
Puberty is the time in a child’s life when sexual maturation occurs. There are several stages of puberty. A child goes through many physical and internal changes during the various stages of puberty, beginning around the age of 8 years in girls and 10 years in boys, till the age of 18 years when they attain complete maturation. These stages of puberty are called the Tanner stages (or sexual maturity ratings), named after the child development expert Professor James M. Tanner, who was the first to identify, study, and classify the physical changes occurring during puberty into five stages. Although each child may have a different growth and puberty timetable, which is normal, Tanner stages serve as a guide in most cases.
Puberty can be challenging for kids and parents. In addition to physical changes, children also experience emotional changes due to hormones. The child’s mood and behavior may change. The child may also face insecurities and lack of confidence due to the changes in their body. Children need to receive adequate support at home and at school.
The five Tanner stages of puberty
The Tanner scale (also known as the Tanner stages or Sexual Maturity Rating (SMR)) is a scale of physical development in children, adolescents, and adults. The scale defines physical measurements of development based on external primary and secondary sex characteristics, such as the size of the breasts, genitals, testicular volume, and development of pubic hair.
Tanner stage 1: In Tanner stage 1, there aren’t any obvious physical changes, but it describes the child’s appearance before any physical signs of puberty appear. These initial signs, although not visible, usually begin around the age of 8 years in girls and around 10 years in boys. The brain starts sending signals to the body, getting the body ready for physical changes. The hypothalamus is a gland that releases gonadotropin-releasing hormone (GnRH). GnRH stimulates the pituitary gland, a small gland under the brain that secretes hormones that regulate other glands in the body and body functions, such as growth hormone (GH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH).
Tanner stage 2: In Tanner stage 2, the early physical changes of puberty begin to appear.
Girls: The physical changes of puberty begin between the ages of 9 and 11 years. The signs include:
- Breast “buds” form under the nipple.
- Itching and tenderness are felt over and around the nipples.
- Breast buds may be of different sizes and grow at different rates.
- The areola (the darker area around the nipple) becomes larger.
- Small amounts of pubic hair start appearing.
- The size of the uterus increases.
Some girls may have their first period during this stage. Girls with higher body mass index may experience an earlier onset of puberty.
Boys: Puberty usually starts around the age of 11 years in boys.
- The testicles begin to enlarge.
- Small amount of pubic hair forms at the base of the penis.
Tanner stage 3: Physical changes are becoming more obvious and visible.
Girls: Physical changes in girls begin after the age of 12 years. These changes include:
- Breast “buds” continue to grow.
- Pubic hair becomes thicker and curly.
- Hair starts forming under the armpits.
- Acne may appear on the face, upper chest, and back.
- The growth rate is the highest during this stage (around 3.2 inches per year).
- Fat builds up in the hips and thighs.
- Body odor may develop at this stage or earlier.
Boys: Physical changes in boys usually start around the age of 13 years. These changes include:
- The penis and testicles continue to grow bigger.
- Some breast tissue may develop under the nipples, which usually disappears after a few years.
- Boys may have wet dreams (ejaculation at night).
- Voice begins to change; it may “crack”.
- Muscles get larger.
- Height increases at the rate of 2-3.2 inches per year.
- Body odor may develop at this stage or earlier.
Tanner stage 4: In stage 4, puberty is in full swing. Both boys and girls notice many visible and internal changes.
Girls: Puberty begins after the age of 13 years. Changes include:
- Breasts appear larger and fuller in shape.
- Pubic hair becomes thicker.
- Many girls get their first period between the ages of 12 and 14 years, but it can start earlier, especially if the body mass index is high.
- Height growth begins to slow down to about 2-3 inches per year.
Boys: Usually, puberty begins around the age of 14 years. Changes include:
- The testicles, penis, and scrotum continue to grow and become bigger.
- Scrotum darkens in color.
- Armpit hair starts to grow.
- A deep voice becomes permanent.
- Acne may appear on the face, back, or upper chest.
Tanner stage 5: This final phase marks the end of physical maturation.
Girls: Usually, puberty occurs around the age of 15 years. Changes include:
- Breasts reach approximate adult size and shape, although breasts may change till the age of 18 years.
- Periods become regular after six months to two years of onset.
- Girls reach adult height; a minor increase may occur until 18 years.
- Pubic hair fills out, reaching the inner thighs.
- Reproductive organs and genitals are fully developed.
- Hips, thighs, and buttocks fill out in shape.
Boys: Usually, puberty starts around the age of 15 years, and most boys reach full growth by the age of 18 years. Changes include:
- Penis, testicles, and scrotum reach adult size.
- Pubic hair fills out, reaching the inner thighs.
- Facial hair starts growing, and some may need to shave.
- Growth in height slows down but continues.
- Muscles continue to grow.

SLIDESHOW
The 14 Most Common Causes of Fatigue See SlideshowHealth Solutions From Our Sponsors
https://pubmed.ncbi.nlm.nih.gov/29262142/
https://www.racgp.org.au/afp/2017/december/growth-disorders-in-adolescents/
Top Stages of Puberty: In Boys and Girls Related Articles
Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
Does Your Body Shape Change During Puberty?
Puberty is the phase when children become sexually mature. Many changes occur in the shape and appearance of the body during puberty.How to talk to your kids about sex: Age to Age Ranges Guide
Conversations about sex shouldn’t be limited to one big “talk.” Instead, parents can discuss it with their kids throughout their childhood. Breaking down how to talk about sex by children’s age range can make the topic more approachable.Puberty
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development, and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.Puberty in Girls Quiz
Take the Puberty In Girls Quiz to learn the myths and facts about normal adolescent growth and development for teens and tweens.Teen Girls Skin Care
Want to know how to get rid of blackheads? Discover tips on clogged pores, sunscreen SPF and how to remove makeup for different skin types like dry skin and oily skin in these health tips for teens.