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.