What are the 5 stages of puberty?

Puberty is the time in a child’s life where they become sexually mature and are able to reproduce. Puberty causes physical changes and affects boys and girls differently. The staff at Banner Health is here to help you through every stage of your child’s puberty journey.

What Are the First Signs of Puberty?

The first signs that indicate your child is going through puberty are usually smaller physical changes. They are different for boys and girls.

Girls

Puberty in girls typically starts earlier than it does for boys. Girls usually start puberty between ages 8 and 13. Changes your daughter may notice that signify they are going through puberty include:

• Breast development (usually the first sign)
• Pubic and armpit hair growth
• Menstruation (usually the last sign)

Boys

Puberty in boys usually starts a little later than girls – typically around age 11. Some changes your son may notice when they are going through puberty are:

• Testicle and penis growth
• Pubic area and armpit hair growth
• Muscle growth
• Deepening of the voice
• Facial hair development

What Are the Stages of Puberty?

There are five stages of puberty. These include:

Tanner Stage 1

This first stage describes a child’s appearance before any physical changes start to develop. During the end of stage 1, the brain is starting to send signals to the body to prepare for changes.

For girls, this phase starts around age 8. For boys, this phase happens around 9 or 10.

Tanner Stage 2

Stage 2 is the stage in which physical changes start to appear.

Girls

Stage 2 for girls starts between ages 9 and 11. During this stage, the first signs of breasts, called “buds,” start to appear. Buds can be different sizes, might grow at different rates and may also be itchy or tender. The areola will also begin to expand during this time.

In addition to breast development, girls will notice small amounts of pubic hair start growing. The uterus also begins to get larger during stage 2.

Boys

The second stage usually starts around age 11 for boys. Boys will notice the testicles and scrotum starting to get bigger as well as early stages of pubic hair forming around the base of the penis.

Tanner Stage 3

Stage three is where the physical changes appear more obvious.

Girls

The rest of a girl’s physical changes typically start after they turn 12. Physical changes for girls include:

• Signs of acne on the face or back
• Thicker and curlier pubic hair
• “Buds” continue to grow and develop into breasts
• Hips and thighs start to build fat
• Highest growth increases

Boys

For boys, the physical changes in stage 3 start around age 13. These changes include:

• Voice changes
• Muscle development
• The penis gets longer and testicles continue to grow
• Wet dreams begin
• Height growth increases
• In some instances, breast tissue may start to form under the nipples, but goes away within a couple of years

Tanner Stage 4

In stage 4, puberty is in full swing. This is when your child will start noticing many changes.

Girls

Stage 4 in girls usually begins around age 13. Girls will see several physical changes including:

• Their first period
• Thicker pubic hair
• Fuller breasts
• Height growth slows down

Boys

Stage 4 in boys usually starts around age 14. Changes seen in boys during this time include:

• The testicles, scrotum and penis continue to grow
• Armpit hair growth
• Acne may start to develop
• Their deeper voice becomes permanent

Physical Growth Development in Children

During puberty, your child will do the majority of their physical growth. Boys and girls experience growth spurts at different rates, especially as they start going through puberty. A growth spurt refers to sudden and quick growth during a short period of time. Due to the disparity in growth, doctors will use different growth charts for boys and girls.

Girls will usually experience a growth spurt a year or two before they get their first period. After that, another growth spurt happens between ages 10 and 14. During this second spurt, girls will grow about 1 to 2 inches within a couple of years after they get their first period. Girls will reach their adult height by age 15.

Boys will grow at different rates during puberty. There are early maturers, who start puberty at ages 11 or 12, and late maturers who start puberty around age 13 or 14. Regardless of when they start puberty, boys will grow about 3 inches per year. By age 16, boys will have reached most of their adult height.

If you’re concerned your child may be experiencing growth delays during puberty, talk to your doctor.

What Are Growing Pains?

Growing pains are generally described as a throbbing or aching in the legs. This sensation is usually experienced in the front of the thighs, calves or behind the knees. Growing pains usually affect both legs and often occur in the late afternoon or early evenings. In some cases, growing pains may wake a child from sleep.

The cause of growing pains is unknown – there’s no evidence that a child’s growth is painful. Growing pains may be linked to restless legs syndrome or overuse during the day from activities such as running or jumping.

If your child is experiencing persistent pain, pain in the joints, growing pains that are still present in the morning or that interfere with your child’s normal activities, speak to your pediatrician. They can help by providing additional tests to see if there’s another underlying cause of their leg pain.

Kids’ Puberty Concerns

Your child may have some questions concerning the way their body is changing. We’ve compiled the most common concerns your child may have during puberty and share how you can help. Learn more here.

When Do I Need to Speak to a Pediatrician?

In some cases, your child may experience delays or other issues related to puberty. If you notice anything out of the ordinary, talk to your doctor. They can perform more tests to see if puberty issues are a result of other, underlying conditions. Some possible issues that can arise include:

Delayed Puberty

Delayed puberty is when body changes do not occur or progress normally between the ages of 10 and 14.

Contrasexual Pubertal Development

Contrasexual pubertal development happens when a child’s hormone levels increase dramatically and cause physical and hormonal changes. In girls, this may cause a deeper voice or facial hair. Boys will mainly develop breasts if they experience contrasexual pubertal development.

Precocious Puberty

Precocious puberty is when a child’s body begins to mature at an abnormally early age – typically before age 8 in girls and 9 in boys. You will see the first signs of puberty start to develop during precocious puberty. In addition to early signs of puberty, your child may also experience acne and have a growth spurt.

Premature Thelarche

Premature thelarche happens when girls develop breast tissue before the typical age range (10 to 14 years old) for breast development. In most cases, girls are diagnosed with premature thelarche before the age of 3.

Premature Adrenarche

Premature adrenarche is the appearance of pubic hair before it normally occurs. Other symptoms of premature adrenarche include oily skin, unexplained, rapid growth and body odor.

No matter where your child is in their development, Banner Health is here to support you and your child as they grow into adulthood.

Medically Reviewed by Renee A. Alli, MD on February 11, 2021

Puberty's changes start when the brain triggers the production of sex hormones. Although physical changes follow a predictable pattern, every child develops at their own pace. Puberty usually begins for girls before boys. For most girls, puberty begins around age 11. For boys, puberty starts from 10 to 14. The average age is 12.

Breast growth is usually the first sign of puberty girls will notice. First, small lumps form behind the nipples. They can be sore, but the pain goes away as breasts grow and change shape over the next few years. As they grow, it’s not unusual for one breast to develop more slowly than the other, but they will even out in time. Boys also may have some swelling on their chest but it tends to go away within a year or two.

The first sign of puberty in boys is subtle -- an increase in testicle size. About a year later, the penis and scrotum start to grow. Semen can be released during an erection when they are awake or when they are asleep.

After breasts and testicles start growing, body hair will start to grow in and become thicker. For both boys and girls, new hair will start growing in the armpits and pubic area around the genitals. Arm and leg hair gets thicker. Boys also may start developing chest and facial hair.

Mild acne may be normal in early puberty. Puberty's high hormone levels can trigger acne outbreaks. During puberty, the oil glands are more active and your child will probably sweat more. Keeping the face and body clean can help, but if acne is a concern, talk to a doctor. Medications may help.

About a year after puberty begins, girls have a growth spurt. A girl will get taller and start to get wider hips and fuller breasts. Some curve-related fat will appear on their stomach, buttocks, and legs. Girls usually reach adult height by their mid- to late teens.

The peak growth spurt for boys happens later than it does for girls. It occurs around six months after pubic hair development. When it does, your son's shoulders will become fuller and broader, and they'll grow taller, too. Their face shape will look less round and more adult-like. Depending on when puberty starts, they may not reach their adult height until their late teens or even early 20s.

A girl usually gets their first period between 10 and 16 years old (about 2 to 2 1/2 years after they start puberty.) Menstruation is a sign that they're physically an adult and able to get pregnant. You may want to talk to your doctor if your daughter doesn’t get their first period by the time they're 16.

Toward the end of puberty, your son's voice may start cracking. This is normal, and will stop after a few months. When it does, their voice will sound deeper. Voice changes are caused by testosterone, a hormone released in boys during puberty. It causes the vocal cords to get thicker and longer and their larynx to grow bigger. This is their "Adam’s apple."

Some kids become sexually mature at a very early age. Early or precocious puberty is when a child reaches a physical or hormonal milestone -- breast, testes, or pubic hair growth -- before age 6 to 8 in girls or 9 in boys. Early puberty is linked with obesity in girls. Early puberty rarely is due to hormone exposure or a problem with the thyroid, ovaries, or brain. Talk to your doctor if you're concerned.

Keep track of your child's bodily changes in a way that respects their desire for privacy. Call the doctor if:

• Puberty signs appear in a girl before age 6-8 or in a boy before age 9
• Puberty changes aren't seen in a girl by age 13 or in a boy by age 14
• Puberty changes do not follow the typical pattern of development

IMAGES PROVIDED BY:

1)    Image Source 2)    Vanessa Davies/Dorling Kindersley 3)    Steve Pomberg/WebMD 4)    Paul Burns/Lifesize 5)    PHANIE/Photo Researchers Inc 6)    Anna Webb/WebMD 7)    Comstock 8)    Getty Images 9)    Digital Vision 10)  Peter Dazeley/Photographer's Choice

11)  Kevin Horan/Stone

SOURCES:

American Academy of Pediatrics: "Puberty: Information for Boys."

Family Doctor, American Academy of Family Physicians: "Puberty: What to Expect When Your Child Goes Through Puberty."

Healthy Children, American Academy of Pediatrics: "Physical Development of School Age Children, "Stages of Puberty," "When Puberty Starts Early," "What's Happening to My Body?"

KidsHealth: "Everything You Wanted to Know About Puberty," "Your Child’s Changing Voice," "Causes of Precocious Puberty," "All About Menstruation," "Breasts and Bras," "When Does Height Happen?"

Medscape: "Precocious Puberty."

4Parents, U.S. Department of Health & Human Services: "Physical Changes During Puberty For Girls," "Physical Changes During Puberty For Boys."