Puberty usually takes place between the ages of 8 and 14 in females and may
last for 2-3 years. At puberty, hormones are produced in the body that
cause the ovaries to increase hormone production of female sex hormones (estrogen). This
causes a woman’s body to mature and allows for reproduction to become
During puberty there are many physical changes that occur. These include:
- Breast budding. This is usually the first sign and occurs around
age 11. The breasts may grow at uneven rates and this is considered
normal and the difference in size is usually undetectable by the time full
maturity is reached.
- Growth of pubic hair. In some females this may be the first sign
- Growth of hair under the arms usually starts about 1 year after pubic hair
- Growth spurt. There is usually a significant growth spurt and increase
in weight during adolescence. Some girls obtain their adult stature
by age 13 and others not until age 18.
- Widening of the hips and enlargement of uterus.
- Sweat glands develop under the arms and in the groin.
- Menstruation occurs on average by age 12 ½. Girls who are
overweight may menstruate earlier while menstruation may delayed in girls
who are malnourished or involved in strenuous exercise or sports. The
first few menstrual periods are sporadic and may be irregular for the first
Early puberty (occurring before age 8) should be evaluated by a doctor.
Delayed puberty may be considered if a girl has no signs of sexual development
by age 13. Extensive work up however is not recommended until after
Tampons or sanitary pads are acceptable for use during menstruyal periods. A
girls’ first pelvic examination should occur by age 18 or when a child
becomes sexually active to ensure normal reproductive anatomy, function, STD
counseling, contraception counseling and for Pap smear testing.
If an eating disorder is suspected immediate professional care should be sought.
Please call out office if you have concerns about your daughter’s sexual
or physical development, any unusual vaginal bleeding, discharge or excessive
painful menstruation or if your daughter develops psychological or behavioral