ANNEX HSEXUAL MATURITY RATING (TANNER STAGING) IN ADOLESCENTS
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| Stage | Female | Male |
|---|
| Age range (years) | Breast growth | Pubic hair growth | Other changes | Age range (years) | Testes growth | Penis growth | Pubic hair growth | Other changes |
|---|
| I | 0–15 | Pre-adolescent | None | Pre-adolescent | 0–15 | Pre-adolescent testes
(≤2.5 cm) | Pre-adolescent | None | Pre-adolescent |
| II | 8–15 | Breast budding (thelarche); areolar hyperplasia with small amount of breast tissue | Long downy pubic hair near the labia, often appearing with breast budding or several weeks or months later | Peak growth velocity often occurs soon after stage II | 10–15 | Enlargement of testes; pigmentation of scrotal sac | Minimal or no enlargement | Long downy hair, often appearing several months after testicular growth; variable pattern noted with pubarche | Not applicable |
| III | 10–15 | Further enlargement of breast tissue and areola, with no separation of their contours | Increase in amount and pigmentation of hair | Menarche occurs in 2% of girls late in stage III | 1½–16.5 | Further enlargement | Significant enlargement, especially in diameter | Increase in amount; curling | Not applicable |
| IV | 10–17 | Separation of contours; areola and nipple form secondary mound above breasts tissue | Adult in type but not in distribution | Menarche occurs in most girls in stage IV, 1–3 years after thelarche | Variable: 12–17 | Further enlargement | Further enlargement, especially in diameter | Adult in type but not in distribution | Development of axillary hair and some facial hair |
| V | 12.5–18 | Large breast with single contour | Adult in distribution | Menarche occurs in 10% of girls in stage V. | 13–18 | Adult in size | Adult in size | Adult in distribution (medial aspects of thighs; linea alba) | Body hair continues to grow and muscles continue to increase in size for several months to years; 20% of boys reach peak growth velocity during this period |
Source: Adapted from reference [218].
