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What is puberty?

Puberty is the period when growing boys or girls undergo the process of sexual maturation. Puberty involves a series of physical stages or steps that lead to the achievement of fertility and the development of the so-called secondary sex characteristics, the physical features associated with adult males and females (such as the growth of pubic hair). While puberty involves a series of biological or physical transformations, the process can also have an effect on the psychosocial and emotional development of the adolescent.

The onset of puberty varies among individuals. Puberty usually occurs in girls between the ages of 10 and 14, while in boys it generally occurs later, between the ages of 12 and 16. Adolescent girls reach puberty today at earlier ages than were ever recorded previously. Nutritional and other environmental influences may be responsible for this change.


What are the symptoms of puberty?

First signs of puberty in girls:

  • The first sign of puberty in girls is usually that their breasts begin to develop. It’s normal for breast buds to sometimes be very tender or for one breast to start to develop several months before the other one.
  • Pubic hair also starts to grow and some girls may notice more hair on their legs and arms.

Later signs of puberty in girls: after a year or when puberty beginning, and for the next couple of years:

  • Girls’ breasts continue to grow and become fuller.
  • Around two years after beginning puberty, girls usually have their first period.
  • Pubic hair becomes coarser and curlier.
  • Underarm hair begins to grow. Some girls also have hair in other parts of their body, such as their top lip. This is completely normal.
  • Girls start to sweat more.
  • Girls often get acne – a skin condition that shows up as different types of spots including whiteheads, blackheads, and pus-filled spots called pustules.
  • Girls have a white vaginal discharge.
  • Girls go through a growth spurt. From the time their periods start, girls grow 5 – 7.5 cm annually over the next year or two, then reach their adult height.
  • Most girls gain weight – and it’s normal for this to happen – as their body shape changes. Girls develop more body fat along their upper arms, thighs, and upper back; their hips grow rounder and their waist gets narrower.

After about four years of puberty in girls:

  • Breasts become adult-like.
  • Pubic hair has spread to the inner thigh.
  • Genitals should be fully developed.
  • Girls stop growing taller.

First signs of puberty in boys:

  • The first sign of puberty in boys is usually that their testicles get bigger and the scrotum begins to thin and redden.
  • Pubic hair also starts to appear at the base of the penis.

Later signs of puberty in boys: after a year or when puberty starting, and for the next couple of years:

  • The penis and testicles grow and the scrotum gradually becomes darker.
  • Pubic hair becomes thicker and curlier.
  • Underarm hair starts to grow.
  • Boys start to sweat more.
  • Breasts can swell slightly temporarily, this is normal and is not the same as “man-boobs”.
  • Boys may have “wet dreams” (involuntary ejaculations of semen as they sleep).
  • Their voice “breaks” and gets permanently deeper. For a while, a boy might find his voice goes very deep one minute and very high the next.
  • Boys often develop acne – a skin condition that shows up as different types of spots, including whiteheads, blackheads and pus-filled spots called pustules.
  • Boys go through a growth spurt and become taller by an average of 7-8cm, or around 7,5 cm a year, and more muscular.

After about four years of puberty in boys:

  • Genitals look like an adult’s and pubic hair has spread to the inner thighs.
  • Facial hair begins to grow and boys may start shaving.
  • Boys get taller at a slower rate and stop growing completely at around 16 years of age (but may continue to get more muscular).
  • Most boys will have reached full adult maturity by 18 years of age.

Mood changes in puberty:

Puberty can be a difficult time for children. They’re coping with changes in their body, and possibly acne or body odor as well, at a time when they feel self-conscious.

Puberty can also be an exciting time, as children develop new emotions and feelings. But the “emotional rollercoaster” they’re on can have psychological and emotional effects, such as:

  • Unexplained mood swings;
  • Low self-esteem;
  • Aggression;
  • Depression.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Children who begin puberty either very early (before the age of 8) or very late (after 14) should see a doctor to rule out an underlying medical condition.


What causes puberty?

Puberty is the body’s natural process of sexual maturation. Puberty’s trigger lies in a small part of the brain called the hypothalamus, a gland that secretes gonadotropin-releasing hormone (GnRH). GnRH stimulates the pituitary gland, a pea-sized organ connected to the bottom of the hypothalamus, to emit two hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These two hormones signal the female and male sex organs (ovaries and testes, respectively) to begin releasing the appropriate sex hormones, including estrogens and testosterone, which launch the other signs of puberty in the body.

Risk factors

What increases my risk for puberty?

There are many risk factors for precocious puberty, such as:

  • Being a girl. Girls are much more likely to develop precocious puberty.
  • Being African-American. Precocious puberty affects African-Americans more often than children of other races.
  • Being obese. If your daughter is significantly overweight, she has a higher risk of developing precocious puberty.
  • Being exposed to sex hormones. Coming in contact with an estrogen or testosterone cream or ointment, or other substances that contain these hormones (such as an adult’s medication or dietary supplements), can increase your child’s risk of developing precocious puberty.
  • Having other medical conditions. Precocious puberty may be a complication of McCune-Albright syndrome or congenital adrenal hyperplasia — conditions that involve abnormal production of the male hormones (androgens). In rare cases, precocious puberty may also be associated with hypothyroidism.
  • Having received radiation therapy of the central nervous system. Radiation treatment for tumors, leukemia or other conditions can increase the risk of precocious puberty.

Risk factors for delays puberty include:

  • Congenital pituitary abnormalities;
  • Gene mutations;
  • Chromosomal disorders;
  • Anosmia;
  • Eating disorders;
  • Chronic systemic illness;
  • Malnutrition;
  • Intense exercise;
  • Congenital and acquired gonadal abnormalities.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is puberty diagnosed?

To identify whether a child is entering puberty, a pediatrician (a physician specializing in the treatment of children) will carefully examine the following:

  • In girls, the growth of pubic hair and breasts;
  • In boys, the increase in size of the testicles and penis and the growth of pubic hair.

The pediatrician will compare what he or she finds against the tanner scale, a 5-point scale that gauges the extent of puberty development in children.

After giving a child a complete physical examination and analyzing his or her medical history, a healthcare provider may perform tests to diagnose precocious puberty, including:

  • A blood test to check the level of hormones, such as the gonadotropins (luteinizing hormone [LH] and follicle-stimulating hormone [FSH]), estradiol, testosterone, dehydroepiandrosterone sulfate (DHEAS), and thyroid hormones.
  • A gonadotropin-releasing hormone agonist (GnRH) stimulation test, which can tell whether a child’s precocious puberty is gonadotropin-dependent or gonadotropin-independent.
  • Measuring blood 17-hydroxyprogesterone to test for congenital adrenal hyperplasia.
  • A “bone age” X­ray to determine if bones are growing at a normal rate.

The health care provider may also use imaging techniques to rule out a tumor or other organ abnormality as a cause. These imaging methods may include:

  • Ultrasound (sonography) to examine the gonads. An ultrasound painlessly creates an image on a computer screen of blood vessels and tissues, allowing a health care provider to monitor organs and blood flow in real time.
  • An MRI (magnetic resonance imaging) scan of the brain and pituitary gland using an instrument that produces detailed images of organs and bodily structures.

To diagnose delayed puberty, a health care provider may prescribe these tests:

  • Blood tests to measure hormone levels;
  • Blood tests to measure if the pituitary gland can correctly respond to GnRH;
  • An MRI of the brain and pituitary gland.

How is puberty treated?

Precocious puberty: not all children with precocious puberty require treatment, particularly if the onset of puberty is only slightly early. The goal of treatment is to prevent the production of sex hormones to prevent the early halt of growth, short stature in adulthood, emotional effects, social problems, and problems with libido (especially in boys).

If precocious puberty is caused by a specific medical problem, treating the underlying problem can often stop the progression of precocious puberty. In addition, precocious puberty can often be stopped by medical treatment to block the hormones that cause puberty. For example, medications called gonadotropin-releasing hormone agonists (GnRH) are used to treat central precocious puberty. These medications, some of which are injected, suppress production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

With delayed puberty, treatment varies with the origin of the problem but may involve:

  • In males, testosterone injections, skin patches, or gel;
  • In females, estrogen and/or progesterone given as pills or skin patches.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage puberty?

The following lifestyles and home remedies might help you cope with Precocious puberty:

  • Chelation Therapy;
  • Vitamin D;
  • Probiotics.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: October 25, 2016 | Last Modified: January 4, 2017

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