Puberty is when a child's body begins to develop and change as they become an adult.
Signs of pubertyinclude girls developing breasts andstarting periods, and boys developing a larger penis and testicl*s, a deeper voice and a more muscular appearance.
The average age for girls to start puberty is 11, while for boys the average age is 12.
But it's perfectly normal for puberty to begin at any point between the ages of 8 and 13 in girls and 9 and 14 in boys.
There's not usually any need to worry ifpuberty does not startaround the average age, but it's a good idea tospeakto your GP for advice if it starts before 8 or has not started by around 14.
In some cases,early pubertyordelayed puberty could be a sign of an underlying condition that may need to be treated.
Earlypuberty
Early puberty,also called precocious puberty,is when:
- girls havesigns of puberty before8 years of age
- boys have signs of puberty before9 years of age
Some girls and boys may develop certain signs of puberty at a young age, but not others.
For example, girls may start periods before the age of 8 but have no breast development.
See your GP if this happens to your child.
Causes of early puberty
It'snot always clear what causes early puberty. It may just be a tendency that runs in your family.
Occasionally it can be caused by:
- a problem in the brain, such as abrain tumour
- damageto the brainasa result ofan infection, surgery or radiotherapy
- a problemwith the ovaries or thyroid gland
- agenetic disorder, such asMcCune-Albright syndrome – read more about McCune-Albright syndrome on the MedlinePlus website
Early puberty mostlyaffects girls and often has no obvious cause. It's less common in boys andmay bemore likely to be associated with an underlying problem.
Tests and treatmentsfor early puberty
Your GPmay refer you to a specialist if they think there could bean underlying cause that needs to be investigated.
Tests that may be carried out include:
- ablood testto check hormone levels
- a handX-ray to help determine likely adult height
- an ultrasound scan orMRI scanto check for problems such as tumours
Early puberty can be treated by:
- treatingany underlying cause
- usingmedication toreduce hormone levels and pause sexual development for a few years
Treatment with medication is usually only recommended if it's thought early puberty will cause emotional or physical problems, such as short height in adulthood or early periods in girls, which may cause significant distress.
Delayedpuberty
Delayed puberty is when:
- boys have no signs oftesticular development by 14 years of age
- girls have not started to develop breasts by 13 years of age, or they have developed breasts but their periods have not startedby 15
Causes of delayed puberty
It's not always clear what causes delayed puberty. It may just be a tendency that runs in your family. Delayed puberty is generally more common in boys.
Occasionally it can be caused by:
- a long-term illness, such as cystic fibrosis,diabetes orkidney disease
- malnutrition, possibly from aneating disorder ora conditionsuch ascystic fibrosis orcoeliac disease
- a problem with the ovaries, testes, thyroid glandor pituitary gland
- differences in sex development, such asandrogen insensitivity syndrome
- a genetic condition, such asKlinefelter syndrome and Kallmann syndrome – read more about Kallmann syndrome on the MedlinePlus website
Tests and treatments for delayed puberty
Your GPmay refer you to a specialist if they think there could be an underlying cause of delayed puberty that needs to be investigated.
Tests that may be carried out include a blood test to check hormone levels, a hand X-ray to help determine likely adult height, and an ultrasound or MRI scan to check for problems with glands or organs.
Delayedpuberty can be treated by:
- treatingany underlying cause
- usingmedication for a few months to increase hormone levels and trigger the start of puberty
Treatment with medication is usually only recommended if the lack of development is causing problems, such as significant distress.
Page last reviewed: 06 September 2022
Next review due: 06 September 2025