What Are the Five Stages of Puberty?

Reviewed on 6/24/2021

Puberty is the time of growth in which adolescents mature from a child into an adult. This includes cognitive, psychosocial, and biological maturation. The “Tanner stages
Puberty is the time of growth in which adolescents mature from a child into an adult. This includes cognitive, psychosocial, and biological maturation. The “Tanner stages" classify puberty into five stages, which break down the various physical and reproductive changes that occur in both boys and girls.

The transition from childhood to adulthood is called puberty, a time when adolescents experience cognitive, psychosocial, and biological maturation. 

Visible changes that occur during puberty that are most noticeable include growth in stature and development of secondary sexual characteristics. 

Puberty is often classified into five stages, as published by Marshall and Tanner, referred to as “Tanner stages.”

  • Tanner stage 1
    • Describes a child’s appearance before physical signs appear
    • Signs of stage 1 that occur are not visible
    • This stage usually begins at about 8 years old in girls and 10 years old in boys
    • The hypothalamus gland releases gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland that secretes hormones such as growth hormone (GH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) 
  • Tanner stage 2
    • Boys: 
      • Enlargement of scrotum and testes
      • Skin of the scrotum reddens and changes in texture
      • Height: growth of 5-6 cm per year
    • Girls:
      • Breast bud stage with elevation of breast and nipple
      • Enlargement of areola (the dark area surrounding the nipple)
      • Height: 7-8 cm per year
      • Both boys and girls:
      • Sparse growth of long, slightly pigmented pubic hair, straight or curled, at base of the penis or along the labia
  • Tanner stage 3
    • Boys: 
      • Enlargement of penis (length at first)
      • Further growth of testes
      • Height: growth 7-8 cm per year
    • Girls:
      • Further enlargement of breast and areola with no separation of their contour
      • Height: growth 8 cm per year
      • Both boys and girls:
      • Darker, coarser, and more curled pubic hair that begins to extend away from the midline of the body
  • Tanner stage 4
    • Boys: 
      • Increased size of penis with growth in width and development of the glans (the tip of the penis)
      • Testes and scrotum get larger and the scrotum skin becomes darker
      • Height: growth 10 cm per year
    • Girls:
      • The areola and nipple form a secondary mound above the level of the breast
      • Height: growth 7 cm per year
    • Both boys and girls:
      • Pubic hair is adult in type, but covering a smaller area than in adults
      • There is no spread of pubic hair to the inner surface of the thighs
  • Tanner stage 5
    • Boys: 
      • Adult genitalia
      • No further height increase after age 17
    • Girls:
      • Projection of nipple only, related to the recession of the areola
      • No further height increase after age 16
    • Both boys and girls:
      • Public hair is adult in type and quantity, with horizontal distribution 

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Reviewed on 6/24/2021
References
https://childgrowthfoundation.org/wp-content/uploads/2018/05/Puberty-and-the-Tanner-Stages.pdf