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Sexual Development
Aka: Sexual Development, Puberty, Pubertal Milestone, Puberty Stage, Tanner Staging, Tanner Scale, Pubarche, Thelarche, Adrenarche, Gonadarche
- See Also
- Male Tanner Stage
- Female Tanner Stage
- Precocious Puberty
- Delayed Puberty
- 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
- Ovaries grow in size
- FSH stimulates Estrogen and follicle formation
- LH stimulates corpus luteum after Ovulation
- Thelarche
- Onset of secondary Breast development (marks the observable start of Puberty in girls)
- Breast buds palpable and areolae enlarge
- Peaks at ages 10.2 to 11.3 years, and precedes Menarche by 24 months
- Coincides with Tanner Stage 2
- 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
- Exam: Normal Development
- Male Tanner Stage
- Female Tanner Stage
- 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
- No signs of Breast development by age 13 years, or Menarche by age 15 years in girls
- No signs of testicular enlargement by age 14 years in boys
- References
- Klein (2017) Am Fam Physician 96(9): 590-99 [PubMed]