Testosterone is a hormone produced in the male testes. During a boy's pubescent years (ages 9 to 14), there is an increase in production that leads to male secondary sexual characteristics such as a deeper voice, more muscle mass, facial hair growth and enlargement of the Adam's apple (among others). Some teenage boys experience these puberty changes at later ages than others. The timing of puberty is often genetically determined (through heredity), but other factors can play a role in delaying it, such as poor nutrition, physical trauma and certain diseases. Stimulating testosterone production naturally is possible in teen boys, although in rare cases hormone therapy may be needed to trigger and complete puberty.