Early or Delayed Puberty

Overview

Puberty usually starts between 8 and 13 in girls and 9 and 14 in boys. Starting much earlier or later can have physical and emotional effects and should be checked.

Signs

• Breast development or periods before age 8 in girls
• Testicle growth, pubic hair or voice changes before age 9 in boys
• No breast development by 13 in girls
• No testicle growth by 14 in boys

Causes and risk factors

Early puberty is often without a clear cause but may be due to brain, adrenal or ovarian conditions. Late puberty is often a family pattern but can be due to hormone or chronic health problems.

Diagnosis

Diagnosis includes a growth assessment, hormone blood tests, a bone age X-ray and sometimes brain imaging.

Treatment

Treatment depends on the cause. Medicines can pause early puberty or start late puberty when needed.

When to see a doctor

See a doctor if puberty signs start very early or have not started by the ages above.