Isn’t It Too Early For All That?-Puberty and Periods

10 Aug

School physical time still going crazy around here…

Lots of pre-teen boys and girls in the office getting checked out and ready for school.  I did the boy specific post last week.  Check it out if you haven’t seen it yet: Do You Want Your Mom In or Out?-School Physicals and Testicle Checks

Now one for the girls…

I try to start mentioning some of the changes associated with puberty and talking with families about what to expect around the 9-10 year check up.  

Queue: Deer in the Headlights Face!!!


Isn’t it too early for “all that”?

Let’s look at the evidence and see…

What are the physical changes associated with puberty?

  • Increase in height (about 20% of adult height comes during these few years)
  • Physical maturity (breast development and pubertal hair changes)
  • Body weight changes (typically with an increase in body fat percent)

The earliest changes of development in most girls is development of the breast.  This usually occurs about 2.5 years prior to the onset of puberty.  So, if you pay attention, you can start to think about and discuss some of these things early.

How early is too early?

There have been some studies done in the past decade that describe average age of puberty in girls and boys and showing an overall earlier age to starting puberty.  There is a difference between ethnic groups with African-American girls generally starting periods earlier than other ethnicities.

Generally, girls who start sexual development (breast development and/or pubic hair development) prior to age 8 should be evaluated for early puberty.  The evaluation may include simply an office visit and a discussion but could also involve blood work, x-rays to assess bone age and possibly a referral to an endocrinologist.

So, why mention it so early?

As you can see, many girls can have started to show changes associated with early puberty as early as 8 years of age.  That is why I think mentioning it in the 9-10 year check up is important.  There are many changes associated with puberty besides just the physical changes that I mentioned above.

Other changes associated with puberty:

  • Acne
  • Scoliosis
  • Musculoskeletal injuries

But, perhaps the most distressing part about puberty is the onset of periods.  This doesn’t have to be the case.  This can be particularly distressing for the girl who is unsuspecting and caught off guard.  Having early, small conversations along the way can make the transition as smooth as possible.  In some families, having “the talk” might work but I’ve found families who give information early and in short bursts to be the most successful in surviving this time unscathed.  

A great resource for having this discussion with your girls is by Cara Natterson, 

The Care and Keeping of You 2: The Body Book for Older Girls

So, good luck navigating these water with your pre-teen girls and don’t be surprised to hear me question you about your conversations about puberty at an “early” age.


2 Responses to “Isn’t It Too Early For All That?-Puberty and Periods”

  1. Hayley Webb August 15, 2013 at 3:33 pm #

    Love and appreciate the humor in all your posts – so, so great!

    On Sat, Aug 10, 2013 at 1:52 PM, DoctorJSmith

    • jrsmith120880 August 15, 2013 at 6:53 pm #

      I enjoy writing them…hopefully they get some useful information out there occasionally.

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