II. Definitions

  1. Pubarche
    1. First onset of public hair as a result of Estrogens in girls and androgens in boys
    2. Coincides with Tanner Stage 2, and typically with Thelarche in girls
  2. Gonadarche
    1. Marks the onset of Puberty (more evident in boys, as ovarian growth is not readily evident)
    2. GnRH released (activating the hypothalamic-pituitary-gonadal axis)
    3. Boys
      1. Testicles grow in size
      2. LH stimulates Testosterone production
      3. FSH stimulates sperm maturation
    4. Girls
      1. Ovaries grow in size
      2. FSH stimulates Estrogen and follicle formation
      3. LH stimulates corpus luteum after Ovulation
  3. Thelarche
    1. Onset of secondary Breast development (marks the observable start of Puberty in girls)
    2. Breast buds palpable and areolae enlarge
    3. Peaks at ages 10.2 to 11.3 years, and precedes Menarche by 24 months
    4. Coincides with Tanner Stage 2
  4. Adrenarche
    1. Increased weak adrenal androgen secretion (DHEA, Androstenedione)
    2. Primarily related to adrenal maturation
      1. Contrast with Gonadarche which is more specific to Sexual Development
    3. Peaks between ages 10-14 years
    4. Coincides with Tanner Stage 3 and 4
    5. Transient growth spurt
    6. Axillary and pubic Hair Growth (beyond the minimal pubic hair present in Tanner Stage 2)
    7. Skin oiliness develops (mild acne may form)
    8. Body odor starts

III. Exam: Normal Development

IV. Exam: Abnormal Development

  1. Precocious Puberty
    1. Secondary sexual characteristics before age 8 years in girls, and before age 9 years in boys
    2. Significant abnormalities more frequently affect boys
  2. Delayed Puberty
    1. No signs of Breast development by age 13 years, or Menarche by age 15 years in girls
    2. No signs of testicular enlargement by age 14 years in boys

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Related Studies (from Trip Database) Open in New Window

Ontology: Endocrine disorder related to puberty (C0271522)

Concepts Disease or Syndrome (T047)
SnomedCT 4900002

Ontology: Puberty stage (C0429595)

Concepts Finding (T033)
SnomedCT 251804006
English puberty stage, puberty stages, puberty staging, Puberty stage, Puberty stage (observable entity)
Spanish etapa de la pubertad (entidad observable), etapa de la pubertad, etapa puberal

Ontology: Adrenarche (C0686792)

Concepts Biologically Active Substance (T123)
MSH D050499
SnomedCT 103020000
Czech adrenarche
Finnish Adrenarke
Swedish Adrenarke
English adrenarche, Adrenarche (finding), Adrenarche
Polish Adrenarche
Spanish adrenarca (hallazgo), adrenarca, Adrenarquia
Portuguese Adrenarca
German Adrenarche
Italian Adrenarca
French Adrénarche, Puberté surrénalienne

Ontology: Thelarche finding (C1291704)

Definition (GO) The beginning of development of the breasts in the female. [GOC:curators, PMID:19117864]
Concepts Finding (T033)
SnomedCT 102888000, 118186000
English pubertal breast development, pubertal breast development (physical finding), breast development puberty, thelarche, puberty breast development, Breast development at puberty, Thelarche, Thelarche (finding), Thelarche finding (finding), Thelarche finding
Spanish desarrollo mamario de la pubertad, hallazgo en la telarca (hallazgo), hallazgo en la telarca, telarca (hallazgo), telarca

Ontology: Tanner Scale (C2826146)

Concepts Intellectual Product (T170)
English Tanner Scale, Tanner Stages