CINXE.COM

<!DOCTYPE html> <html class="client-nojs vector-feature-language-in-header-enabled vector-feature-language-in-main-page-header-disabled vector-feature-sticky-header-disabled vector-feature-page-tools-pinned-disabled vector-feature-toc-pinned-clientpref-1 vector-feature-main-menu-pinned-disabled vector-feature-limited-width-clientpref-1 vector-feature-limited-width-content-enabled vector-feature-custom-font-size-clientpref-1 vector-feature-appearance-pinned-clientpref-1 vector-feature-night-mode-enabled skin-theme-clientpref-day vector-toc-available" lang="en" dir="ltr"> <head> <meta charset="UTF-8"> <title>Pubarche - Wikipedia</title> <script>(function(){var className="client-js vector-feature-language-in-header-enabled vector-feature-language-in-main-page-header-disabled vector-feature-sticky-header-disabled vector-feature-page-tools-pinned-disabled vector-feature-toc-pinned-clientpref-1 vector-feature-main-menu-pinned-disabled vector-feature-limited-width-clientpref-1 vector-feature-limited-width-content-enabled vector-feature-custom-font-size-clientpref-1 vector-feature-appearance-pinned-clientpref-1 vector-feature-night-mode-enabled skin-theme-clientpref-day vector-toc-available";var cookie=document.cookie.match(/(?:^|; )enwikimwclientpreferences=([^;]+)/);if(cookie){cookie[1].split('%2C').forEach(function(pref){className=className.replace(new RegExp('(^| )'+pref.replace(/-clientpref-\w+$|[^\w-]+/g,'')+'-clientpref-\\w+( |$)'),'$1'+pref+'$2');});}document.documentElement.className=className;}());RLCONF={"wgBreakFrames":false,"wgSeparatorTransformTable":["",""],"wgDigitTransformTable":["",""],"wgDefaultDateFormat":"dmy", "wgMonthNames":["","January","February","March","April","May","June","July","August","September","October","November","December"],"wgRequestId":"3fbd07c2-5e32-406f-868c-1cf39ea3b9b2","wgCanonicalNamespace":"","wgCanonicalSpecialPageName":false,"wgNamespaceNumber":0,"wgPageName":"Pubarche","wgTitle":"Pubarche","wgCurRevisionId":1251397987,"wgRevisionId":1251397987,"wgArticleId":755413,"wgIsArticle":true,"wgIsRedirect":false,"wgAction":"view","wgUserName":null,"wgUserGroups":["*"],"wgCategories":["Articles with short description","Short description is different from Wikidata","Developmental stages","Gynaecological endocrinology","Human development","Pubic hair","Sexuality and age"],"wgPageViewLanguage":"en","wgPageContentLanguage":"en","wgPageContentModel":"wikitext","wgRelevantPageName":"Pubarche","wgRelevantArticleId":755413,"wgIsProbablyEditable":true,"wgRelevantPageIsProbablyEditable":true,"wgRestrictionEdit":[],"wgRestrictionMove":[],"wgNoticeProject":"wikipedia", "wgCiteReferencePreviewsActive":false,"wgFlaggedRevsParams":{"tags":{"status":{"levels":1}}},"wgMediaViewerOnClick":true,"wgMediaViewerEnabledByDefault":true,"wgPopupsFlags":0,"wgVisualEditor":{"pageLanguageCode":"en","pageLanguageDir":"ltr","pageVariantFallbacks":"en"},"wgMFDisplayWikibaseDescriptions":{"search":true,"watchlist":true,"tagline":false,"nearby":true},"wgWMESchemaEditAttemptStepOversample":false,"wgWMEPageLength":30000,"wgRelatedArticlesCompat":[],"wgCentralAuthMobileDomain":false,"wgEditSubmitButtonLabelPublish":true,"wgULSPosition":"interlanguage","wgULSisCompactLinksEnabled":false,"wgVector2022LanguageInHeader":true,"wgULSisLanguageSelectorEmpty":false,"wgWikibaseItemId":"Q490608","wgCheckUserClientHintsHeadersJsApi":["brands","architecture","bitness","fullVersionList","mobile","model","platform","platformVersion"],"GEHomepageSuggestedEditsEnableTopics":true,"wgGETopicsMatchModeEnabled":false,"wgGEStructuredTaskRejectionReasonTextInputEnabled":false, "wgGELevelingUpEnabledForUser":false};RLSTATE={"ext.globalCssJs.user.styles":"ready","site.styles":"ready","user.styles":"ready","ext.globalCssJs.user":"ready","user":"ready","user.options":"loading","ext.cite.styles":"ready","skins.vector.search.codex.styles":"ready","skins.vector.styles":"ready","skins.vector.icons":"ready","jquery.makeCollapsible.styles":"ready","ext.wikimediamessages.styles":"ready","ext.visualEditor.desktopArticleTarget.noscript":"ready","ext.uls.interlanguage":"ready","wikibase.client.init":"ready","ext.wikimediaBadges":"ready"};RLPAGEMODULES=["ext.cite.ux-enhancements","mediawiki.page.media","site","mediawiki.page.ready","jquery.makeCollapsible","mediawiki.toc","skins.vector.js","ext.centralNotice.geoIP","ext.centralNotice.startUp","ext.gadget.ReferenceTooltips","ext.gadget.switcher","ext.urlShortener.toolbar","ext.centralauth.centralautologin","mmv.bootstrap","ext.popups","ext.visualEditor.desktopArticleTarget.init","ext.visualEditor.targetLoader", "ext.echo.centralauth","ext.eventLogging","ext.wikimediaEvents","ext.navigationTiming","ext.uls.interface","ext.cx.eventlogging.campaigns","ext.cx.uls.quick.actions","wikibase.client.vector-2022","ext.checkUser.clientHints","ext.quicksurveys.init","ext.growthExperiments.SuggestedEditSession","wikibase.sidebar.tracking"];</script> <script>(RLQ=window.RLQ||[]).push(function(){mw.loader.impl(function(){return["user.options@12s5i",function($,jQuery,require,module){mw.user.tokens.set({"patrolToken":"+\\","watchToken":"+\\","csrfToken":"+\\"}); }];});});</script> <link rel="stylesheet" href="/w/load.php?lang=en&modules=ext.cite.styles%7Cext.uls.interlanguage%7Cext.visualEditor.desktopArticleTarget.noscript%7Cext.wikimediaBadges%7Cext.wikimediamessages.styles%7Cjquery.makeCollapsible.styles%7Cskins.vector.icons%2Cstyles%7Cskins.vector.search.codex.styles%7Cwikibase.client.init&only=styles&skin=vector-2022"> <script async="" src="/w/load.php?lang=en&modules=startup&only=scripts&raw=1&skin=vector-2022"></script> <meta name="ResourceLoaderDynamicStyles" content=""> <link rel="stylesheet" href="/w/load.php?lang=en&modules=site.styles&only=styles&skin=vector-2022"> <meta name="generator" content="MediaWiki 1.44.0-wmf.4"> <meta name="referrer" content="origin"> <meta name="referrer" content="origin-when-cross-origin"> <meta name="robots" content="max-image-preview:standard"> <meta name="format-detection" content="telephone=no"> <meta name="viewport" content="width=1120"> <meta property="og:title" content="Pubarche - Wikipedia"> <meta property="og:type" content="website"> <link rel="preconnect" href="//upload.wikimedia.org"> <link rel="alternate" media="only screen and (max-width: 640px)" href="//en.m.wikipedia.org/wiki/Pubarche"> <link rel="alternate" type="application/x-wiki" title="Edit this page" href="/w/index.php?title=Pubarche&action=edit"> <link rel="apple-touch-icon" href="/static/apple-touch/wikipedia.png"> <link rel="icon" href="/static/favicon/wikipedia.ico"> <link rel="search" type="application/opensearchdescription+xml" href="/w/rest.php/v1/search" title="Wikipedia (en)"> <link rel="EditURI" type="application/rsd+xml" href="//en.wikipedia.org/w/api.php?action=rsd"> <link rel="canonical" href="https://en.wikipedia.org/wiki/Pubarche"> <link rel="license" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en"> <link rel="alternate" type="application/atom+xml" title="Wikipedia Atom feed" href="/w/index.php?title=Special:RecentChanges&feed=atom"> <link rel="dns-prefetch" href="//meta.wikimedia.org" /> <link rel="dns-prefetch" href="//login.wikimedia.org"> </head> <body class="skin--responsive skin-vector skin-vector-search-vue mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject mw-editable page-Pubarche rootpage-Pubarche skin-vector-2022 action-view"><a class="mw-jump-link" href="#bodyContent">Jump to content</a> <div class="vector-header-container"> <header class="vector-header mw-header"> <div class="vector-header-start"> <nav class="vector-main-menu-landmark" aria-label="Site"> <div id="vector-main-menu-dropdown" class="vector-dropdown vector-main-menu-dropdown vector-button-flush-left vector-button-flush-right" > <input type="checkbox" id="vector-main-menu-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-main-menu-dropdown" class="vector-dropdown-checkbox " aria-label="Main menu" > <label id="vector-main-menu-dropdown-label" for="vector-main-menu-dropdown-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-menu mw-ui-icon-wikimedia-menu"></span> <span class="vector-dropdown-label-text">Main menu</span> </label> <div class="vector-dropdown-content"> <div id="vector-main-menu-unpinned-container" class="vector-unpinned-container"> <div id="vector-main-menu" class="vector-main-menu vector-pinnable-element"> <div class="vector-pinnable-header vector-main-menu-pinnable-header vector-pinnable-header-unpinned" data-feature-name="main-menu-pinned" data-pinnable-element-id="vector-main-menu" data-pinned-container-id="vector-main-menu-pinned-container" data-unpinned-container-id="vector-main-menu-unpinned-container" > <div class="vector-pinnable-header-label">Main menu</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-main-menu.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-main-menu.unpin">hide</button> </div> <div id="p-navigation" class="vector-menu mw-portlet mw-portlet-navigation" > <div class="vector-menu-heading"> Navigation </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="n-mainpage-description" class="mw-list-item"><a href="/wiki/Main_Page" title="Visit the main page [z]" accesskey="z"><span>Main page</span></a></li><li id="n-contents" class="mw-list-item"><a href="/wiki/Wikipedia:Contents" title="Guides to browsing Wikipedia"><span>Contents</span></a></li><li id="n-currentevents" class="mw-list-item"><a href="/wiki/Portal:Current_events" title="Articles related to current events"><span>Current events</span></a></li><li id="n-randompage" class="mw-list-item"><a href="/wiki/Special:Random" title="Visit a randomly selected article [x]" accesskey="x"><span>Random article</span></a></li><li id="n-aboutsite" class="mw-list-item"><a href="/wiki/Wikipedia:About" title="Learn about Wikipedia and how it works"><span>About Wikipedia</span></a></li><li id="n-contactpage" class="mw-list-item"><a href="//en.wikipedia.org/wiki/Wikipedia:Contact_us" title="How to contact Wikipedia"><span>Contact us</span></a></li> </ul> </div> </div> <div id="p-interaction" class="vector-menu mw-portlet mw-portlet-interaction" > <div class="vector-menu-heading"> Contribute </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="n-help" class="mw-list-item"><a href="/wiki/Help:Contents" title="Guidance on how to use and edit Wikipedia"><span>Help</span></a></li><li id="n-introduction" class="mw-list-item"><a href="/wiki/Help:Introduction" title="Learn how to edit Wikipedia"><span>Learn to edit</span></a></li><li id="n-portal" class="mw-list-item"><a href="/wiki/Wikipedia:Community_portal" title="The hub for editors"><span>Community portal</span></a></li><li id="n-recentchanges" class="mw-list-item"><a href="/wiki/Special:RecentChanges" title="A list of recent changes to Wikipedia [r]" accesskey="r"><span>Recent changes</span></a></li><li id="n-upload" class="mw-list-item"><a href="/wiki/Wikipedia:File_upload_wizard" title="Add images or other media for use on Wikipedia"><span>Upload file</span></a></li> </ul> </div> </div> </div> </div> </div> </div> </nav> <a href="/wiki/Main_Page" class="mw-logo"> <img class="mw-logo-icon" src="/static/images/icons/wikipedia.png" alt="" aria-hidden="true" height="50" width="50"> <span class="mw-logo-container skin-invert"> <img class="mw-logo-wordmark" alt="Wikipedia" src="/static/images/mobile/copyright/wikipedia-wordmark-en.svg" style="width: 7.5em; height: 1.125em;"> <img class="mw-logo-tagline" alt="The Free Encyclopedia" src="/static/images/mobile/copyright/wikipedia-tagline-en.svg" width="117" height="13" style="width: 7.3125em; height: 0.8125em;"> </span> </a> </div> <div class="vector-header-end"> <div id="p-search" role="search" class="vector-search-box-vue vector-search-box-collapses vector-search-box-show-thumbnail vector-search-box-auto-expand-width vector-search-box"> <a href="/wiki/Special:Search" class="cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only search-toggle" title="Search Wikipedia [f]" accesskey="f"><span class="vector-icon mw-ui-icon-search mw-ui-icon-wikimedia-search"></span> <span>Search</span> </a> <div class="vector-typeahead-search-container"> <div class="cdx-typeahead-search cdx-typeahead-search--show-thumbnail cdx-typeahead-search--auto-expand-width"> <form action="/w/index.php" id="searchform" class="cdx-search-input cdx-search-input--has-end-button"> <div id="simpleSearch" class="cdx-search-input__input-wrapper" data-search-loc="header-moved"> <div class="cdx-text-input cdx-text-input--has-start-icon"> <input class="cdx-text-input__input" type="search" name="search" placeholder="Search Wikipedia" aria-label="Search Wikipedia" autocapitalize="sentences" title="Search Wikipedia [f]" accesskey="f" id="searchInput" > <span class="cdx-text-input__icon cdx-text-input__start-icon"></span> </div> <input type="hidden" name="title" value="Special:Search"> </div> <button class="cdx-button cdx-search-input__end-button">Search</button> </form> </div> </div> </div> <nav class="vector-user-links vector-user-links-wide" aria-label="Personal tools"> <div class="vector-user-links-main"> <div id="p-vector-user-menu-preferences" class="vector-menu mw-portlet emptyPortlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> <div id="p-vector-user-menu-userpage" class="vector-menu mw-portlet emptyPortlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> <nav class="vector-appearance-landmark" aria-label="Appearance"> <div id="vector-appearance-dropdown" class="vector-dropdown " title="Change the appearance of the page's font size, width, and color" > <input type="checkbox" id="vector-appearance-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-appearance-dropdown" class="vector-dropdown-checkbox " aria-label="Appearance" > <label id="vector-appearance-dropdown-label" for="vector-appearance-dropdown-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-appearance mw-ui-icon-wikimedia-appearance"></span> <span class="vector-dropdown-label-text">Appearance</span> </label> <div class="vector-dropdown-content"> <div id="vector-appearance-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <div id="p-vector-user-menu-notifications" class="vector-menu mw-portlet emptyPortlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> <div id="p-vector-user-menu-overflow" class="vector-menu mw-portlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="pt-sitesupport-2" class="user-links-collapsible-item mw-list-item user-links-collapsible-item"><a data-mw="interface" href="https://donate.wikimedia.org/wiki/Special:FundraiserRedirector?utm_source=donate&utm_medium=sidebar&utm_campaign=C13_en.wikipedia.org&uselang=en" class=""><span>Donate</span></a> </li> <li id="pt-createaccount-2" class="user-links-collapsible-item mw-list-item user-links-collapsible-item"><a data-mw="interface" href="/w/index.php?title=Special:CreateAccount&returnto=Pubarche" title="You are encouraged to create an account and log in; however, it is not mandatory" class=""><span>Create account</span></a> </li> <li id="pt-login-2" class="user-links-collapsible-item mw-list-item user-links-collapsible-item"><a data-mw="interface" href="/w/index.php?title=Special:UserLogin&returnto=Pubarche" title="You're encouraged to log in; however, it's not mandatory. [o]" accesskey="o" class=""><span>Log in</span></a> </li> </ul> </div> </div> </div> <div id="vector-user-links-dropdown" class="vector-dropdown vector-user-menu vector-button-flush-right vector-user-menu-logged-out" title="Log in and more options" > <input type="checkbox" id="vector-user-links-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-user-links-dropdown" class="vector-dropdown-checkbox " aria-label="Personal tools" > <label id="vector-user-links-dropdown-label" for="vector-user-links-dropdown-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-ellipsis mw-ui-icon-wikimedia-ellipsis"></span> <span class="vector-dropdown-label-text">Personal tools</span> </label> <div class="vector-dropdown-content"> <div id="p-personal" class="vector-menu mw-portlet mw-portlet-personal user-links-collapsible-item" title="User menu" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="pt-sitesupport" class="user-links-collapsible-item mw-list-item"><a href="https://donate.wikimedia.org/wiki/Special:FundraiserRedirector?utm_source=donate&utm_medium=sidebar&utm_campaign=C13_en.wikipedia.org&uselang=en"><span>Donate</span></a></li><li id="pt-createaccount" class="user-links-collapsible-item mw-list-item"><a href="/w/index.php?title=Special:CreateAccount&returnto=Pubarche" title="You are encouraged to create an account and log in; however, it is not mandatory"><span class="vector-icon mw-ui-icon-userAdd mw-ui-icon-wikimedia-userAdd"></span> <span>Create account</span></a></li><li id="pt-login" class="user-links-collapsible-item mw-list-item"><a href="/w/index.php?title=Special:UserLogin&returnto=Pubarche" title="You're encouraged to log in; however, it's not mandatory. [o]" accesskey="o"><span class="vector-icon mw-ui-icon-logIn mw-ui-icon-wikimedia-logIn"></span> <span>Log in</span></a></li> </ul> </div> </div> <div id="p-user-menu-anon-editor" class="vector-menu mw-portlet mw-portlet-user-menu-anon-editor" > <div class="vector-menu-heading"> Pages for logged out editors <a href="/wiki/Help:Introduction" aria-label="Learn more about editing"><span>learn more</span></a> </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="pt-anoncontribs" class="mw-list-item"><a href="/wiki/Special:MyContributions" title="A list of edits made from this IP address [y]" accesskey="y"><span>Contributions</span></a></li><li id="pt-anontalk" class="mw-list-item"><a href="/wiki/Special:MyTalk" title="Discussion about edits from this IP address [n]" accesskey="n"><span>Talk</span></a></li> </ul> </div> </div> </div> </div> </nav> </div> </header> </div> <div class="mw-page-container"> <div class="mw-page-container-inner"> <div class="vector-sitenotice-container"> <div id="siteNotice"></div> </div> <div class="vector-column-start"> <div class="vector-main-menu-container"> <div id="mw-navigation"> <nav id="mw-panel" class="vector-main-menu-landmark" aria-label="Site"> <div id="vector-main-menu-pinned-container" class="vector-pinned-container"> </div> </nav> </div> </div> <div class="vector-sticky-pinned-container"> <nav id="mw-panel-toc" aria-label="Contents" data-event-name="ui.sidebar-toc" class="mw-table-of-contents-container vector-toc-landmark"> <div id="vector-toc-pinned-container" class="vector-pinned-container"> <div id="vector-toc" class="vector-toc vector-pinnable-element"> <div class="vector-pinnable-header vector-toc-pinnable-header vector-pinnable-header-pinned" data-feature-name="toc-pinned" data-pinnable-element-id="vector-toc" > <h2 class="vector-pinnable-header-label">Contents</h2> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-toc.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-toc.unpin">hide</button> </div> <ul class="vector-toc-contents" id="mw-panel-toc-list"> <li id="toc-mw-content-text" class="vector-toc-list-item vector-toc-level-1"> <a href="#" class="vector-toc-link"> <div class="vector-toc-text">(Top)</div> </a> </li> <li id="toc-Assessment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Assessment"> <div class="vector-toc-text"> <span class="vector-toc-numb">1</span> <span>Assessment</span> </div> </a> <ul id="toc-Assessment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Average_age" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Average_age"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Average age</span> </div> </a> <button aria-controls="toc-Average_age-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Average age subsection</span> </button> <ul id="toc-Average_age-sublist" class="vector-toc-list"> <li id="toc-Environmental_exposures" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Environmental_exposures"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Environmental exposures</span> </div> </a> <ul id="toc-Environmental_exposures-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Geographical_location_and_nutritional_needs" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Geographical_location_and_nutritional_needs"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Geographical location and nutritional needs</span> </div> </a> <ul id="toc-Geographical_location_and_nutritional_needs-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Premature_pubarche" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Premature_pubarche"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Premature pubarche</span> </div> </a> <button aria-controls="toc-Premature_pubarche-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Premature pubarche subsection</span> </button> <ul id="toc-Premature_pubarche-sublist" class="vector-toc-list"> <li id="toc-Clinical_Examination" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Clinical_Examination"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Clinical Examination</span> </div> </a> <ul id="toc-Clinical_Examination-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Delayed_pubarche" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Delayed_pubarche"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Delayed pubarche</span> </div> </a> <button aria-controls="toc-Delayed_pubarche-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Delayed pubarche subsection</span> </button> <ul id="toc-Delayed_pubarche-sublist" class="vector-toc-list"> <li id="toc-Adrenal_Insufficiency" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Adrenal_Insufficiency"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Adrenal Insufficiency</span> </div> </a> <ul id="toc-Adrenal_Insufficiency-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Turner_Syndrome" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Turner_Syndrome"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Turner Syndrome</span> </div> </a> <ul id="toc-Turner_Syndrome-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hypogonadotropic_Hypogonadism" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hypogonadotropic_Hypogonadism"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Hypogonadotropic Hypogonadism</span> </div> </a> <ul id="toc-Hypogonadotropic_Hypogonadism-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Treatment_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.4</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment_2-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Pubarche</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 15 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-15" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">15 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A8%D8%AF%D8%A1_%D8%A7%D9%84%D8%B4%D8%B9%D8%B1%D8%A9_(%D8%B7%D8%A8)" title="بدء الشعرة (طب) – Arabic" lang="ar" hreflang="ar" data-title="بدء الشعرة (طب)" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Pubarha" title="Pubarha – Bosnian" lang="bs" hreflang="bs" data-title="Pubarha" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Pubarquia" title="Pubarquia – Catalan" lang="ca" hreflang="ca" data-title="Pubarquia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Pubarche" title="Pubarche – German" lang="de" hreflang="de" data-title="Pubarche" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Pubarquia" title="Pubarquia – Spanish" lang="es" hreflang="es" data-title="Pubarquia" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Pubarche" title="Pubarche – French" lang="fr" hreflang="fr" data-title="Pubarche" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9D%8C%EB%AA%A8%EB%B0%9C%EC%83%9D" title="음모발생 – Korean" lang="ko" hreflang="ko" data-title="음모발생" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Pubarca" title="Pubarca – Italian" lang="it" hreflang="it" data-title="Pubarca" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-ja badge-Q70893996 mw-list-item" title=""><a href="https://ja.wikipedia.org/wiki/%E9%99%B0%E6%AF%9B%E7%99%BA%E7%8F%BE" title="陰毛発現 – Japanese" lang="ja" hreflang="ja" data-title="陰毛発現" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Pubarche" title="Pubarche – Low German" lang="nds" hreflang="nds" data-title="Pubarche" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target"><span>Plattdüütsch</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Pubarche" title="Pubarche – Polish" lang="pl" hreflang="pl" data-title="Pubarche" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Pubarca" title="Pubarca – Portuguese" lang="pt" hreflang="pt" data-title="Pubarca" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Pubar%C5%9F" title="Pubarş – Turkish" lang="tr" hreflang="tr" data-title="Pubarş" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9F%D1%8E%D0%B1%D0%B0%D1%80%D1%85%D0%B5" title="Пюбархе – Ukrainian" lang="uk" hreflang="uk" data-title="Пюбархе" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E9%98%B4%E6%AF%9B%E5%88%9D%E7%8E%B0" title="阴毛初现 – Chinese" lang="zh" hreflang="zh" data-title="阴毛初现" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q490608#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-nstab-main" class="selected vector-tab-noicon mw-list-item"><a href="/wiki/Pubarche" title="View the content page [c]" accesskey="c"><span>Article</span></a></li><li id="ca-talk" class="vector-tab-noicon mw-list-item"><a href="/wiki/Talk:Pubarche" rel="discussion" title="Discuss improvements to the content page [t]" accesskey="t"><span>Talk</span></a></li> </ul> </div> </div> <div id="vector-variants-dropdown" class="vector-dropdown emptyPortlet" > <input type="checkbox" id="vector-variants-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-variants-dropdown" class="vector-dropdown-checkbox " aria-label="Change language variant" > <label id="vector-variants-dropdown-label" for="vector-variants-dropdown-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet" aria-hidden="true" ><span class="vector-dropdown-label-text">English</span> </label> <div class="vector-dropdown-content"> <div id="p-variants" class="vector-menu mw-portlet mw-portlet-variants emptyPortlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> </div> </div> </nav> </div> <div id="right-navigation" class="vector-collapsible"> <nav aria-label="Views"> <div id="p-views" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-views" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-view" class="selected vector-tab-noicon mw-list-item"><a href="/wiki/Pubarche"><span>Read</span></a></li><li id="ca-edit" class="vector-tab-noicon mw-list-item"><a href="/w/index.php?title=Pubarche&action=edit" title="Edit this page [e]" accesskey="e"><span>Edit</span></a></li><li id="ca-history" class="vector-tab-noicon mw-list-item"><a href="/w/index.php?title=Pubarche&action=history" title="Past revisions of this page [h]" accesskey="h"><span>View history</span></a></li> </ul> </div> </div> </nav> <nav class="vector-page-tools-landmark" aria-label="Page tools"> <div id="vector-page-tools-dropdown" class="vector-dropdown vector-page-tools-dropdown" > <input type="checkbox" id="vector-page-tools-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-tools-dropdown" class="vector-dropdown-checkbox " aria-label="Tools" > <label id="vector-page-tools-dropdown-label" for="vector-page-tools-dropdown-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet" aria-hidden="true" ><span class="vector-dropdown-label-text">Tools</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-tools-unpinned-container" class="vector-unpinned-container"> <div id="vector-page-tools" class="vector-page-tools vector-pinnable-element"> <div class="vector-pinnable-header vector-page-tools-pinnable-header vector-pinnable-header-unpinned" data-feature-name="page-tools-pinned" data-pinnable-element-id="vector-page-tools" data-pinned-container-id="vector-page-tools-pinned-container" data-unpinned-container-id="vector-page-tools-unpinned-container" > <div class="vector-pinnable-header-label">Tools</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-page-tools.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-page-tools.unpin">hide</button> </div> <div id="p-cactions" class="vector-menu mw-portlet mw-portlet-cactions emptyPortlet vector-has-collapsible-items" title="More options" > <div class="vector-menu-heading"> Actions </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-more-view" class="selected vector-more-collapsible-item mw-list-item"><a href="/wiki/Pubarche"><span>Read</span></a></li><li id="ca-more-edit" class="vector-more-collapsible-item mw-list-item"><a href="/w/index.php?title=Pubarche&action=edit" title="Edit this page [e]" accesskey="e"><span>Edit</span></a></li><li id="ca-more-history" class="vector-more-collapsible-item mw-list-item"><a href="/w/index.php?title=Pubarche&action=history"><span>View history</span></a></li> </ul> </div> </div> <div id="p-tb" class="vector-menu mw-portlet mw-portlet-tb" > <div class="vector-menu-heading"> General </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="t-whatlinkshere" class="mw-list-item"><a href="/wiki/Special:WhatLinksHere/Pubarche" title="List of all English Wikipedia pages containing links to this page [j]" accesskey="j"><span>What links here</span></a></li><li id="t-recentchangeslinked" class="mw-list-item"><a href="/wiki/Special:RecentChangesLinked/Pubarche" rel="nofollow" title="Recent changes in pages linked from this page [k]" accesskey="k"><span>Related changes</span></a></li><li id="t-upload" class="mw-list-item"><a href="/wiki/Wikipedia:File_Upload_Wizard" title="Upload files [u]" accesskey="u"><span>Upload file</span></a></li><li id="t-specialpages" class="mw-list-item"><a href="/wiki/Special:SpecialPages" title="A list of all special pages [q]" accesskey="q"><span>Special pages</span></a></li><li id="t-permalink" class="mw-list-item"><a href="/w/index.php?title=Pubarche&oldid=1251397987" title="Permanent link to this revision of this page"><span>Permanent link</span></a></li><li id="t-info" class="mw-list-item"><a href="/w/index.php?title=Pubarche&action=info" title="More information about this page"><span>Page information</span></a></li><li id="t-cite" class="mw-list-item"><a href="/w/index.php?title=Special:CiteThisPage&page=Pubarche&id=1251397987&wpFormIdentifier=titleform" title="Information on how to cite this page"><span>Cite this page</span></a></li><li id="t-urlshortener" class="mw-list-item"><a href="/w/index.php?title=Special:UrlShortener&url=https%3A%2F%2Fen.wikipedia.org%2Fwiki%2FPubarche"><span>Get shortened URL</span></a></li><li id="t-urlshortener-qrcode" class="mw-list-item"><a href="/w/index.php?title=Special:QrCode&url=https%3A%2F%2Fen.wikipedia.org%2Fwiki%2FPubarche"><span>Download QR code</span></a></li> </ul> </div> </div> <div id="p-coll-print_export" class="vector-menu mw-portlet mw-portlet-coll-print_export" > <div class="vector-menu-heading"> Print/export </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="coll-download-as-rl" class="mw-list-item"><a href="/w/index.php?title=Special:DownloadAsPdf&page=Pubarche&action=show-download-screen" title="Download this page as a PDF file"><span>Download as PDF</span></a></li><li id="t-print" class="mw-list-item"><a href="/w/index.php?title=Pubarche&printable=yes" title="Printable version of this page [p]" accesskey="p"><span>Printable version</span></a></li> </ul> </div> </div> <div id="p-wikibase-otherprojects" class="vector-menu mw-portlet mw-portlet-wikibase-otherprojects" > <div class="vector-menu-heading"> In other projects </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="t-wikibase" class="wb-otherproject-link wb-otherproject-wikibase-dataitem mw-list-item"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q490608" title="Structured data on this page hosted by Wikidata [g]" accesskey="g"><span>Wikidata item</span></a></li> </ul> </div> </div> </div> </div> </div> </div> </nav> </div> </div> </div> <div class="vector-column-end"> <div class="vector-sticky-pinned-container"> <nav class="vector-page-tools-landmark" aria-label="Page tools"> <div id="vector-page-tools-pinned-container" class="vector-pinned-container"> </div> </nav> <nav class="vector-appearance-landmark" aria-label="Appearance"> <div id="vector-appearance-pinned-container" class="vector-pinned-container"> <div id="vector-appearance" class="vector-appearance vector-pinnable-element"> <div class="vector-pinnable-header vector-appearance-pinnable-header vector-pinnable-header-pinned" data-feature-name="appearance-pinned" data-pinnable-element-id="vector-appearance" data-pinned-container-id="vector-appearance-pinned-container" data-unpinned-container-id="vector-appearance-unpinned-container" > <div class="vector-pinnable-header-label">Appearance</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-appearance.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-appearance.unpin">hide</button> </div> </div> </div> </nav> </div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Debut of pubic hair following the onset of puberty</div> <p><b>Pubarche</b> (<span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˈ/: primary stress follows">ˈ</span><span title="'p' in 'pie'">p</span><span title="/j/: 'y' in 'yes'">j</span><span title="/uː/: 'oo' in 'goose'">uː</span><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'b' in 'buy'">b</span><span title="/ɑːr/: 'ar' in 'far'">ɑːr</span><span title="'k' in 'kind'">k</span><span title="/i/: 'y' in 'happy'">i</span></span>/</a></span></span>) refers to the first appearance of <a href="/wiki/Pubic_hair" title="Pubic hair">pubic hair</a> at <a href="/wiki/Puberty" title="Puberty">puberty</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> It is one of the physical changes of puberty and can occur independently of complete puberty. The early stage of sexual maturation, also known as <a href="/wiki/Adrenarche" title="Adrenarche">adrenarche</a>, is marked by characteristics including the development of pubic hair, <a href="/wiki/Underarm_hair" title="Underarm hair">axillary hair</a>, <a href="/wiki/Body_odor" title="Body odor">adult apocrine body odor</a>, <a href="/wiki/Acne" title="Acne">acne</a>, and increased oiliness of hair and skin. The Encyclopedia of Child and Adolescent Health corresponds SMR2 (sexual maturity rating) with pubarche, defining it as the development of pubic hair that occurs at a mean age of 11.6 years in females (range 9.3–13.9 years) and 12.6 years in males (range 10.7–14.5 years). It further describes that pubarche's physical manifestation is <a href="/wiki/Vellus_hair" title="Vellus hair">vellus</a> hair over the <a href="/wiki/Labia" title="Labia">labia</a> or the base of the penis.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> See Table 1 for the entirety of the sexual maturity rating description. </p><p>A study researched whether <a href="/wiki/Thelarche" title="Thelarche">thelarche</a> pathway, beginning puberty with breast development alone, or the pubarche pathway, beginning puberty with pubic hair development alone, represents the true pubertal development. The study is an observational, longitudinal cohort study. The study cohort is limited to a group of black and white girls who were seen annually for ten years. It is concluded in the research that pubarche may represent true pubertal maturation.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Assessment">Assessment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=1" title="Edit section: Assessment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Male_genitalia_five_Tanner_stages.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/29/Male_genitalia_five_Tanner_stages.png/220px-Male_genitalia_five_Tanner_stages.png" decoding="async" width="220" height="95" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/29/Male_genitalia_five_Tanner_stages.png/330px-Male_genitalia_five_Tanner_stages.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/29/Male_genitalia_five_Tanner_stages.png/440px-Male_genitalia_five_Tanner_stages.png 2x" data-file-width="1091" data-file-height="470" /></a><figcaption>Five Tanner stages of male genitalia and pubic hair, <i>The Adolescent Period</i></figcaption></figure><figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Adolescent_Period_Average_girl_4_to_16_yo.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6e/Adolescent_Period_Average_girl_4_to_16_yo.jpg/220px-Adolescent_Period_Average_girl_4_to_16_yo.jpg" decoding="async" width="220" height="114" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6e/Adolescent_Period_Average_girl_4_to_16_yo.jpg/330px-Adolescent_Period_Average_girl_4_to_16_yo.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6e/Adolescent_Period_Average_girl_4_to_16_yo.jpg/440px-Adolescent_Period_Average_girl_4_to_16_yo.jpg 2x" data-file-width="952" data-file-height="492" /></a><figcaption>Stages of female genitalia and pubic hair during puberty</figcaption></figure><p>The <a href="/wiki/Tanner_scale" title="Tanner scale">Tanner scale</a> remains the gold standard for determining pubarche. In clinical settings, this scale is primarily used by physicians, nurses, or other trained healthcare providers as part of a physical examination to assess the stage of puberty in children and adolescents, though in some cases the stage of puberty can be self-assessed.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><table class="wikitable"> <caption>Table 1 </caption> <tbody><tr> <th>Tanner stage </th> <th>Description of pubic hair development </th></tr> <tr> <td>SMR 1 </td> <td>Prepubertal – No pubic hair </td></tr> <tr> <td>SMR 2 </td> <td>Pubarche – Sparse, fine, straight, downy hair over labia or penis </td></tr> <tr> <td>SMR 3 </td> <td>Appearance of terminal hair – Adult quality, confined to the pubis </td></tr> <tr> <td>SMR 4 </td> <td>Terminal hair fills the pubic region, not beyond inguinal crease </td></tr> <tr> <td>SMR 5 </td> <td>Terminal hair extends onto medial thighs, achieving full adult distribution </td></tr> <tr> <td>SMR 6 </td> <td>Terminal hair extends up the linea alba toward the umbilicus (only in males) </td></tr></tbody></table> <div class="mw-heading mw-heading2"><h2 id="Average_age">Average age</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=2" title="Edit section: Average age"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Tanner_scale" title="Tanner scale">Tanner scale</a></div><p>The average beginning of pubarche varies due to many factors, including environmental exposures, nourishment, weight, race and ethnicity, and geographical location. First (and often transient) pubic hair resulting from <a href="/wiki/Adrenarche" title="Adrenarche">adrenarche</a> may appear between ages 10–12 at the beginning of puberty. </p><div class="mw-heading mw-heading3"><h3 id="Environmental_exposures">Environmental exposures</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=3" title="Edit section: Environmental exposures"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:DDTHCL.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/DDTHCL.svg/220px-DDTHCL.svg.png" decoding="async" width="220" height="66" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/DDTHCL.svg/330px-DDTHCL.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/24/DDTHCL.svg/440px-DDTHCL.svg.png 2x" data-file-width="570" data-file-height="171" /></a><figcaption>DDT and its metabolite, DDE</figcaption></figure><p>Chemical toxins in the environment are one of many factors influencing adolescent development. In the early 1970s, more than 4000 people were accidentally exposed to polybrominated biphenyls (PBBs).<sup id="cite_ref-:3_5-0" class="reference"><a href="#cite_note-:3-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> A study was conducted in the child-bearing women exposed to the toxin, with their baby girls reaching menarche by the age of 11.6 years, compared to girls who had low exposure reaching menarche by the age of 12.2–12.6 years.<sup id="cite_ref-:3_5-1" class="reference"><a href="#cite_note-:3-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In everyday life, people are exposed to a various number of pesticides, with a large amount found to be disruptive to the endocrine system. Although dichlorodiphenyltrichloroethane (DDT) and the metabolite dichlorodiphenyl dichloroethane (DDE) were banned in the United States in the 1970s, countries around the world are still using these pesticides.<sup id="cite_ref-:3_5-2" class="reference"><a href="#cite_note-:3-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><div class="mw-heading mw-heading3"><h3 id="Geographical_location_and_nutritional_needs">Geographical location and nutritional needs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=4" title="Edit section: Geographical location and nutritional needs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Geographical location and zones also plays a part in the timing of pubarche. A study was done in different zones in Nigeria and found that males in the Northeast, Northwest, and Southwest had an earlier timing of pubarche compared to the males in the Southeast, whereas females had delayed pubarche in the Southeast regions of Nigeria.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Within these regions, socio-economic classes were also taken into consideration. They found that households with a higher economic status posed an increased risk of premature, or an early onset of pubarche, possibly related to food being easily accessible. Nutrition is vital in adolescent development. Failure to meeting average nutritional needs, such as calcium and vitamin D for bone growth,<sup id="cite_ref-:42_7-0" class="reference"><a href="#cite_note-:42-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> may result in growth stunting. Over-nourishment and/or living a sedentary lifestyle can lead to obesity which can also affect adolescent pubarche.<sup id="cite_ref-:42_7-1" class="reference"><a href="#cite_note-:42-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The Dietary Guidelines for Americans 2010 declared that females between the ages of 9 to 13 year should meet a caloric intake of 1400 to 2200, while females between the ages of 14 to 18 years should meet a caloric intake of 1800 to 2400 calories a day.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Premature_pubarche">Premature pubarche</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=5" title="Edit section: Premature pubarche"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Premature pubarche, or <i>precocious pubarche</i>, refers to the appearance of pubic hair before the age of 8 in females or before the age of 9 in males.<sup id="cite_ref-:6_9-0" class="reference"><a href="#cite_note-:6-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Premature pubarche is one marker of "incomplete, partial, or dissociated precocious puberty", where incomplete puberty refers to the premature development of one secondary sexual characteristic, such as <a href="/wiki/Premature_thelarche" title="Premature thelarche">premature thelarche</a> or premature pubarche.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Premature <a href="/wiki/Adrenarche" title="Adrenarche">adrenarche</a>,<sup id="cite_ref-Normal_and_Premature_Adrenarche_11-0" class="reference"><a href="#cite_note-Normal_and_Premature_Adrenarche-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> as indicated by elevated levels of steroids that are naturally produced by the body (e.g., <a href="/wiki/Dehydroepiandrosterone_sulfate" title="Dehydroepiandrosterone sulfate">DHEAS</a>), is the most common cause of premature pubarche. Premature pubarche is linked to adrenarcheal androgen levels with dehydroepiandrosterone sulfate (DHEAS) of 40–130 ųg/dL.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>However, premature pubarche may also arise independently of adrenarche. Premature pubarche is a subset of precocious puberty which divide into 1) true precocious puberty that includes complete and central precocious puberty and 2) incomplete puberty which has 3 subsets: premature thelacrche, premature pubarche and isolated menarche.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> When <a href="/wiki/Adrenarche" title="Adrenarche">adrenarche</a>, an increase in adrenal androgen production, central puberty,<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> and all disease-causing conditions have been excluded, the term <i>isolated premature pubarche</i> is used to describe the unexplained development of pubic hair at an early age in people without other hormonal or physical changes of puberty. Other potential indicators of <a href="/wiki/Precocious_puberty" title="Precocious puberty">premature puberty</a> should also be considered when diagonosing premature pubarche, such as <a href="/wiki/Hyperandrogenism" title="Hyperandrogenism">hyperandrogenemia</a> (high levels of androgen in the blood) and <a href="/wiki/Virilization" title="Virilization">virilization</a>. </p><p>Premature pubarche is also a symptom of other hormone- and puberty-related medical conditions, including <a href="/wiki/Polycystic_ovary_syndrome" title="Polycystic ovary syndrome">polycystic ovary syndrome</a>, and classic and non-classic <a href="/wiki/Congenital_adrenal_hyperplasia" title="Congenital adrenal hyperplasia">congenital adrenal hyperplasia</a>.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Clinical_Examination">Clinical Examination</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=6" title="Edit section: Clinical Examination"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>When premature pubarche has been identified, the clinical examination primarily involves the assessment of signs indicating an elevation of androgens in the body, as well as overall body growth and bone age. If these factors appear normal, it is considered "simple premature pubarche", and it is recommended to monitor its progression to distinguish between central precious puberty or adolescent polycystic ovary syndrome. If these factors, especially body growth and bone age, appear to increase faster than usual, tests for various hormones may be ordered. These tests may include <a href="/wiki/Testosterone" title="Testosterone">testosterone</a>, <a href="/wiki/17-OH-progesterone" class="mw-redirect" title="17-OH-progesterone">17-OH</a>, <a href="/wiki/Dehydroepiandrosterone_sulfate" title="Dehydroepiandrosterone sulfate">DHEAS</a>, and <a href="/wiki/Synacthen_test" class="mw-redirect" title="Synacthen test">Synacthen test</a>.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Treatment">Treatment</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=7" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Scientists have traditionally thought that premature pubarche has no significant effect to the body, and this is reflected in the lack of a scientific consensus with respect to treatment of premature pubarche. However, it has now been shown clinically that it could be a forerunner of the metabolic syndrome, a cause clinical ovarian androgen excess and <a href="/wiki/Hyperinsulinemia" title="Hyperinsulinemia">hyperinsulinemia</a> in adolescence. Studies have shown that females with premature pubarche and lower birth weight obtained reduced height as adults because of early onset of puberty and a shorter duration of puberty. There is ongoing study on <a href="/wiki/Metformin" title="Metformin">metformin</a> therapy in these females with the goal to improve final height. The use of metformin has been shown clinically to prevent ovarian hyperandrogenism development in females with premature pubarche. A randomized control trial studied the effect of metformin 850 mg daily for 12 months compared to placebo. The results show that all abnormalities regarding insulini sensitivity, serum androgens, lipids, total and truncal fat mass, and lean body mass were reversed within 6 months. The untreated group had data that continued to deviate from the normal range. Later on, a cohort study replicated these results.<sup id="cite_ref-:6_9-1" class="reference"><a href="#cite_note-:6-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Delayed_pubarche">Delayed pubarche</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=8" title="Edit section: Delayed pubarche"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Delayed pubarche can be caused by numerous aspects. This can include insufficient hormones, medical or genetic conditions (i.e., <a href="/wiki/Turner_syndrome" title="Turner syndrome">Turner syndrome</a>, <a href="/wiki/Hypogonadotropic_hypogonadism" title="Hypogonadotropic hypogonadism">hypogonadotropic hypogonadism</a>), and chemicals that interfere with the hormones in the body. In young males, genetic differences that impacts the function of enzymes can affect how steroids are eliminated in urine. This can influence the development of pubic hair and can impact the physical appearance from person to person.<sup id="cite_ref-:0_17-0" class="reference"><a href="#cite_note-:0-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> In young females, the development of breasts and pubic hair can occur at different times. Some may experience breast development before the start of pubic hair growth, and vice versa. Therefore, in order to determine if delayed pubarche is a health issue or not, looking for the signs of puberty happening and the specific timing of it is important to note. The determination of the underlying cause of delayed pubarche can be done so with specific tests of antibodies, <a href="/wiki/Karyotype" title="Karyotype">karyotype</a>, and hormone levels (i.e., <a href="/wiki/Cortisol" title="Cortisol">cortisol</a>, <a href="/wiki/Thyroid-stimulating_hormone" title="Thyroid-stimulating hormone">thyroid stimulating hormone</a>).<sup id="cite_ref-:0_17-1" class="reference"><a href="#cite_note-:0-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Adrenal_Insufficiency">Adrenal Insufficiency</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=9" title="Edit section: Adrenal Insufficiency"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Adrenal_Gland_detail_-_English.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/88/Adrenal_Gland_detail_-_English.png/220px-Adrenal_Gland_detail_-_English.png" decoding="async" width="220" height="110" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/88/Adrenal_Gland_detail_-_English.png/330px-Adrenal_Gland_detail_-_English.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/88/Adrenal_Gland_detail_-_English.png/440px-Adrenal_Gland_detail_-_English.png 2x" data-file-width="1985" data-file-height="996" /></a><figcaption>Adrenal gland</figcaption></figure> <p><a href="/wiki/Adrenal_insufficiency" title="Adrenal insufficiency">Adrenal insufficiency</a> is a life-threatening medical condition in which the adrenal gland is damaged. This leads to not enough hormones being produced, which include <a href="/wiki/Glucocorticoid" title="Glucocorticoid">glucocorticoids</a> and <a href="/wiki/Mineralocorticoid" title="Mineralocorticoid">mineralcorticoids</a>. These types of hormones are crucial for the regulation of many functions in the body and with not enough levels of these hormones that are produced by the <a href="/wiki/Adrenal_gland" title="Adrenal gland">adrenal glands</a>, it can lead to <a href="/wiki/Primary_adrenal_insufficiency" class="mw-redirect" title="Primary adrenal insufficiency">primary adrenal insufficiency</a>. Delayed pubarche can be expected in young individuals with this medical condition due to the lack of hormones that aid for pubic hair growth. Therefore, if signs and symptoms of adrenal insufficiency are present such as fatigue, weakness, abdominal pain, or any history an autoimmune disease, adrenal insufficiency should be taken into consideration as an underlying cause for delayed pubarche.<sup id="cite_ref-:0_17-2" class="reference"><a href="#cite_note-:0-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_19-0" class="reference"><a href="#cite_note-:1-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Turner_Syndrome">Turner Syndrome</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=10" title="Edit section: Turner Syndrome"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Turner_syndrome" title="Turner syndrome">Turner syndrome</a> is a genetic condition that affects the nerves and brain, which can lead to certain physical and clinical features such as a greater chance for certain diseases, shortness in height, or abnormal heartbeat sounds.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> For some individuals with Turner syndrome, the sign and growth of pubic hair can sometimes be delayed or even be absent. This is especially in females with Turner syndrome who have <a href="/wiki/Primary_ovarian_insufficiency" title="Primary ovarian insufficiency">premature ovarian failure</a>. One possible explanation for this is that ovaries are important for the adrenal gland regulation of <a href="/wiki/Dehydroepiandrosterone" title="Dehydroepiandrosterone">dehydropiandrosterone</a> (DHEA).<sup id="cite_ref-Normal_and_Premature_Adrenarche_11-1" class="reference"><a href="#cite_note-Normal_and_Premature_Adrenarche-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> The role of DHEA is to be transformed into various androgens, which play a crucial role during pubarche. Therefore, much high levels of androgens may be required in order to meet the levels of androgens in comparison to ovaries that work properly. </p> <div class="mw-heading mw-heading3"><h3 id="Hypogonadotropic_Hypogonadism">Hypogonadotropic Hypogonadism</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=11" title="Edit section: Hypogonadotropic Hypogonadism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Another cause of delayed puberty in both males and females is hypogonadotropic hypogonadism,<sup id="cite_ref-:2_21-0" class="reference"><a href="#cite_note-:2-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> which is a condition in which the male and female genitalia produce little to none of the sex hormones. This is a temporary condition in adolescents, usually caused by various stresses, including disease states such as asthma, ulcerative colitis, and sickle cell anemia.<sup id="cite_ref-:2_21-1" class="reference"><a href="#cite_note-:2-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Specifically in males, this condition will result in low testosterone levels. Low levels of testosterone can cause levels of other hormones to rise, such as the luteinizing hormone (LH), the follicle-stimulating hormone (FSH), and the gonadotropin-releasing hormone (GnRH).<sup id="cite_ref-:2_21-2" class="reference"><a href="#cite_note-:2-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Hypogonadotropic hypogonadism is more prevalent in females, which usually develops under conditions such as anorexia nervosa or if the female individual participates in an abundant amount of exercise. With these situations decreasing body fat, both estrogen production and secretion will also decrease resulting in delayed puberty, and with it, delayed pubarche. Other health conditions that can cause hypogonadotropic hypogonadism include ovarian failure and autoimmune diseases of the ovaries. Regardless of whether hypogonadotropic hypogonadism is acquired or congenital in males and females, it is always important for providers to conduct detailed family and social histories. </p> <div class="mw-heading mw-heading3"><h3 id="Treatment_2">Treatment</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=12" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>With a lack of secondary sources to provide standardized procedures or guidelines to follow in treating delayed pubarche, many studies have been used to find formulations that work best in both males and females. In males diagnosed with constitutional delay in puberty and growth (CDPG), a short-course of testosterone in low doses is used to initiate puberty. In females diagnosed with CDPG, a short-course of estrogen in low doses is used to initiate puberty.<sup id="cite_ref-:2_21-3" class="reference"><a href="#cite_note-:2-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Testosterone is available via oral route or intramuscular injection (IM), with IM being the preferred method of administration because oral testosterone has been shown to have liver toxicity side effects. Estrogen is available via oral route and IM, however oral estrogen is the preferred method of administration.<sup id="cite_ref-:2_21-4" class="reference"><a href="#cite_note-:2-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Upon initiation of treatment and thereafter, the adolescent must be monitored for pubertal development, which includes breast development in females and enlargement of the testicles in males.<sup id="cite_ref-:2_21-5" class="reference"><a href="#cite_note-:2-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> A provider can make a clinical judgment to stop treatment and monitor development while an adolescent is off therapy. </p><p>There seems to be no guideline or standard treatment for hypogonadotropic hypogonadism, however the table below (Table 2) shows different formulations of the treatments available as well as the initial doses and adult doses.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> The estrogen and progesterone formulation, also known as an oral contraceptive or hormonal birth control, should not be used to induce puberty. The transdermal and oral formulation of testosterone is also not preferred to induce puberty in males. </p> <table class="wikitable"> <caption>Table 2. Formulations of Estrogen, Progesterone, and Testosterone Treatment </caption> <tbody><tr> <th> </th> <th>Brand Name </th> <th>Initiation Dose </th> <th>Adult Dose </th></tr> <tr> <td><b>Estrogen Formulation</b> </td> <td> </td> <td> </td> <td> </td></tr> <tr> <td>Transdermal </td> <td>Vivelle </td> <td>6.25–12.5 mcg twice daily </td> <td>25–100 mcg twice weekly </td></tr> <tr> <td>Oral </td> <td>Estrace </td> <td>0.35 mg daily </td> <td>1–4 mg daily </td></tr> <tr> <td><b>Progesterone Formulation</b> </td> <td> </td> <td> </td> <td> </td></tr> <tr> <td>Oral </td> <td>Provera </td> <td>Added after first vaginal bleed or after 2 years of treatment </td> <td>10 mg day for 10 days each month <p>100–200 mg daily for 10–21 days each month </p> </td></tr> <tr> <td><b>Testosterone Formulation</b> </td> <td> </td> <td> </td> <td> </td></tr> <tr> <td>Intramuscular </td> <td>Depot-Testosterone </td> <td>50–100 mg monthly </td> <td>200–250 mg every 2–4 weeks </td></tr></tbody></table> <p>In patients with Turner syndrome (TS), treatment formulations differ. The initiation dose is a fraction of the adult dose in most cases but this can also differ between different formulations available. In females, doses are started low and slowly titrated up over years.<sup id="cite_ref-:4_23-0" class="reference"><a href="#cite_note-:4-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Oral formulations are not preferred because they pose for the risk of first-pass metabolism, affecting the normal function of the liver. The preferred administration of estrogen is transdermal, such as a patch. A study found that the females with TS using the transdermal estrogen formulation had an improved bone mineral content and uterine development.<sup id="cite_ref-:4_23-1" class="reference"><a href="#cite_note-:4-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=13" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Puberty" title="Puberty">Puberty</a></li> <li><a href="/wiki/Adrenarche" title="Adrenarche">Adrenarche</a></li> <li><a href="/wiki/Gonadarche" title="Gonadarche">Gonadarche</a></li> <li><a href="/wiki/Thelarche" title="Thelarche">Thelarche</a></li> <li><a href="/wiki/Menarche" title="Menarche">Menarche</a></li> <li><a href="/wiki/Spermarche" title="Spermarche">Spermarche</a></li> <li><a href="/wiki/Androgen" title="Androgen">Androgen</a></li> <li><a href="/wiki/Estrogen" title="Estrogen">Estrogen</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=14" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.merriam-webster.com/medical/pubarche">"Medical Definition of PUBARCHE"</a>. <i>www.merriam-webster.com</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2023-07-27</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.merriam-webster.com&rft.atitle=Medical+Definition+of+PUBARCHE&rft_id=https%3A%2F%2Fwww.merriam-webster.com%2Fmedical%2Fpubarche&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAvila2023" class="citation book cs1">Avila JT (2023-01-01). "Normal adolescent growth and development". In Halpern-Felsher B (ed.). <i>Encyclopedia of Child and Adolescent Health</i> (First ed.). Oxford: Academic Press. pp. 735–745. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fb978-0-12-818872-9.00011-x">10.1016/b978-0-12-818872-9.00011-x</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-12-818873-6" title="Special:BookSources/978-0-12-818873-6"><bdi>978-0-12-818873-6</bdi></a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:234101888">234101888</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Normal+adolescent+growth+and+development&rft.btitle=Encyclopedia+of+Child+and+Adolescent+Health&rft.place=Oxford&rft.pages=735-745&rft.edition=First&rft.pub=Academic+Press&rft.date=2023-01-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A234101888%23id-name%3DS2CID&rft_id=info%3Adoi%2F10.1016%2Fb978-0-12-818872-9.00011-x&rft.isbn=978-0-12-818873-6&rft.aulast=Avila&rft.aufirst=JT&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBiroHuangDanielsLucky2008" class="citation journal cs1">Biro FM, Huang B, Daniels SR, Lucky AW (December 2008). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576862">"Pubarche as well as thelarche may be a marker for the onset of puberty"</a>. <i>Journal of Pediatric and Adolescent Gynecology</i>. <b>21</b> (6): 323–328. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jpag.2007.09.008">10.1016/j.jpag.2007.09.008</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576862">3576862</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19064225">19064225</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Pediatric+and+Adolescent+Gynecology&rft.atitle=Pubarche+as+well+as+thelarche+may+be+a+marker+for+the+onset+of+puberty&rft.volume=21&rft.issue=6&rft.pages=323-328&rft.date=2008-12&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3576862%23id-name%3DPMC&rft_id=info%3Apmid%2F19064225&rft_id=info%3Adoi%2F10.1016%2Fj.jpag.2007.09.008&rft.aulast=Biro&rft.aufirst=FM&rft.au=Huang%2C+B&rft.au=Daniels%2C+SR&rft.au=Lucky%2C+AW&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3576862&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCampisiMarchandSiddiquiIslam2020" class="citation journal cs1">Campisi SC, Marchand JD, Siddiqui FJ, Islam M, Bhutta ZA, Palmert MR (August 2020). <a rel="nofollow" class="external text" href="https://doi.org/10.1210%2Fclinem%2Fdgaa135">"Can we rely on adolescents to self-assess puberty stage? A systematic review and meta-analysis"</a>. <i>The Journal of Clinical Endocrinology and Metabolism</i>. <b>105</b> (8): 2846–2856. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1210%2Fclinem%2Fdgaa135">10.1210/clinem/dgaa135</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32179891">32179891</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:212739533">212739533</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Journal+of+Clinical+Endocrinology+and+Metabolism&rft.atitle=Can+we+rely+on+adolescents+to+self-assess+puberty+stage%3F+A+systematic+review+and+meta-analysis&rft.volume=105&rft.issue=8&rft.pages=2846-2856&rft.date=2020-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A212739533%23id-name%3DS2CID&rft_id=info%3Apmid%2F32179891&rft_id=info%3Adoi%2F10.1210%2Fclinem%2Fdgaa135&rft.aulast=Campisi&rft.aufirst=SC&rft.au=Marchand%2C+JD&rft.au=Siddiqui%2C+FJ&rft.au=Islam%2C+M&rft.au=Bhutta%2C+ZA&rft.au=Palmert%2C+MR&rft_id=https%3A%2F%2Fdoi.org%2F10.1210%252Fclinem%252Fdgaa135&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-:3-5"><span class="mw-cite-backlink">^ <a href="#cite_ref-:3_5-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:3_5-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:3_5-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFisherEugster2014" class="citation journal cs1">Fisher MM, Eugster EA (April 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096833">"What is in our environment that effects puberty?"</a>. <i>Reproductive Toxicology</i>. <b>44</b>: 7–14. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.reprotox.2013.03.012">10.1016/j.reprotox.2013.03.012</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096833">4096833</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23602892">23602892</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Reproductive+Toxicology&rft.atitle=What+is+in+our+environment+that+effects+puberty%3F&rft.volume=44&rft.pages=7-14&rft.date=2014-04&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4096833%23id-name%3DPMC&rft_id=info%3Apmid%2F23602892&rft_id=info%3Adoi%2F10.1016%2Fj.reprotox.2013.03.012&rft.aulast=Fisher&rft.aufirst=MM&rft.au=Eugster%2C+EA&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4096833&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFagbamigbeObiyanFawole2022" class="citation journal cs1">Fagbamigbe AF, Obiyan M, Fawole OI (Nov 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678277">"Gender differentials in the timing and prognostic factors of pubarche in Nigeria"</a>. <i>PLOS ONE</i>. <b>17</b> (11): e0277844. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2022PLoSO..1777844F">2022PLoSO..1777844F</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pone.0277844">10.1371/journal.pone.0277844</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678277">9678277</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/36409757">36409757</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=PLOS+ONE&rft.atitle=Gender+differentials+in+the+timing+and+prognostic+factors+of+pubarche+in+Nigeria&rft.volume=17&rft.issue=11&rft.pages=e0277844&rft.date=2022-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9678277%23id-name%3DPMC&rft_id=info%3Apmid%2F36409757&rft_id=info%3Adoi%2F10.1371%2Fjournal.pone.0277844&rft_id=info%3Abibcode%2F2022PLoSO..1777844F&rft.aulast=Fagbamigbe&rft.aufirst=AF&rft.au=Obiyan%2C+M&rft.au=Fawole%2C+OI&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9678277&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-:42-7"><span class="mw-cite-backlink">^ <a href="#cite_ref-:42_7-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:42_7-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDasSalamThornburgPrentice2017" class="citation journal cs1">Das JK, Salam RA, Thornburg KL, Prentice AM, Campisi S, Lassi ZS, et al. (April 2017). <a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fnyas.13330">"Nutrition in adolescents: physiology, metabolism, and nutritional needs"</a>. <i>Annals of the New York Academy of Sciences</i>. <b>1393</b> (1): 21–33. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2017NYASA1393...21D">2017NYASA1393...21D</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fnyas.13330">10.1111/nyas.13330</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28436102">28436102</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:572300">572300</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Annals+of+the+New+York+Academy+of+Sciences&rft.atitle=Nutrition+in+adolescents%3A+physiology%2C+metabolism%2C+and+nutritional+needs&rft.volume=1393&rft.issue=1&rft.pages=21-33&rft.date=2017-04&rft_id=info%3Adoi%2F10.1111%2Fnyas.13330&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A572300%23id-name%3DS2CID&rft_id=info%3Apmid%2F28436102&rft_id=info%3Abibcode%2F2017NYASA1393...21D&rft.aulast=Das&rft.aufirst=JK&rft.au=Salam%2C+RA&rft.au=Thornburg%2C+KL&rft.au=Prentice%2C+AM&rft.au=Campisi%2C+S&rft.au=Lassi%2C+ZS&rft.au=Koletzko%2C+B&rft.au=Bhutta%2C+ZA&rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fnyas.13330&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-8">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSolimanDe_SanctisElalaily2014" class="citation journal cs1">Soliman A, De Sanctis V, Elalaily R (November 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266867">"Nutrition and pubertal development"</a>. <i>Indian Journal of Endocrinology and Metabolism</i>. <b>18</b> (Suppl 1): S39–S47. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4103%2F2230-8210.145073">10.4103/2230-8210.145073</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266867">4266867</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25538876">25538876</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Indian+Journal+of+Endocrinology+and+Metabolism&rft.atitle=Nutrition+and+pubertal+development&rft.volume=18&rft.issue=Suppl+1&rft.pages=S39-S47&rft.date=2014-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4266867%23id-name%3DPMC&rft_id=info%3Apmid%2F25538876&rft_id=info%3Adoi%2F10.4103%2F2230-8210.145073&rft.aulast=Soliman&rft.aufirst=A&rft.au=De+Sanctis%2C+V&rft.au=Elalaily%2C+R&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4266867&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-:6-9"><span class="mw-cite-backlink">^ <a href="#cite_ref-:6_9-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:6_9-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFIbáñezDíazLópez-BermejoMarcos2009" class="citation journal cs1">Ibáñez, Lourdes; Díaz, Rubén; López-Bermejo, Abel; Marcos, Maria Victoria (March 2009). <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18726694/">"Clinical spectrum of premature pubarche: links to metabolic syndrome and ovarian hyperandrogenism"</a>. <i>Reviews in Endocrine & Metabolic Disorders</i>. <b>10</b> (1): 63–76. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs11154-008-9096-y">10.1007/s11154-008-9096-y</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1389-9155">1389-9155</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18726694">18726694</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Reviews+in+Endocrine+%26+Metabolic+Disorders&rft.atitle=Clinical+spectrum+of+premature+pubarche%3A+links+to+metabolic+syndrome+and+ovarian+hyperandrogenism&rft.volume=10&rft.issue=1&rft.pages=63-76&rft.date=2009-03&rft.issn=1389-9155&rft_id=info%3Apmid%2F18726694&rft_id=info%3Adoi%2F10.1007%2Fs11154-008-9096-y&rft.aulast=Ib%C3%A1%C3%B1ez&rft.aufirst=Lourdes&rft.au=D%C3%ADaz%2C+Rub%C3%A9n&rft.au=L%C3%B3pez-Bermejo%2C+Abel&rft.au=Marcos%2C+Maria+Victoria&rft_id=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F18726694%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFJuulHagenAksglaedeSørensen2012" class="citation book cs1">Juul A, Hagen CP, Aksglaede L, Sørensen K, Mouritsen A, Frederiksen H, et al. (Jul 2012). "Endocrine evaluation of reproductive function in girls during infancy, childhood and adolescence.". In Sultan C (ed.). <a rel="nofollow" class="external text" href="https://karger.com/books/book/2694/Pediatric-and-Adolescent-GynecologyEvidence-Based"><i>Pediatric and Adolescent Gynecology: Evidence-Based Clinical Practice</i></a>. Endocrine Development. Vol. 22. S. Karger AG. pp. 24–39. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000326625">10.1159/000326625</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-3-8055-9337-3" title="Special:BookSources/978-3-8055-9337-3"><bdi>978-3-8055-9337-3</bdi></a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22846519">22846519</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Endocrine+evaluation+of+reproductive+function+in+girls+during+infancy%2C+childhood+and+adolescence.&rft.btitle=Pediatric+and+Adolescent+Gynecology%3A+Evidence-Based+Clinical+Practice&rft.series=Endocrine+Development&rft.pages=24-39&rft.pub=S.+Karger+AG&rft.date=2012-07&rft_id=info%3Apmid%2F22846519&rft_id=info%3Adoi%2F10.1159%2F000326625&rft.isbn=978-3-8055-9337-3&rft.aulast=Juul&rft.aufirst=A&rft.au=Hagen%2C+CP&rft.au=Aksglaede%2C+L&rft.au=S%C3%B8rensen%2C+K&rft.au=Mouritsen%2C+A&rft.au=Frederiksen%2C+H&rft.au=Main%2C+KM&rft.au=Mogensen%2C+SS&rft.au=Pedersen%2C+AT&rft_id=https%3A%2F%2Fkarger.com%2Fbooks%2Fbook%2F2694%2FPediatric-and-Adolescent-GynecologyEvidence-Based&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-Normal_and_Premature_Adrenarche-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-Normal_and_Premature_Adrenarche_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Normal_and_Premature_Adrenarche_11-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRosenfield2021" class="citation journal cs1">Rosenfield RL (November 2021). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599200">"Normal and Premature Adrenarche"</a>. <i>Endocrine Reviews</i>. <b>42</b> (6): 783–814. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1210%2Fendrev%2Fbnab009">10.1210/endrev/bnab009</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599200">8599200</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33788946">33788946</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Endocrine+Reviews&rft.atitle=Normal+and+Premature+Adrenarche&rft.volume=42&rft.issue=6&rft.pages=783-814&rft.date=2021-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8599200%23id-name%3DPMC&rft_id=info%3Apmid%2F33788946&rft_id=info%3Adoi%2F10.1210%2Fendrev%2Fbnab009&rft.aulast=Rosenfield&rft.aufirst=RL&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8599200&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://doi.org/10.1016/B978-1-4160-4090-3.X5001-7"><i>Pediatric Endocrinology</i></a>. 2008. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fb978-1-4160-4090-3.x5001-7">10.1016/b978-1-4160-4090-3.x5001-7</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9781416040903" title="Special:BookSources/9781416040903"><bdi>9781416040903</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Pediatric+Endocrinology&rft.date=2008&rft_id=info%3Adoi%2F10.1016%2Fb978-1-4160-4090-3.x5001-7&rft.isbn=9781416040903&rft_id=https%3A%2F%2Fdoi.org%2F10.1016%2FB978-1-4160-4090-3.X5001-7&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-13">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSultanGaspariMaimounKalfa2018" class="citation journal cs1">Sultan, Charles; Gaspari, Laura; Maimoun, Laurent; Kalfa, Nicolas; Paris, Françoise (April 2018). <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29422239/">"Disorders of puberty"</a>. <i>Best Practice & Research. Clinical Obstetrics & Gynaecology</i>. <b>48</b>: 62–89. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.bpobgyn.2017.11.004">10.1016/j.bpobgyn.2017.11.004</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1532-1932">1532-1932</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29422239">29422239</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Best+Practice+%26+Research.+Clinical+Obstetrics+%26+Gynaecology&rft.atitle=Disorders+of+puberty&rft.volume=48&rft.pages=62-89&rft.date=2018-04&rft.issn=1532-1932&rft_id=info%3Apmid%2F29422239&rft_id=info%3Adoi%2F10.1016%2Fj.bpobgyn.2017.11.004&rft.aulast=Sultan&rft.aufirst=Charles&rft.au=Gaspari%2C+Laura&rft.au=Maimoun%2C+Laurent&rft.au=Kalfa%2C+Nicolas&rft.au=Paris%2C+Fran%C3%A7oise&rft_id=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F29422239%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-14">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLatronicoBritoCarel2016" class="citation journal cs1">Latronico AC, Brito VN, Carel JC (March 2016). "Causes, diagnosis, and treatment of central precocious puberty". <i>The Lancet. Diabetes & Endocrinology</i>. <b>4</b> (3): 265–274. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs2213-8587%2815%2900380-0">10.1016/s2213-8587(15)00380-0</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26852255">26852255</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Lancet.+Diabetes+%26+Endocrinology&rft.atitle=Causes%2C+diagnosis%2C+and+treatment+of+central+precocious+puberty&rft.volume=4&rft.issue=3&rft.pages=265-274&rft.date=2016-03&rft_id=info%3Adoi%2F10.1016%2Fs2213-8587%2815%2900380-0&rft_id=info%3Apmid%2F26852255&rft.aulast=Latronico&rft.aufirst=AC&rft.au=Brito%2C+VN&rft.au=Carel%2C+JC&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-15">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWitchel2017" class="citation journal cs1">Witchel SF (October 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624825">"Congenital Adrenal Hyperplasia"</a>. <i>Journal of Pediatric and Adolescent Gynecology</i>. <b>30</b> (5): 520–534. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jpag.2017.04.001">10.1016/j.jpag.2017.04.001</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624825">5624825</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28450075">28450075</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Pediatric+and+Adolescent+Gynecology&rft.atitle=Congenital+Adrenal+Hyperplasia&rft.volume=30&rft.issue=5&rft.pages=520-534&rft.date=2017-10&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5624825%23id-name%3DPMC&rft_id=info%3Apmid%2F28450075&rft_id=info%3Adoi%2F10.1016%2Fj.jpag.2017.04.001&rft.aulast=Witchel&rft.aufirst=SF&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5624825&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-16">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSultanGaspariKalfaParis2012" class="citation journal cs1">Sultan C, Gaspari L, Kalfa N, Paris F (July 2012). "Clinical expression of precocious puberty in girls". <i>Endocrine Development</i>. <b>22</b>: 84–100. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000334304">10.1159/000334304</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-3-8055-9336-6" title="Special:BookSources/978-3-8055-9336-6"><bdi>978-3-8055-9336-6</bdi></a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22846523">22846523</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Endocrine+Development&rft.atitle=Clinical+expression+of+precocious+puberty+in+girls&rft.volume=22&rft.pages=84-100&rft.date=2012-07&rft_id=info%3Apmid%2F22846523&rft_id=info%3Adoi%2F10.1159%2F000334304&rft.isbn=978-3-8055-9336-6&rft.aulast=Sultan&rft.aufirst=C&rft.au=Gaspari%2C+L&rft.au=Kalfa%2C+N&rft.au=Paris%2C+F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-:0-17"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_17-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_17-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:0_17-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBaldoBarbiTornese2021" class="citation journal cs1">Baldo F, Barbi E, Tornese G (September 2021). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422600">"Delayed pubarche"</a>. <i>Italian Journal of Pediatrics</i>. <b>47</b> (1): 180. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1186%2Fs13052-021-01134-0">10.1186/s13052-021-01134-0</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422600">8422600</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/34488834">34488834</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Italian+Journal+of+Pediatrics&rft.atitle=Delayed+pubarche&rft.volume=47&rft.issue=1&rft.pages=180&rft.date=2021-09&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8422600%23id-name%3DPMC&rft_id=info%3Apmid%2F34488834&rft_id=info%3Adoi%2F10.1186%2Fs13052-021-01134-0&rft.aulast=Baldo&rft.aufirst=F&rft.au=Barbi%2C+E&rft.au=Tornese%2C+G&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8422600&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGottliebPinskyBeitelTrifiro1999" class="citation journal cs1">Gottlieb B, Pinsky L, Beitel LK, Trifiro M (December 1999). "Androgen insensitivity". <i>American Journal of Medical Genetics</i>. <b>89</b> (4): 210–217. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F%28sici%291096-8628%2819991229%2989%3A4%3C210%3A%3Aaid-ajmg5%3E3.0.co%3B2-p">10.1002/(sici)1096-8628(19991229)89:4<210::aid-ajmg5>3.0.co;2-p</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10727996">10727996</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=American+Journal+of+Medical+Genetics&rft.atitle=Androgen+insensitivity&rft.volume=89&rft.issue=4&rft.pages=210-217&rft.date=1999-12&rft_id=info%3Adoi%2F10.1002%2F%28sici%291096-8628%2819991229%2989%3A4%3C210%3A%3Aaid-ajmg5%3E3.0.co%3B2-p&rft_id=info%3Apmid%2F10727996&rft.aulast=Gottlieb&rft.aufirst=B&rft.au=Pinsky%2C+L&rft.au=Beitel%2C+LK&rft.au=Trifiro%2C+M&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-:1-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-:1_19-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHueckerBhuttaDominique2023" class="citation book cs1">Huecker MR, Bhutta BS, Dominique E (April 2023). <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/books/NBK441832/">"Adrenal Insufficiency"</a>. <i>StatPearls</i>. Treasure Island (FL): StatPearls Publishing. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28722862">28722862</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Adrenal+Insufficiency&rft.btitle=StatPearls&rft.place=Treasure+Island+%28FL%29&rft.pub=StatPearls+Publishing&rft.date=2023-04&rft_id=info%3Apmid%2F28722862&rft.aulast=Huecker&rft.aufirst=MR&rft.au=Bhutta%2C+BS&rft.au=Dominique%2C+E&rft_id=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fbooks%2FNBK441832%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKesler2007" class="citation journal cs1">Kesler SR (July 2007). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2023872">"Turner syndrome"</a>. <i>Child and Adolescent Psychiatric Clinics of North America</i>. <b>16</b> (3): 709–722. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.chc.2007.02.004">10.1016/j.chc.2007.02.004</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2023872">2023872</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17562588">17562588</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Child+and+Adolescent+Psychiatric+Clinics+of+North+America&rft.atitle=Turner+syndrome&rft.volume=16&rft.issue=3&rft.pages=709-722&rft.date=2007-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2023872%23id-name%3DPMC&rft_id=info%3Apmid%2F17562588&rft_id=info%3Adoi%2F10.1016%2Fj.chc.2007.02.004&rft.aulast=Kesler&rft.aufirst=SR&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2023872&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-:2-21"><span class="mw-cite-backlink">^ <a href="#cite_ref-:2_21-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:2_21-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:2_21-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:2_21-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:2_21-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-:2_21-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTangZafar_GondalDamian2022" class="citation book cs1">Tang C, Zafar Gondal A, Damian M (August 2022). <a rel="nofollow" class="external text" href="http://www.ncbi.nlm.nih.gov/books/NBK544322/">"Delayed Puberty"</a>. <i>StatPearls</i>. Treasure Island (FL): StatPearls Publishing. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31335042">31335042</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Delayed+Puberty&rft.btitle=StatPearls&rft.place=Treasure+Island+%28FL%29&rft.pub=StatPearls+Publishing&rft.date=2022-08&rft_id=info%3Apmid%2F31335042&rft.aulast=Tang&rft.aufirst=C&rft.au=Zafar+Gondal%2C+A&rft.au=Damian%2C+M&rft_id=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fbooks%2FNBK544322%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-22">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGohilEugster2020" class="citation journal cs1">Gohil A, Eugster EA (December 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705597">"Delayed and Precocious Puberty: Genetic Underpinnings and Treatments"</a>. <i>Endocrinology and Metabolism Clinics of North America</i>. Pediatric Endocrinology. <b>49</b> (4): 741–757. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ecl.2020.08.002">10.1016/j.ecl.2020.08.002</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705597">7705597</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33153677">33153677</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Endocrinology+and+Metabolism+Clinics+of+North+America&rft.atitle=Delayed+and+Precocious+Puberty%3A+Genetic+Underpinnings+and+Treatments&rft.volume=49&rft.issue=4&rft.pages=741-757&rft.date=2020-12&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7705597%23id-name%3DPMC&rft_id=info%3Apmid%2F33153677&rft_id=info%3Adoi%2F10.1016%2Fj.ecl.2020.08.002&rft.aulast=Gohil&rft.aufirst=A&rft.au=Eugster%2C+EA&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7705597&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-:4-23"><span class="mw-cite-backlink">^ <a href="#cite_ref-:4_23-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:4_23-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFViswanathanEugster2011" class="citation journal cs1">Viswanathan V, Eugster EA (October 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102132">"Etiology and treatment of hypogonadism in adolescents"</a>. <i>Pediatric Clinics of North America</i>. Pediatric Endocrinology. <b>58</b> (5): 1181–200, x. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.pcl.2011.07.009">10.1016/j.pcl.2011.07.009</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102132">4102132</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21981955">21981955</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Pediatric+Clinics+of+North+America&rft.atitle=Etiology+and+treatment+of+hypogonadism+in+adolescents&rft.volume=58&rft.issue=5&rft.pages=1181-200%2C+x&rft.date=2011-10&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4102132%23id-name%3DPMC&rft_id=info%3Apmid%2F21981955&rft_id=info%3Adoi%2F10.1016%2Fj.pcl.2011.07.009&rft.aulast=Viswanathan&rft.aufirst=V&rft.au=Eugster%2C+EA&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4102132&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> <li id="cite_note-24"><span class="mw-cite-backlink"><b><a href="#cite_ref-24">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNabhanDimeglioQiPerkins2009" class="citation journal cs1">Nabhan ZM, Dimeglio LA, Qi R, Perkins SM, Eugster EA (June 2009). <a rel="nofollow" class="external text" href="https://doi.org/10.1210%2Fjc.2008-2123">"Conjugated oral versus transdermal estrogen replacement in girls with Turner syndrome: a pilot comparative study"</a>. <i>The Journal of Clinical Endocrinology and Metabolism</i>. <b>94</b> (6): 2009–2014. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1210%2Fjc.2008-2123">10.1210/jc.2008-2123</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19318455">19318455</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Journal+of+Clinical+Endocrinology+and+Metabolism&rft.atitle=Conjugated+oral+versus+transdermal+estrogen+replacement+in+girls+with+Turner+syndrome%3A+a+pilot+comparative+study&rft.volume=94&rft.issue=6&rft.pages=2009-2014&rft.date=2009-06&rft_id=info%3Adoi%2F10.1210%2Fjc.2008-2123&rft_id=info%3Apmid%2F19318455&rft.aulast=Nabhan&rft.aufirst=ZM&rft.au=Dimeglio%2C+LA&rft.au=Qi%2C+R&rft.au=Perkins%2C+SM&rft.au=Eugster%2C+EA&rft_id=https%3A%2F%2Fdoi.org%2F10.1210%252Fjc.2008-2123&rfr_id=info%3Asid%2Fen.wikipedia.org%3APubarche" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Pubarche&action=edit&section=15" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/924002-overview">e-medicine</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output .navbox-list-with-group{text-align:left;border-left-width:2px;border-left-style:solid}.mw-parser-output tr+tr>.navbox-abovebelow,.mw-parser-output tr+tr>.navbox-group,.mw-parser-output tr+tr>.navbox-image,.mw-parser-output tr+tr>.navbox-list{border-top:2px solid #fdfdfd}.mw-parser-output .navbox-title{background-color:#ccf}.mw-parser-output .navbox-abovebelow,.mw-parser-output .navbox-group,.mw-parser-output .navbox-subgroup .navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}</style></div><div role="navigation" class="navbox" aria-labelledby="Human_physiology_of_sexual_reproduction" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Human_reproductive_physiology" title="Template:Human reproductive physiology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Human_reproductive_physiology" title="Template talk:Human reproductive physiology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Human_reproductive_physiology" title="Special:EditPage/Template:Human reproductive physiology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Human_physiology_of_sexual_reproduction" style="font-size:114%;margin:0 4em"><a href="/wiki/Human_body" title="Human body">Human physiology</a> of <a href="/wiki/Human_reproduction" title="Human reproduction">sexual reproduction</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Menstrual_cycle" title="Menstrual cycle">Menstrual cycle</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Menarche" title="Menarche">Menarche</a></li> <li><a href="/wiki/Menstruation" title="Menstruation">Menstruation</a></li> <li><a href="/wiki/Follicular_phase" title="Follicular phase">Follicular phase</a></li> <li><a href="/wiki/Ovulation" title="Ovulation">Ovulation</a></li> <li><a href="/wiki/Luteal_phase" title="Luteal phase">Luteal phase</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gametogenesis" title="Gametogenesis">Gametogenesis</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Spermatogenesis" title="Spermatogenesis">Spermatogenesis</a> <ul><li><a href="/wiki/Spermatogonium" title="Spermatogonium">spermatogonium</a></li> <li><a href="/wiki/Spermatocyte" title="Spermatocyte">spermatocyte</a></li> <li><a href="/wiki/Spermatid" title="Spermatid">spermatid</a></li> <li><a href="/wiki/Sperm" title="Sperm">sperm</a></li></ul></li> <li><a href="/wiki/Oogenesis" title="Oogenesis">Oogenesis</a> <ul><li><a href="/wiki/Oogonium" title="Oogonium">oogonium</a></li> <li><a href="/wiki/Oocyte" title="Oocyte">oocyte</a></li> <li><a href="/wiki/Immature_ovum" title="Immature ovum">ootid</a></li> <li><a href="/wiki/Egg_cell" title="Egg cell">ovum</a></li></ul></li> <li><a href="/wiki/Germ_cell" title="Germ cell">Germ cell</a> <ul><li><a href="/wiki/Gonocyte" title="Gonocyte">gonocyte</a></li> <li><a href="/wiki/Gamete" title="Gamete">gamete</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_sexual_activity" title="Human sexual activity">Human sexual activity</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sexual_arousal" title="Sexual arousal">Sexual arousal</a></li> <li><a href="/wiki/Sexual_intercourse" title="Sexual intercourse">Sexual intercourse</a></li> <li><a href="/wiki/Masturbation" title="Masturbation">Masturbation</a></li> <li>Erection <ul><li><a href="/wiki/Erection" title="Erection">Penile</a></li> <li><a href="/wiki/Clitoral_erection" title="Clitoral erection">Clitoral</a></li></ul></li> <li><a href="/wiki/Orgasm" title="Orgasm">Orgasm</a></li> <li>Ejaculation <ul><li><a href="/wiki/Ejaculation" title="Ejaculation">Male</a></li> <li><a href="/wiki/Female_ejaculation" title="Female ejaculation">Female</a></li></ul></li> <li><a href="/wiki/Insemination" title="Insemination">Insemination</a></li> <li><a href="/wiki/Human_fertilization" title="Human fertilization">Fertilization</a> / <a href="/wiki/Fertility" title="Fertility">Fertility</a></li> <li><a href="/wiki/Implantation_(embryology)" title="Implantation (embryology)">Implantation</a></li> <li><a href="/wiki/Pregnancy" title="Pregnancy">Pregnancy</a></li> <li><a href="/wiki/Postpartum_period" title="Postpartum period">Postpartum period</a></li> <li><a href="/wiki/Mechanics_of_human_sexuality" title="Mechanics of human sexuality">Mechanics of sex</a></li> <li><a href="/wiki/Vaginal_lubrication" title="Vaginal lubrication">Vaginal lubrication</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Development_of_the_reproductive_system" title="Development of the reproductive system">Development of the<br /> reproductive system</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sexual_differentiation_in_humans" title="Sexual differentiation in humans">Sexual differentiation</a> <ul><li><a href="/wiki/Sexual_dimorphism" title="Sexual dimorphism">Sexual dimorphism</a></li> <li><a href="/wiki/Feminization_(biology)" title="Feminization (biology)">Feminization</a></li> <li><a href="/wiki/Virilization" title="Virilization">Virilization</a></li></ul></li> <li><a href="/wiki/Puberty" title="Puberty">Puberty</a> <ul><li><a href="/wiki/Gonadarche" title="Gonadarche">Gonadarche</a></li> <li><a href="/wiki/Tanner_scale" title="Tanner scale">Tanner scale</a></li> <li><a class="mw-selflink selflink">Pubarche</a></li> <li><a href="/wiki/Menarche" title="Menarche">Menarche</a></li> <li><a href="/wiki/Spermarche" title="Spermarche">Spermarche</a></li> <li><a href="/wiki/Adrenarche" title="Adrenarche">Adrenarche</a></li></ul></li> <li><a href="/wiki/Advanced_maternal_age" title="Advanced maternal age">Maternal age</a> / <a href="/wiki/Paternal_age_effect" title="Paternal age effect">Paternal age</a></li> <li><a href="/wiki/Menopause" title="Menopause">Menopause</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Egg" title="Egg">Egg</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Egg_cell" title="Egg cell">Ovum</a></li> <li><a href="/wiki/Viviparity" title="Viviparity">Vivipary</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Reproductive_endocrinology_and_infertility" title="Reproductive endocrinology and infertility">Reproductive endocrinology<br />and infertility</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis" title="Hypothalamic–pituitary–gonadal axis">Hypothalamic–pituitary–gonadal axis</a></li> <li><a href="/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93prolactin_axis" title="Hypothalamic–pituitary–prolactin axis">Hypothalamic–pituitary–prolactin axis</a></li> <li><a href="/wiki/Andrology" title="Andrology">Andrology</a></li> <li><a href="/wiki/Hormone" title="Hormone">Hormone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Breast" title="Breast">Breast</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Thelarche" title="Thelarche">Thelarche</a></li> <li><a href="/wiki/Breast_development" title="Breast development">Development</a></li> <li><a href="/wiki/Lactation" title="Lactation">Lactation</a></li> <li><a href="/wiki/Breastfeeding" title="Breastfeeding">Breastfeeding</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_reproductive_system" title="Human reproductive system">Human reproductive system</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Male_reproductive_system" title="Male reproductive system">Male</a></li> <li><a href="/wiki/Female_reproductive_system" title="Female reproductive system">Female</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Diseases and disorders</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anorgasmia" title="Anorgasmia">Anorgasmia</a></li> <li><a href="/wiki/Dysorgasmia" title="Dysorgasmia">Dysorgasmia</a></li> <li><a href="/wiki/Dyspareunia" title="Dyspareunia">Dyspareunia</a></li> <li><a href="/wiki/Erectile_dysfunction" title="Erectile dysfunction">Erectile dysfunction</a></li> <li><a href="/wiki/Hard_flaccid_syndrome" title="Hard flaccid syndrome">Hard flaccid syndrome</a></li> <li><a href="/wiki/Premature_ejaculation" title="Premature ejaculation">Premature ejaculation</a></li> <li><a href="/wiki/Vaginismus" title="Vaginismus">Vaginismus</a></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Pubarche&oldid=1251397987">https://en.wikipedia.org/w/index.php?title=Pubarche&oldid=1251397987</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Developmental_stages" title="Category:Developmental stages">Developmental stages</a></li><li><a href="/wiki/Category:Gynaecological_endocrinology" title="Category:Gynaecological endocrinology">Gynaecological endocrinology</a></li><li><a href="/wiki/Category:Human_development" title="Category:Human development">Human development</a></li><li><a href="/wiki/Category:Pubic_hair" title="Category:Pubic hair">Pubic hair</a></li><li><a href="/wiki/Category:Sexuality_and_age" title="Category:Sexuality and age">Sexuality and age</a></li></ul></div><div id="mw-hidden-catlinks" class="mw-hidden-catlinks mw-hidden-cats-hidden">Hidden categories: <ul><li><a href="/wiki/Category:Articles_with_short_description" title="Category:Articles with short description">Articles with short description</a></li><li><a href="/wiki/Category:Short_description_is_different_from_Wikidata" title="Category:Short description is different from Wikidata">Short description is different from Wikidata</a></li></ul></div></div> </div> </main> </div> <div class="mw-footer-container"> <footer id="footer" class="mw-footer" > <ul id="footer-info"> <li id="footer-info-lastmod"> This page was last edited on 15 October 2024, at 23:06<span class="anonymous-show"> (UTC)</span>.</li> <li id="footer-info-copyright">Text is available under the <a href="/wiki/Wikipedia:Text_of_the_Creative_Commons_Attribution-ShareAlike_4.0_International_License" title="Wikipedia:Text of the Creative Commons Attribution-ShareAlike 4.0 International License">Creative Commons Attribution-ShareAlike 4.0 License</a>; additional terms may apply. By using this site, you agree to the <a href="https://foundation.wikimedia.org/wiki/Special:MyLanguage/Policy:Terms_of_Use" class="extiw" title="foundation:Special:MyLanguage/Policy:Terms of Use">Terms of Use</a> and <a href="https://foundation.wikimedia.org/wiki/Special:MyLanguage/Policy:Privacy_policy" class="extiw" title="foundation:Special:MyLanguage/Policy:Privacy policy">Privacy Policy</a>. Wikipedia® is a registered trademark of the <a rel="nofollow" class="external text" href="https://wikimediafoundation.org/">Wikimedia Foundation, Inc.</a>, a non-profit organization.</li> </ul> <ul id="footer-places"> <li id="footer-places-privacy"><a href="https://foundation.wikimedia.org/wiki/Special:MyLanguage/Policy:Privacy_policy">Privacy policy</a></li> <li id="footer-places-about"><a href="/wiki/Wikipedia:About">About Wikipedia</a></li> <li id="footer-places-disclaimers"><a href="/wiki/Wikipedia:General_disclaimer">Disclaimers</a></li> <li id="footer-places-contact"><a href="//en.wikipedia.org/wiki/Wikipedia:Contact_us">Contact Wikipedia</a></li> <li id="footer-places-wm-codeofconduct"><a href="https://foundation.wikimedia.org/wiki/Special:MyLanguage/Policy:Universal_Code_of_Conduct">Code of Conduct</a></li> <li id="footer-places-developers"><a href="https://developer.wikimedia.org">Developers</a></li> <li id="footer-places-statslink"><a href="https://stats.wikimedia.org/#/en.wikipedia.org">Statistics</a></li> <li id="footer-places-cookiestatement"><a href="https://foundation.wikimedia.org/wiki/Special:MyLanguage/Policy:Cookie_statement">Cookie statement</a></li> <li id="footer-places-mobileview"><a href="//en.m.wikipedia.org/w/index.php?title=Pubarche&mobileaction=toggle_view_mobile" class="noprint stopMobileRedirectToggle">Mobile view</a></li> </ul> <ul id="footer-icons" class="noprint"> <li id="footer-copyrightico"><a href="https://wikimediafoundation.org/" class="cdx-button cdx-button--fake-button cdx-button--size-large cdx-button--fake-button--enabled"><img src="/static/images/footer/wikimedia-button.svg" width="84" height="29" alt="Wikimedia Foundation" loading="lazy"></a></li> <li id="footer-poweredbyico"><a href="https://www.mediawiki.org/" class="cdx-button cdx-button--fake-button cdx-button--size-large cdx-button--fake-button--enabled"><img src="/w/resources/assets/poweredby_mediawiki.svg" alt="Powered by MediaWiki" width="88" height="31" loading="lazy"></a></li> </ul> </footer> </div> </div> </div> <div class="vector-settings" id="p-dock-bottom"> <ul></ul> </div><script>(RLQ=window.RLQ||[]).push(function(){mw.config.set({"wgHostname":"mw-web.codfw.main-7dfb9d98f5-hq9ft","wgBackendResponseTime":128,"wgPageParseReport":{"limitreport":{"cputime":"0.472","walltime":"0.581","ppvisitednodes":{"value":1683,"limit":1000000},"postexpandincludesize":{"value":76856,"limit":2097152},"templateargumentsize":{"value":612,"limit":2097152},"expansiondepth":{"value":8,"limit":100},"expensivefunctioncount":{"value":2,"limit":500},"unstrip-depth":{"value":1,"limit":20},"unstrip-size":{"value":107804,"limit":5000000},"entityaccesscount":{"value":0,"limit":400},"timingprofile":["100.00% 503.428 1 -total"," 50.90% 256.235 1 Template:Reflist"," 19.69% 99.121 1 Template:Reproductive_physiology"," 18.81% 94.687 18 Template:Cite_journal"," 18.58% 93.531 1 Template:Navbox"," 16.34% 82.239 1 Template:Cite_web"," 13.89% 69.915 1 Template:Short_description"," 7.96% 40.077 2 Template:Pagetype"," 6.26% 31.518 5 Template:Cite_book"," 6.06% 30.491 1 Template:IPAc-en"]},"scribunto":{"limitreport-timeusage":{"value":"0.313","limit":"10.000"},"limitreport-memusage":{"value":5868845,"limit":52428800}},"cachereport":{"origin":"mw-web.codfw.main-f69cdc8f6-55zsq","timestamp":"20241122142805","ttl":2592000,"transientcontent":false}}});});</script> <script type="application/ld+json">{"@context":"https:\/\/schema.org","@type":"Article","name":"Pubarche","url":"https:\/\/en.wikipedia.org\/wiki\/Pubarche","sameAs":"http:\/\/www.wikidata.org\/entity\/Q490608","mainEntity":"http:\/\/www.wikidata.org\/entity\/Q490608","author":{"@type":"Organization","name":"Contributors to Wikimedia projects"},"publisher":{"@type":"Organization","name":"Wikimedia Foundation, Inc.","logo":{"@type":"ImageObject","url":"https:\/\/www.wikimedia.org\/static\/images\/wmf-hor-googpub.png"}},"datePublished":"2004-06-26T14:47:11Z","dateModified":"2024-10-15T23:06:30Z","headline":"the debut of pubic hair following the onset of puberty"}</script> </body> </html>