Dr. MJ Bazos MD,
What is puberty?
Puberty is the time in life when a young person
starts to become sexually mature.
In girls, puberty may start as early as 6 or 7
years of age, but it usually starts around 11 years of age. This represents a
change in how doctors think about normal puberty. Until recently, puberty that
started at 8 years of age or later in girls was considered normal. In boys,
though, the age considered normal for the beginning of puberty has not changed.
In boys, puberty begins around 12 years as age, but may start as early as 9
years of age. This is a process that goes on for several years. Most girls are
physically mature by about 14 years of age. Boys mature at about 15 or 16.
What are the first signs of puberty
in boys and girls?
The first sign of puberty in most girls is
breast development. The first sign of puberty in most boys is an increase in the
size of the testicles.
Does sexual development have a
Yes. In girls, breasts develop first. Then, hair
starts growing in the pubic area. Next, hair starts growing in the armpits. In
girls, acne usually starts around 13 years of age. Menstruation (the period)
usually happens last.
In boys, the testicles and the penis get bigger
first. Then hair grows in the pubic area and the armpits. A small amount of
breast tissue might develop at this time. The voice becomes deeper. Muscles
grow. Last, acne and facial hair show up.
Does sexual development always
follow the same pattern?
No. Some children can have different patterns.
Some girls develop breasts at a very young age but have no other signs of sexual
development. A few children have pubic and armpit hair long before they show
other signs of sexual growth. These changes in pattern usually don't mean the
child has a problem, but it's a good idea to visit your doctor to find out for
What is early puberty? What causes
Early puberty is sometimes called precocious or
premature puberty. In most cases, early puberty is just a variation of normal
puberty. In a few cases, there may be a medical reason for early puberty.
You may want to visit your doctor if a young
- Develops breasts and pubic hair before 6 or 7
years of age.
You may want to
visit your doctor if a young boy:
- Has an increase in testicle size and penis length
before 9 years of age.
What is delayed
puberty? What causes it?
Sometimes a medical reason causes delayed
puberty, but sometimes not. For example, malnutrition (not eating enough of the
right kinds of food) can cause delayed puberty.
Puberty may be late in girls who have the
- No development of breast tissue by age 14
- No periods for 5 years or more after the first
appearance of breast tissue.
Puberty may be late in boys who
have the following signs:
- No testicle development by age 14
- Development of the male organs isn't complete by
5 years after they first start to develop.
Do early and late
puberty run in families?
Both early and late puberty can run in families.
There can be other causes, too.
How will my doctor know what is
causing the change in puberty pattern?
Your doctor will talk to you and your child.
Then your child will have a physical exam. The doctor might suspect a cause for
the puberty variation and order some tests. Sometimes the cause can't be found
even after several tests.
These are some tests your doctor might order for
- Blood tests to check hormone levels
- An x-ray of the wrist to see if bone growth is
- A CT or MRI scan (special pictures) of the head
to look for a tumor or brain injury
- Chromosome (gene) studies
Are early and late
In most children, no cause is found. It's just a
variation of normal puberty. No treatment is needed. In some children, a medical
cause is found and treated. For example, if the reason for late puberty is lack
of hormones, hormone shots can help.
What can I do to help my child?
The way children see their own body has a lot to
do with their self-esteem. It's important to let children know they're OK the
way they are and that you love them that way. You can let your child know that
he or she is normal (when the tests are normal). You can tell your child that
you'll help him or her with any problems (if the tests show a problem). If you
need help or if you think your child may need counseling, talk to your family