1. Take the Quiz on Puberty
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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Puberty facts
• What is puberty?
• When does puberty occur?
• What determines when puberty begins?
• What are the physical changes of puberty in girls and boys?
• What other changes in the body occur during puberty in boys and girls?
• What are the medical concerns associated with normal puberty?
• What are medical conditions associated with early or late puberty?
• Puberty In Girls FAQs
• Patient Comments: Puberty - Physical Changes
• Find a local Pediatrician in your town
• Puberty Index

While puberty is a normal condition and not an illness, many medical conditions and illnesses may first appear during puberty. Some conditions potentially associated with puberty include the following:

• Acne: Acne is an inflammation of the sebaceous glands and hair follicles of the skin, which is most pronounced on the face but may occur on the neck, back, chest, or other areas. The hormonal changes in puberty lead to the development of acne in many adolescent boys and girls.
• Gynecomastia: Gynecomastia is the term used to describe enlargement of the male breasts. The hormonal changes of puberty can cause a transient gynecomastia in normal boys that typically lasts for six to 18 months. Pubertal gynecomastia occurs at an average age of 13 in boys and affects up to one-half of normal adolescent boys.
• Anemia: The normal pubertal progression in males is associated with increases in the ferritin (iron) and hemoglobin concentrations in the blood, but this increase is not observed in females. Adolescent girls tend to consume less iron-containing foods than boys, and this, combined with blood losses through menstrual bleeding, may place adolescent girls at risk for anemia.
• Sexually transmitted diseases (STDs): If teens become sexually active at puberty, they are at risk for HIV and other sexually transmitted infections.
• Scoliosis: Because of rapid growth during puberty, scoliosis (abnormal curvature of the spine) can be worsened or may first become apparent during puberty.
• Vision changes: Nearsightedness (myopia) has a high incidence during puberty because of growth in the axial diameter of the eye.
• Musculoskeletal injuries: Adolescents may be particularly prone to musculoskeletal injuries during the growth spurt and during growth of muscle mass. Since bone growth usually precedes full bone mineralization, adolescents are at risk for fractures. Also, since the growth in the limbs usually occurs prior to growth in the trunk, some joints may be left with a limited range of motion that increases the risk for sprains and strains.
• Dysfunctional uterine bleeding: Girls who have recently begun menstruating may have irregular, prolonged, or heavy menstrual bleeding. Anovulation (not ovulating) is the most common reason for abnormal menstrual bleeding in adolescent girls.