Puberty: advancements, delays, investigation and management Flashcards
Define puberty
Describes the physiological, morphological, and behavioural changes as the gonads switch from infantile to adult forms
What are the definitive signs of puberty in boys and girls?
- Girls: menarche - first menstrual bleeding
- Boys: first ejaculation, often nocturnal
- These do not signify fertility
What are the secondary sexual characteristics for girls?
Occur at puberty:
- Ovarian oestrogens regulate the growth of breast and female genitalia
- Ovarian and adrenal androgens control pubic and axillary hair
What are the secondary sexual characteristics for boys?
- Testicular androgens
- External genitalia and pubic hair growth
- enlargement of larynx and laryngeal muscles
→ voice deepening
What are Tanner stages?
A scale that defines physical measurements of development based on external primary and
secondary sex characteristics
Describe tanner stage 1 in boys
- Prepubertal: No pubic hair
- Testicular length <2.5 cm
- Testicular volume <3.0 mL
Describe tanner stage 2 in boys
- Sparse growth of slightly curly pubic hair, mainly base of penis
- Testes >3mL (>2.5cm in longest diameter)
- Scrotum thinning and reddening
Describe tanner stage 3 in boys
- Thicker, curlier hair spread to mons pubis
- Growth of penis in width and length; further growth of testes
Describe tanner stage 4 in boys
- Adult-type hair, not yet spread to medial surface of thighs
- Penis further enlarged; testes larger, darker scrotal skin colour
Describe tanner stage 5 in boys
- Adult-type hair spread to medial surface of thighs
- Genitalia adult size and shape
What instrument measures testicular volume in mL?
Orchidometer
Describe tanner stage 1 in girls
- Prepubertal: No pubic hair
- Elevation of papilla only
Describe tanner stage 2 in girls
- Sparse growth of long, straight or slightly curly, minimally pigmented hair, mainly on labia
- Breast bud noted/ palpable; enlargement of areola
Describe tanner stage 3 in girls
- Darker, coarser hair spreading over mons pubis
- Further enlargement of breast and areola, with no separation of contours
Describe tanner stage 4 in girls
- Thick adult-type hair, not yet spread to medial surface of thighs
- Projection of areola and papilla to form secondary mound above level of breast
Describe tanner stage 5 in girls
- Hair adult-type and distributed in classic inverse triangle
- Adult contour breast with projection of papilla only