Sexual Development

Aka: Sexual Development, Puberty, Pubertal Milestone, Puberty Stage, Tanner Staging, Tanner Scale, Pubarche, Thelarche, Adrenarche, Gonadarche

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

  1. Male Tanner Stage
  2. Female Tanner Stage

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

V. References

  1. Klein (2017) Am Fam Physician 96(9): 590-99 [PubMed]

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Related Studies

Ontology: Endocrine disorder related to puberty (C0271522)

Concepts Disease or Syndrome (T047)
SnomedCT 4900002
English Endocrine disorder related to puberty (disorder), Endocrine disorder related to puberty, Endocrine disorder related to puberty, NOS
Spanish enfermedad endocrina relacionada con la pubertad (trastorno), enfermedad endocrina relacionada con la pubertad
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Adrenarche (C0686792)

Definition (MSH) A stage of development at which the ADRENAL GLANDS undergo maturation leading to the capability of producing increasing amounts of adrenal androgens, DEHYDROEPIANDROSTERONE and ANDROSTENEDIONE. Adrenarche usually begins at about 7 or 8 years of age before the signs of PUBERTY and continues throughout puberty.
Concepts Biologically Active Substance (T123)
MSH D050499
SnomedCT 103020000
Czech adrenarche
Finnish Adrenarke
Russian ADRENARKHE, АДРЕНАРХЕ
Swedish Adrenarke
English adrenarche, Adrenarche (finding), Adrenarche
Polish Adrenarche
Spanish adrenarca (hallazgo), adrenarca, Adrenarquia
Portuguese Adrenarca
German Adrenarche
Italian Adrenarca
French Adrénarche, Puberté surrénalienne
Derived from the NIH UMLS (Unified Medical Language System)

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
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Tanner Scale (C2826146)

Definition (NCI) A scale of physical development in children, adolescents and adults based on external primary and secondary sex characteristics, such as the size of the breasts, genitalia, and development of pubic hair.(Tanner JM. Growth at adolescence. 2d ed. Oxford: Blackwell, 1962)
Concepts Intellectual Product (T170)
English Tanner Scale, Tanner Stages
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Examination

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