Puberty—Timing Is Everything!

Puberty is a dynamic period of physical growth, sexual maturation, and psychosocial achievement that generally begins between age 8 and 14 years. The age of onset varies as a function of sex, ethnicity, health status, genetics, nutrition, and activity level. Puberty is initiated by hormonal changes triggered by the hypothalamus. Children with variants of normal pubertal development—both early and late puberty—are common in pediatric practice. Recognizing when variations are normal and when referral for further evaluation is indicated is an important skill.