II. Definitions
- Pubarche
- First onset of public hair as a result of Estrogens in girls and androgens in boys
- Coincides with Tanner Stage 2, and typically with Thelarche in girls
- Gonadarche
- Marks the onset of Puberty (more evident in boys, as ovarian growth is not readily evident)
- GnRH released (activating the hypothalamic-pituitary-gonadal axis)
- Boys
- Testicles grow in size
- LH stimulates Testosterone production
- FSH stimulates sperm maturation
- Girls
- Thelarche
- Adrenarche
- Increased weak adrenal androgen secretion (DHEA, Androstenedione)
- Primarily related to adrenal maturation
- Contrast with Gonadarche which is more specific to Sexual Development
- Peaks between ages 10-14 years
- Coincides with Tanner Stage 3 and 4
- Transient growth spurt
- Axillary and pubic Hair Growth (beyond the minimal pubic hair present in Tanner Stage 2)
- Skin oiliness develops (mild acne may form)
- Body odor starts
III. Exam: Normal Development
IV. Exam: Abnormal Development
-
Precocious Puberty
- Secondary sexual characteristics before age 8 years in girls, and before age 9 years in boys
- Significant abnormalities more frequently affect boys
- Delayed Puberty