TANNER STAGING AND PUBERTY


Delayed or puberty in girls:

Tanner Staging

I. In girls

  1. Breasts
  1. Stage 1: Preadolescent; elevation of papilla only
  2. Stage 2: Breasts bud stage; elevation of breasts and papilla as a small mound; elevation of areola diameter
  3. Stage 3: Further enlargement of breasts and areola; no separation of their contours
  4. Stage 4: Projection of areola and papilla to form a secondary mound above breast level
  5. Stage 5: Mature stage; projection of papilla only, caused by recession of areola to the general breast contour
  1. Pubic hair
  1. Stage 1: Preadolescent; no pubic hair
  2. Stage 2: Slight growth of long, slightly pigmented, downy hair distributed chiefly along labia
  3. Stage 3: Darker, coarser, curlier hair spread sparsely over the junction of the pubes
  4. Stage 4: Hair is adult in type; no spread to medial surface of the thighs
  5. Stage 5: Adult in quantity and quality, with no inverse triangle distribution and spread to medial thighs

II. In boys

  1. Genitalia
  1. Stage 1: Preadolescent; testes, scrotum, and penis are about the same size and proportion as in early childhood
  2. Stage 2: Scrotum and testes are enlarged, with change in texture and slight reddening of the scrotal skin
  3. Stage 3: Growth of penis, mainly in length but also in breadth, continued growth of testes and scrotum
  4. Stage 4: Further enlargement of testes, scrotum, and penis, with development of glans and darkening os skin
  5. Stage 5: Genitalia adult in size and shape
  1. Pubic hair
  1. Stage 1: Preadolescent; no pubic hair
  2. Stage 2: Slight growth of long, slightly pigmented, downy hair distributed chiefly at the base of the penis
  3. Stage 3: Darker, coarser, curlier hair spread sparsely over the junction of the pubes
  4. Stage 4: Hair is adult in type; no spread to medial surface of the thighs
  5. Stage 5: Adult in quantity and quality, with no inverse triangle distribution and spread to medial thighs

(Source: Tanner JM. Endocrine and Genetic Diseases of Childhood, 1975)