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Normal puberty

Frank M Biro, MD
Yee-Ming Chan, MD, PhD
Section Editors
Teresa K Duryea, MD
Peter J Snyder, MD
Mitchell E Geffner, MD
Diane Blake, MD
Deputy Editor
Alison G Hoppin, MD


Adolescents experience several types of maturation, including cognitive (the development of formal operational thought), psychosocial (the stages of adolescence), and physical. This complex series of physical transitions is known as puberty, and these changes may impact psychosocial factors.

The most visible changes during puberty are growth in stature and development of secondary sexual characteristics. Equally profound are changes in body composition; the achievement of fertility; and changes in most body systems, such as bone, with increased growth and mineralization, brain development, and the cardiovascular system, with greater aerobic power reserve, electrocardiographic changes, and blood pressure changes.

The normal sequence of pubertal events and potential perils of puberty are reviewed here. Precocious and delayed puberty are discussed separately. (See "Definition, etiology, and evaluation of precocious puberty" and "Diagnosis and treatment of delayed puberty".)


Puberty is the general term for the transition from sexual immaturity to sexual maturity. There are two main physiological events in puberty:

Gonadarche is the activation of the gonads by the pituitary hormones follicle-stimulating hormone (FSH) and luteinizing hormone (LH).


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Literature review current through: Dec 2016. | This topic last updated: Wed Dec 14 00:00:00 GMT+00:00 2016.
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