What is considered puberty?

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From the Guidelines

Puberty is defined as breast development in girls and the presence of axillary hair in boys, marking the transition from child to adult basic life support guidelines. This definition is based on the 2018 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1. The physical and hormonal changes that occur during puberty transform a child's body into an adult body capable of reproduction.

  • Key characteristics of puberty in girls include breast development and pubic and underarm hair growth.
  • In boys, puberty is marked by the presence of axillary hair, genital enlargement, and other secondary sexual characteristics. The timing of puberty varies widely among individuals due to genetic, nutritional, and environmental factors, with early or delayed puberty sometimes requiring medical evaluation, as noted in the context of basic life support guidelines 1.

From the Research

Definition of Puberty

  • Puberty is a dynamic period of physical growth, sexual maturation, and psychosocial achievement that generally begins between age 8 and 14 years 2.
  • It is a defining phase of human development where growth ends and the ability to reproduce begins 3.

Characteristics of Puberty

  • The age of onset varies as a function of sex, ethnicity, health status, genetics, nutrition, and activity level 2.
  • Puberty is initiated by hormonal changes triggered by the hypothalamus 2.
  • It involves a process of skeletal and gonadal activity that has been ongoing since conception 3.

Assessment of Pubertal Development

  • Assessing pubertal stage can be challenging, particularly in large-scale settings, due to the sensitive nature of Tanner staging by healthcare providers (HCP) or self-reported Tanner stage through photographs or line drawings 4.
  • Self-assessment of puberty is most accurate when identifying Tanner stage 1, Tanner stage 5 and when development is categorized into prepuberty, in, and completing puberty phases 5.
  • The self-reported Pubertal Development Scale (PDS) avoids sensitive issues like genitalia or nudity, is adaptable to various settings, reduces time and cost burdens on researchers, and may be a reliable and cost-effective method for large-scale epidemiological studies 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Puberty-timing is everything!

Journal of pediatric nursing, 2005

Research

Puberty: Normal physiology (brief overview).

Best practice & research. Clinical endocrinology & metabolism, 2019

Research

Can we rely on adolescents to self-assess puberty stage? A systematic review and meta-analysis.

The Journal of clinical endocrinology and metabolism, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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