Puberty Vagina

Puberty Vagina

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Learn About the Stages of Puberty in Boys

When Do Girls Typically Stop Growing?

Age and Sequence of Puberty in Girls and Boys

Answers to Top 5 Questions About Girls and Starting Puberty

How to Recognize When Your Little Girl is Going Through Puberty

Learn the Stages and Signs of Puberty and How Parents Can Help

How You Can Expect Your Breasts to Change During Pregnancy

Many Young Girls Are Unprepared for Puberty - Here's How to Help

Common Concerns Your Teen Might Have About Puberty

How to Talk With Your Child With a Cognitive Disability About Puberty

What Are Those Pimple-Like Pores on Your Areola?

The Problems of Precocious Puberty in Tween Girls

Your 15-Year-Old: Development Milestones

10-Year-Old Child Development Milestones

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Barbara Poncelet, CRNP, is a certified pediatric nurse practitioner specializing in teen health.
Lindsey Waldman, MD, RD, is a board-certified pediatrician and pediatric endocrinologist.

Going through puberty can be a perplexing time—both for young people and their caregivers. There is a lot of change happening and it can be challenging to adjust. But with love and support you can get through this process together.

Understanding puberty in girls, including what to expect, is key to helping support your child. Learn about the stages of puberty as well as how to address any unique concerns that may come with it, like their first period, acne, and body image.

Every female develops at their own rate. Typically, puberty begins as early as age 8, but some females may develop earlier and some may develop later. The changes they experience—including breast development, pubic hair growth, and getting their first period—can happen quickly or can take place more gradually. 1

In addition to hair growth and breast development, you may begin to notice your tween daughter growing taller or filling out in the hips while her waist is getting thinner. Most females will have their growth spurt at a younger age than males do. The biggest height change they will experience usually occurs between when their breast buds emerge and about 6 months before their first period. 1

After the first period, growth will begin to slow down. Most females only grow about 1 to 2 inches after getting their first period. Growth beyond that is uncommon. 1

Puberty also can be fraught with emotion and uncertainty. Some young people struggle to make sense of what is happening in their body and may even wish that it wasn't happening at all. Others may be happy about the changes they are experiencing while others may be disappointed that they are developing at a slower rate than their peers.

Try to remain aware of how your daughter is feeling about puberty and look for the right time to start a conversation about it. It is important that they not only feel supported and understood, but that they can ask questions or express their feelings anytime they want.

Teens go through a multitude of changes as they become young adults. During puberty, their bodies change in a somewhat predictable way. These changes are sometimes called Tanner stages, 2 and healthcare providers use them to gauge if your teen is developing appropriately.

For females, there are Tanner stages for both pubic hair and breast development. Interestingly, these two areas do not always develop at the same time with pubic hair often being the first sign of puberty.

Typically, breast development begins between the ages of 8 and 13. By the time a female reaches 17 or 18, breasts are usually fully developed. In some cases, though, breasts can continue to grow into the early 20s. 3

The first sign of breast development is a slight swelling under the nipple. These nickel-sized bumps are often called breast buds. They are often tender or sore and may grow unevenly, with one side growing faster than the other. 1

Over time, this difference in growth should even out. But many adults find that their breasts differ in size, which is normal. As the breasts grow, they also may itch and feel painful as the skin stretches. Buying a bra —especially a " training bra " with a little padding—will help protect the breasts and minimize pain that can occur from getting bumped. 3

Throughout puberty, the breasts will become rounder and fuller and the area around the nipple, or the areola, may become darker and larger. The nipple also may begin to stick out more. 3

Breast Stage 1 : This is the stage before puberty starts. There is no breast tissue and the areola is flat against the chest.
Breast Stage 2 : There is a small amount of breast tissue under the areola.
Breast Stage 3 : Further enlargement of the breast tissue and areola. The areola is still flat against the chest.
Breast Stage 4 : Breast tissue continues to grow and is distinct from the chest wall. The areola and papilla (small bumps of tissue around the nipple) are now raised up from the chest wall.
Breast Stage 5 : The areola flattens out again to the curve of the breast. The areola gets darker, the nipple begins to protrude, and the papillae start to develop. 2

During puberty, coarser hair will begin to grow in the genital area as well as under the arms and on the legs. In about 15% of girls, pubic hair growth may be the first sign of puberty and may show up before breast budding begins. 1

Some females also will experience a small to moderate amount of clear or white vaginal discharge about 6 to 12 months before they get their first period. This discharge is normal and is in response to the growing amounts of estrogen in the body. 1

Pubic Hair Stage 1 : This is the stage before puberty starts. There are no pubic hairs at this time.
Pubic Hair Stage 2 : There is long, soft, colorless hair near the labia majora (outer labia).
Pubic Hair Stage 3 : More pubic hairs start to grow. Hairs become darker and start to curl.
Pubic Hair Stage 4 : The pubic hairs become coarser, thicker, and curlier, though they are not as abundant as in an adult. Hair fills the entire triangle overlying the pubic region.
Pubic Hair Stage 5 : Pubic hair extends beyond the groin area and spreads onto the inner thigh. 2

As a parent, it is important to be aware of and understand what your child may be going through during puberty. You can empower them as well as decrease apprehension and uncertainty by talking openly and honestly about puberty.

Take time to answer any questions. If you do not know the answer, ask your pediatrician or another healthcare provider. Giving your tween accurate information and supporting them when they are confused or concerned will help build confidence, and even help them appreciate the changes they are experiencing

While every female is different, most young people get their first period two to three years after their breast buds develop. In the U.S., the average age of the first menstrual cycle is 12 years old. Of course, sometimes it will happen earlier and sometimes later. 1

Early on, it is important to establish that having a period is normal and that it is OK to talk about it. They should not feel ashamed or embarrassed and should be encouraged to ask questions or bring up any concerns they have.

Once they begin to develop breast buds, it is important to help tweens and young teens be prepared for that first period. Consider giving them a few pads or pantiliners to put in their backpack or locker at school. You also want to be sure they know what to expect so that they are not alarmed or afraid.

For instance, some will have bright red blood on their first period and others will only experience a red-brown discharge. It is important to know that both are completely normal. 1

First periods may not be predictable; they could potentially be irregular for the first few years as physiological changes continue. Some females experience periods every 21 days and others may go as long as 35 days. Even females with regular cycles may not get a period every month. 1

During puberty, hormones are also changing. These fluctuations can cause changes in emotions as well as the development of acne. 1 If acne becomes problematic and cannot be controlled with over-the-counter cleansers and medications, you may want to talk to your child's pediatrician or make an appointment with a dermatologist. Having uncontrolled acne can contribute to feelings of anxiety and low self-esteem.

Your child also may experience sweating under the armpits and increased body odor. For this reason, most young females begin using deodorant during the start of puberty. Because their bodies are producing more oil and sweat, they may also need to shower and shampoo more frequently. 1

If your child struggles with daily hygiene or resists showering or washing their hair, gently encourage them to develop a routine that fits with their schedule and commitments. It is important for teens to care for their own bodies, but avoid shaming or making negative comments about their hygiene habits. Instead, encourage them to be proactive when it comes to self-care.

Every young person experiences puberty differently. Some kids will be excited to start looking older and others may feel self-conscious and insecure—especially if they are developing earlier or later than their peers. One small study found that females who go through puberty early experience high levels of anxiety and negative body image compared to those who begin puberty at a time consistent with their peers. 4

One area where your teen may struggle is the expected weight gain that comes with puberty. Not only is their body rapidly changing, but these physical changes correspond with a heightened exposure to cultural ideas of beauty. 5

Females may feel pressure to be thin or to have large breasts—both of which can set them up for body image issues. This pressure to be thin or have the ideal body is felt more intensely by early maturing girls, making them more vulnerable to perceiving their bodies in a negative light. Weight-based teasing also can contribute to body dissatisfaction. 5

A negative body image can lead to issues including depression, social withdrawal, and even eating disorders . Research has found that body dissatisfaction is directly linked to disordered eating, particularly among adolescent girls. 6

From the start of puberty, it's important to recognize that these issues are possible and help build your teen's self-confidence and appreciation in what their body can do rather than how it looks. Instead of focusing on weight or appearance, build your teen's self-esteem by pointing out their character strengths like kindness, generosity, or work ethic.

While it is important that your teen learn to love their body, try not to focus on their development, weight, or appearance. Instead, keep the focus on taking care of themselves mentally and physically.

As your child goes through puberty, it is important to recognize that there will be times when they feel uncertain or confused about the changes they are experiencing. Be supportive, understanding, and compassionate and take time to listen. Doing so allows you to clear up misconceptions about puberty, build self-confidence, and ease concerns.

If you have questions or concerns about how your teen is experiencing puberty, talk to their healthcare provider. They can determine if your teen is growing and developing as expected and answer any questions you have. Likewise, if your teen is struggling with body image issues or appears depressed or anxious about the changes they are experiencing, you may want to reach out to a mental health professional.

U.S National Library of Medicine. Tanner stages .
Texas Children's Hospital. Breast development .
Mercader-Yus E, Neipp-López MC, Gómez-Méndez P, et al. Anxiety, self-esteem and body image in girls with precocious puberty . Rev Colomb Psiquiatr (Engl Ed) . 2018;47(4):229-236. doi:10.1016/j.rcp.2017.05.013
Reel J, Voelker D, Greenleaf C. Weight status and body image perceptions in adolescents: Current perspectives . AHMT . 2015:149. doi:10.2147/AHMT.S68344
Hausenblas HA, Campbell A, Menzel JE, Doughty J, Levine M, Thompson JK. Media effects of experimental presentation of the ideal physique on eating disorder symptoms: A meta-analysis of laboratory studies . Clin Psychol Rev . 2013;33(1):168-81. doi:10.1016/j.cpr.2012.10.011
Miller BS, Sarafoglou K, Addo OY. Development of Tanner stage–age adjusted CDC height curves for research and clinical applications . J Endocrine Soc . 2020;4(9):bvaa098. doi:10.1210/jendso/bvaa098

By Barbara Poncelet

Barbara Poncelet, CRNP, is a certified pediatric nurse practitioner specializing in teen health.

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Medically Reviewed by Renee A. Alli, MD on February 11, 2021
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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:
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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?"
4Parents, U.S. Department of Health & Human Services: "Physical Changes During Puberty For Girls," "Physical Changes During Puberty For Boys."
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