Early or Late Puberty – When Should Your Child Be Examined?

Puberty marks the final stage of growth and is a completely natural part of the development from child to adult. The timing of when it starts, however, varies a lot from child to child. Some children enter puberty early, while others are among the last in their class.

Most of the time, this variation is entirely normal. But sometimes an unusually early or late pubertal development can be a reason to examine the child more closely, in order to uncover an underlying condition that needs treatment.

When is puberty too early?

In girls, the most common first sign of puberty is that the breasts begin to develop. In boys, it is usually that the testicles begin to grow.

We speak of early puberty if it starts:

• before age 8 in girls
• before age 9 in boys

Other signs can include rapid growth in height, development of pubic hair and underarm hair, body odor, acne, or menstruation in girls.

Some children develop one or a few such signs without this actually meaning that puberty has started. It is therefore the overall picture of the child's development that matters.

If early puberty is suspected, the pediatrician will assess, among other things, the child's growth, pubertal development, and how quickly the changes have occurred. If needed, blood tests, assessment of bone age via X-ray, and further investigation at a hospital may be relevant.

What if puberty is late in coming?

There is also a great deal of normal variation at the other end of the spectrum. Some adolescents enter puberty later than their friends, and late puberty often runs in families.

There may still be reason for an assessment if a girl has not begun developing breasts by age 13, or has not had her first period by age 15, or if a boy has shown no signs of testicular growth by age 14.

Absent or very slow pubertal development can sometimes be due to an underlying illness, hormonal factors, or other, sometimes serious, causes that require proper diagnosis and treatment.

What does the pediatrician do?

In a puberty assessment, we look at more than just age. We assess, among other things:

• the child's height and growth over time
• signs of pubertal development
• when other family members went through puberty
• the child's general health and any other symptoms, including a thorough physical examination of the whole body

Based on this, we assess whether the development looks normal, whether the child should be monitored over time, or whether further examinations are needed, such as blood tests, ultrasound, or MRI.

Concerned about your child's pubertal development?

It can be difficult for parents to know what counts as normal variation, and when to react. At Doktor Dropin, your child can be assessed by an experienced pediatrician if either early or late puberty is suspected.

Many people first and foremost need a thorough assessment and reassurance that the development is normal. If there are signs that should be examined further, the pediatrician can initiate a relevant workup and assess the need for further follow-up.

Are you unsure whether your child's pubertal development is normal? Book an appointment with a pediatrician for an assessment.