster. Men will have so so so often say that the the most complicated memory they have is about having an inconvenient erection, a spontaneous erection in school or at a party, or having a wet dream. And it’s totally normal for both of those things to happen. Not everyone has wet dreams, but it’s very common. We don’t totally understand a lot about wet dreams, partially because like, people don’t talk about them all that often. But it’s very confusing and alarming to kids. If no one has told them that it’s normal, that it can happen, that they haven’t done anything wrong, that they didn’t wet the bed. Often. They worry, oh my god, like, I’m 13 and I wet the bed, what is wrong with me, there’s something wrong with me. So just affirming to them that it’s normal, that if they want to talk to you about it, that’s fine. Or maybe sometimes with kids, it’s just, hey, it happens. Here’s how you change your sheets, I’m going to teach you how to do the laundry if they don’t already know. Or here’s how you spot clean your sheets, or here’s what you might want to wear to bed at night so that you’re more comfortable. If it does happen, right? Again, it’s just like, this is normal. There’s nothing wrong with you. You didn’t do anything wrong, because that’s another thing kids sometimes wonder. And then like, let’s, if you want to talk about it, I’m here to talk about it.

Lisa Damour
Beautiful. All right, one more on sexual development for you: How do we address arousal, right, the fact that kids are now having the new experience of feeling turned on, and helped them channel that towards being well and wise, what do we do?

Cara Natterson
So I’m going to start with something that we must say a half a dozen times in the book. And I wish we had said it earlier in the podcast. But I’m glad we’re getting in it now: Just because puberty is starting earlier, does not mean that kids are looking to be sexually active earlier. Puberty is stretching like taffy. Puberty used to take three or four years, it now takes almost a decade. Part of the process of becoming sexually mature is certainly feeling crushes, and then having attracted other people and then wanting to act on that attraction. And so it is very much a part of puberty to become aroused, and to want to have sexual experiences. But it is not. And I want to be really clear about this. It is not happening among eight and nine year olds, just because they have mood swings. And breast buds does not mean that they want to be sexually active. And we make the mistake often of treating them the way they look instead of the age they are. So today’s 10 year old might look like a 12 or 13 year old looked a generation or two ago. They’re 10. And it is on us to treat them, like their age. Because as we talked about before, their brain development isn’t going any faster. And so their brain is 10. And their ability to make decisions and think through problems is 10. So with all of that background, what I would say is that we’re landing this conversation beautifully right where we started it. This is hundreds of conversations, talking about how you feel your your crushes your sexual attractions. talking openly with kids, not about yours. By the way, I should restate that about their right because this isn’t about your adult feelings, looking back, it’s about their feelings, but talking about their feelings and bringing those conversations to the forefront and doing it often enough that even if they resist over time, they realize you’re not giving up, you’re going to keep talking about it with them. And one day they’ll talk about it with you as well. That’s how you start to deal with conversations around arousal. Because our goal all of us, every single parent, grandparent person who is invested in raising kids, what do we want for them, we ultimately want them to be happy and part of happiness is Having a huge part of happiness is having deep and meaningful relationships with other people. And some of those relationships may be romantic. And some of those relationships may be sexual. And so if the goal is to one day, raise an adult who can have a really healthy and positive, loving sexual relationship, you’re not going to get there without talking about it.

Reena Ninan
So before we go really quickly know what last few minutes seconds here we have left? We’ve got this listener question. It says, What age should we be offering condoms? I plan on putting them next to our tampons?

Vanessa Kroll Bennett
Wow, I’m so into that person. Whoever asked that question, because they are right on board. I think it really depends. So there are kids who are thinking about sex hearing about sex, I have friends who are having sex at earlier ages than we might expect. And then there are lots of kids who are delaying sex and delaying sex until much later than we would have expected. So there’s not a one size fits all. answer to that question. There is an answer that I think helps people feel like they have a way into the conversation and a way into figuring out whether it’s time in their house, and it might be something like, Hey, we’re in the pharmacy aisle, and we’re getting you know, facewash, and deodorant, and you could casually say to a kid, hey, I’m wondering if it makes sense for us to have some condoms in the house right now. And that kid may say, Oh, my God, I can’t believe you’re asking me that question. And then you may still say, let’s, let’s buy some condoms, we’ll just keep them in the cabinet. Or that kid may say to you, yeah, I think it’s a really good time to buy condoms up. warning to those of you who have not bought condoms in 10, or 20 or 30 years, the condom aisle is much bigger, and much more eclectic, and has a lot more options than maybe the last time you bought condoms. So keep that in mind. But it’s just like a casual way to bring it up, you can go out and buy them and just let a kid know, we’ve got some condoms in the house. If that becomes important to you. I think it’s important. But don’t have the conversation without about condoms without explaining. And making sure kid knows how to put on a condom. Why a condom is important. How a condom keeps you and your partner safe. So buying the condoms is only one part of a much longer process around safe, loving and thoughtful sexual relationships.

Lisa Damour
Beautiful. What a phenomenal way to walk up to these incredibly complex questions. I am just so grateful that the two of you are willing to basically live the seventh grade, day after day after day. That’s right, and help us who you know, as parents are trying to help her kids through it. And it just all feel so loaded and all feel so fraud. And you just bring all the information and none of the shame. And we’re grateful for you.

Reena Ninan
And what a fun duo to absolutely love this conversation. We’d love to have you guys back. The book is called “This Is So Awkward: Modern Puberty Explained” by Dr. Cara Natterson and Vanessa Bennett. Go get the book. This has such juicy details and things that I never thought I’d be discussing.

Vanessa Kroll Bennett
Thank you both so much for having us. And thank you for the incredible work you both do. There’s like a whole companion aspect to what you do that will help people through puberty as much if not more than what we were talking about today.

Reena Ninan
Thank you guys really kind. Thank you so much.

Lisa Damour
Thank you.

Reena Ninan
Oh, I just love those ladies. Were they not fabulous?

Lisa Damour
They’re so fun. They are so fun. And they know their stuff.

Reena Ninan
They really do. So So with all of those gems that they dropped on us, what do you have for us for Parenting to Go that we should keep in mind about puberty?

Lisa Damour
Well, you know, their central message, which I think is so important is like talk to your kids. Like you need to be talking about this. initiate the conversation. Keep the conversations going. Now in real life, any of us who try this, as parents know, like your kids not always like Oh, thank goodness, you’re bringing up wet drains. Can we please talk more? I mean, usually they head for the hills. So do have the conversations do keep trying to have the conversations. But I think there’s such value and also saying to kids, here are some books that you can go read on your own time at your own pace. And I am in total agreement, give them a book about female puberty, give them a book about male puberty, regardless of your kid’s gender. And I also think take a quick look at the book they’ve just written. I think for a lot of kids, you could also hand them that book. And then you can say these are books that will answer your questions and then any questions you have about these I’m ready whenever you are.

Reena Ninan
Great advice. Great advice. You can never be armed with enough information.

Lisa Damour
No, absolutely and especially on topics that kids find so awkward. Yeah, being able to do a little learning on their own can help them feel more comfortable asking.

Reena Ninan
Good point. So next week we are going to talk about toxic relationships. What do you do if your child is in one? Is there a way to get them out? I’ll see you next week.

Lisa Damour
I’ll see you next week.

The advice provided by Dr. Damour here will not and does not constitute - or serve as a substitute for - professional psychological treatment, therapy, or other types of professional advice or intervention. If you have concerns about your child’s well-being, consult a physician or mental health professional.

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