Puberty and Tanner Stages

Pubertal Development
Puberty is divided into five stages, called Tanner Stages (numbered 1-5). Each stage represents the extent of breast and pubic hair growth. Female puberty begins at about age 11, but can range from about ages 9 to 13. It can be difficult to explain the differences between the different stages because there are not quantifiable differences-the process is a very qualitative one. Rough estimates based upon the size and shape of the breasts along with the amount and type of hair present in the pubic area are the indexes used to track pubertal changes.

Tanner Stages
Usually, breast budding is the first sign of puberty, followed by pubic hair growth and a growth spurt. Tanner Stage 1 is pre-pubertal. Tanner Stage 2 is characterized by small breast buds and "peach-fuzz" in the pubic area, and its average age is 11-12. During Stage 3, breast buds become larger and pubic hair growth continues, but it is mostly in the center and does not extend out to the thighs or upward. At about age 13 or 14, Stage 4 will occur, which includes noticeable growth of pubic hair, now in the triangular shape of adulthood. Underarm hair growth is noticeable, and breasts will now begin to take on a "mound" form. The first menstrual period usually occurs sometime during the fourth or fifth stage, usually at around 12 or 13 years. A girl has reached Tanner Stage 5 when her breasts are fully formed and her pubic hair is adult in quantity and type, forming the classical upside-down triangle shape common to women.

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