Puberty: Is Your Daughter On Track, Ahead or Behind?

Age and timeline vary, but changes do not

Puberty can be a confusing and stressful time for adolescent girls. What can you expect your daughter to go through?

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While the timing of puberty differs for each girl, physical changes always take place in the same order, says pediatrician Veronica Issac, MD.

“Doctors will use a tool called Tanner staging to track your daughter’s progress,” she says.

The 5 stages of puberty

Girls generally begin and end puberty about two years earlier than boys, starting around age 11 and ending around age 16.

However, African-American and Hispanic girls tend to start puberty earlier than Caucasian girls, notes Dr. Issac.

The Tanner Stages break down the changes of puberty in girls as well as boys:

Stage 1. In this prepubescent stage, no changes have occurred.

Stage 2. Between ages 8 and 13, girls typically experience the following:

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  • The breasts begin to bud, and the areola (pigmented area around the nipple) enlarges.
  • Light genital hair appears.
  • Height increases by about 2¾ inches per year.

Stage 3. As girls move through this stage, typically between ages 9½ and 14:

  • The breasts continue budding.
  • Pubic and underarm hair begins to grow. Genital hair darkens, coarsens and covers more of the genitals.
  • A growth spurt of more than 3 inches per year occurs.
  • The skin becomes oilier, and acne develops.

Stage 4. As girls go through this stage, usually between ages 10½ and 15:

  • The breasts continue to grow, and the nipples start to protrude.
  • Body hair reaches adult levels.
  • Growth may continue at the rate of about 2 ¾ inches per year.
  • Problems with acne may continue.
  • Periods typically start around age 13 (usually around the same age their mothers’ periods began). Some girls, especially those lacking body fat, start later.

Stage 5. Development typically ends.

In this stage, girls reach physical adulthood. Most attain their peak height by age 16.

Tears, trials and tribulations

“All children go through emotional changes during puberty,” says Dr. Issac. “Some are affected more than others as estrogen and progesterone cycle through their bodies.”

The combination of social and school pressures and moodiness can cause emotional outbursts and conflict with parents. You may think your sweet girl has turned into a mean girl.

But share your concerns with the doctor. Sometimes, prescribing hormonal therapy, such as birth control medication, can ease symptoms and improve mood.

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Delayed puberty

If your daughter starts puberty very late or doesn’t seem to be progressing through puberty, it’s also worth asking the doctor about. “She may just be a late bloomer, especially if Mom was,” says Dr. Issac.

However, hormonal or glandular problems are other possibilities. If your doctor suspects an underlying problem, he or she may refer your daughter to a specialist for testing.

Precocious (early) puberty

A few red flags signal unusual development in girls. These include:

  • Showing signs of puberty before their 8th birthday
  • Body changes that progress very quickly
  • Body changes that occur “out of order,” such as starting periods before developing breasts

If these occur, mention it to the doctor. Dr. Issac says simple testing can help determine the cause of precocious puberty:

  • The pituitary gland may have “turned on” the hormones too early.
  • A tumor may be developing on the adrenal gland or elsewhere.
  • Your daughter may have been exposed to estrogen (through estrogen cream, for instance).

Your doctor may simply wait and monitor your daughter’s progress, or refer her to another doctor for tests. If needed, an endocrinologist can prescribe medication to halt puberty until the appropriate time.

Think your child isn’t experiencing puberty in a typical way? Talk to the doctor for reassurance that your child is on track — or to find out if something else is going on.

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