Pediatric & Young Adult Endocrinology
Puberty & Development
Puberty rarely follows a textbook. The question is usually whether what you are seeing is a variation of normal timing, or a pattern that needs evaluation.
When families notice
- Breast development before age 8, or pubic hair and body odor earlier than expected
- No pubertal changes by age 13 in girls or 14 in boys
- Puberty that started and then stopped progressing
- A rapid change in height, body shape or body odor over a few months
- Periods that are very irregular, very heavy, or that have stopped
What it usually means
Early or late puberty can be a normal variation, a family pattern, or a sign that hormones from the brain, thyroid, adrenal glands or ovaries and testes need a closer look.
Timing matters for more than development itself. Puberty and growth are linked, so the same evaluation usually considers both.
What I look at
- How long the changes have been present and how quickly they are progressing
- Growth in the same period, measured and plotted
- Family history of early or late puberty
- Physical examination, which often narrows the question more than a lab test
- Bone age, hormone levels or imaging, when a specific question calls for them
How I approach it
I look at development and growth together, and I take the time to explain what the findings mean before deciding whether anything needs treatment.
Many children need reassurance and a follow-up visit rather than testing. When treatment is appropriate, we talk through what it does, what it does not do, and what the alternatives are.
When to see me
If puberty seems early or late, if it stalled, or if periods have become irregular or stopped, an evaluation can clarify what is happening.
At a glance
- In person in New York City
- Telehealth
- English & Español
- No referral needed
Dr. Luisa F. González Ballesteros, MD
Conditions families ask about next
Still not sure this is the right question
If the explanation you were given does not fit what you are seeing, a consultation can help you understand the pattern.