Normal Pubertal Timing
The timing of pubertal onset is dependent on both genetic and environmental factors. An estimated 50 to 80% of the variation in pubertal timing is determined by genetic factors. It is also likely influenced by environmental factors such as nutrition, environmental industrial compounds. 95% of boys start puberty (as assessed by increase in testicular volume) between the ages of 9.5 and 13.5 years of age, with a mean age of 11.6 yrs. Among girls, 95% experienced breast development between 8.5 to 13 years of age with an average age of 11.2 years and the duration from breast development to menarche is 2.5 to 3 years. Precocious puberty is the onset of pubertal changes before the age of 9 years in boys and 8 years in girls. (Although newer guidelines suggest lowering the age limit to 6 years in African American girls and 7 years in Caucasian girls as there is an ethnic difference).
Listed below are the types of pubertal disorders managed by a pediatric endocrinologist