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Your Child's Health, Our Priority, Always

Understanding Normal vs Early or “Precocious” Puberty

Puberty is the stage of development in children and adolescents where rapid growth, increased muscle mass, and the first signs of secondary sexual development occur.

Secondary sexual development refers to the development of breast buds in females, enlargement of testes and the penis in males, as well as increase hair including around the genitals (also referred to as pubic hair).

Your pediatrician will monitor for signs of pubertal development at routine annual well child and adolescent visits.



Breast buds develop – This is the first sign and typically starts around age 10 (ranging from age 8-13)

Hair growth – Course hair growth under the arms, on the legs, and pubic area usually starts shortly after breast buds, although sometimes can be the 1st sign of puberty in girls and still be considering part of normal development.  Body odor and sometimes acne develop during this stage as well.

Peak growth and increase in muscle mass typically occur 1 year after the onset of puberty but before menstruation occurs in girls.

Menstruation usually occurs 1.5-3 years after the onset or first signs of puberty, with the average being age 12.


Boys: Puberty starts about 1 year later in boys when compared to girls

Enlargement of testes – This occurs on average around age 11 (range 9-14 years) and is the first sign.

Hair growth – Coarse darker pubic hair typically develops next with spread to the underarms, legs, arms, and face about 2 years later.  Body odor and possibly acne may also develop during this stage.

Penis growth – A male may experience growth to adult sized genitalia anywhere between age 13-18.

Peak growth­ – Most males experience their largest growth spurt closer to the end of puberty.


Precocious Puberty – When signs of puberty occur early – before age 8 in girls or age 9 in boys.

The cause of early puberty can be as simple as a normal speeding of the developmental process but can also be caused by abnormal or excessive hormone levels being produced from one of several glands within the body.

Diagnosis of precocious or abnormal puberty, and the cause, is done by evaluation of growth and physical development and sometimes also x-rays or blood work.

See your pediatrician if signs of puberty occur before age 8 in girls, before age 9 in boys, or if no signs of puberty have started by age 13 in girls and age 14 in boys.