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Pubertad

La pubertad es una serie compleja de transiciones físicas, psicosociales y cognitivas que suelen experimentar los LOS Neisseria adolescentes (11–19 años de edad). La pubertad se caracteriza por un crecimiento en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la estatura y el desarrollo de caracteres sexuales secundarios, el logro de la fertilidad y cambios en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la mayoría de los LOS Neisseria sistemas corporales. Es importante estar familiarizado con la pubertad normal para poder reconocer y manejar anomalías como la pubertad precoz o la pubertad tardía.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Descripción General

Definición

La pubertad es el período de tiempo que transcurre desde la 1ra aparición de los LOS Neisseria caracteres sexuales secundarios hasta lograr el desarrollo sexual completo. La pubertad implica una serie compleja de cambios físicos, psicosociales y cognitivos.

Comienzo

  • La edad media de inicio de la pubertad ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia disminuido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria últimos años.
  • Rango:
    • 8–13 años en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niñas
    • 8–12 años en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños

Control hormonal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el inicio de la pubertad

  • Un evento crítico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la pubertad es un aumento en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la secreción pulsátil de la hormona liberadora de gonadotropina (GnRH, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) del núcleo arqueado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hipotálamo.
    • Las neuronas de kisspeptina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el núcleo arqueado liberan neuroquinina B y dinorfina.
    • La neuroquinina B y la dinorfina provocan la secreción pulsátil de GnRH.
  • GnRH provoca la liberación de la hormona luteinizante ( LH LH A major gonadotropin secreted by the adenohypophysis. Luteinizing hormone regulates steroid production by the interstitial cells of the testis and the ovary. The preovulatory luteinizing hormone surge in females induces ovulation, and subsequent luteinization of the follicle. Luteinizing hormone consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) y la hormona folículoestimulante ( FSH FSH A major gonadotropin secreted by the adenohypophysis. Follicle-stimulating hormone stimulates gametogenesis and the supporting cells such as the ovarian granulosa cells, the testicular sertoli cells, and leydig cells. Fsh consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) de la glándula hipófisis anterior. Tanto la LH LH A major gonadotropin secreted by the adenohypophysis. Luteinizing hormone regulates steroid production by the interstitial cells of the testis and the ovary. The preovulatory luteinizing hormone surge in females induces ovulation, and subsequent luteinization of the follicle. Luteinizing hormone consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle como la FSH FSH A major gonadotropin secreted by the adenohypophysis. Follicle-stimulating hormone stimulates gametogenesis and the supporting cells such as the ovarian granulosa cells, the testicular sertoli cells, and leydig cells. Fsh consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle afectan las células de Leydig y Sertoli en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria testículos y las células de la teca y la granulosa del ovario.
  • La zona reticular de las glándulas suprarrenales secreta andrógenos como DHEA DHEA A major C19 steroid produced by the adrenal cortex. It is also produced in small quantities in the testis and the ovary. Dehydroepiandrosterone (dhea) can be converted to testosterone; androstenedione; estradiol; and estrone. Androgens and Antiandrogens (dehidroepiandrosterona), lo que da como resultado las características de la adrenarquia. La zona reticular funciona separadamente del eje hipotálamo-hipófisis-gonadal.
  • Cambios hormonales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las niñas:
    • LH LH A major gonadotropin secreted by the adenohypophysis. Luteinizing hormone regulates steroid production by the interstitial cells of the testis and the ovary. The preovulatory luteinizing hormone surge in females induces ovulation, and subsequent luteinization of the follicle. Luteinizing hormone consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle actúa sobre las células de la teca del ovario para convertir el colesterol en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum andrógenos.
    • La célula de la granulosa convierte los LOS Neisseria andrógenos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum estradiol Estradiol The 17-beta-isomer of estradiol, an aromatized C18 steroid with hydroxyl group at 3-beta- and 17-beta-position. Estradiol-17-beta is the most potent form of mammalian estrogenic steroids. Noncontraceptive Estrogen and Progestins bajo el control de la señalización de FSH FSH A major gonadotropin secreted by the adenohypophysis. Follicle-stimulating hormone stimulates gametogenesis and the supporting cells such as the ovarian granulosa cells, the testicular sertoli cells, and leydig cells. Fsh consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle.
    • El estradiol Estradiol The 17-beta-isomer of estradiol, an aromatized C18 steroid with hydroxyl group at 3-beta- and 17-beta-position. Estradiol-17-beta is the most potent form of mammalian estrogenic steroids. Noncontraceptive Estrogen and Progestins actúa sobre varios órganos hasta la finalización de la pubertad.
  • Cambios hormonales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria niños:
    • LH LH A major gonadotropin secreted by the adenohypophysis. Luteinizing hormone regulates steroid production by the interstitial cells of the testis and the ovary. The preovulatory luteinizing hormone surge in females induces ovulation, and subsequent luteinization of the follicle. Luteinizing hormone consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle actúa sobre las células de Leydig para convertir el colesterol en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum testosterona.
Desarrollo del eje hipotálamo-pituitario-gonadal (HPG) normal en mujeres

Eje hipotálamo-hipófisis-gonadal (HPG) normal en mujeres
GnRH: hormona liberadora de gonadotropina
FSH: hormona folículoestimulante
LH: hormona luteinizante

Imagen por Lecturio. Licencia: CC BY-NC-SA 4.0

Related videos

Cambios Físicos durante la Pubertad

La pubertad se puede dividir en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 4 etapas consecutivas diferentes: telarquia, pubarquia, crecimiento acelerado y menarquia.

Telarquia

  • Desarrollo mamario con formación del botón mamario y proliferación del epitelio ductal y glandular
  • 1er signo de pubertad en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niñas
  • Hormonas participantes: estrógeno, estradiol Estradiol The 17-beta-isomer of estradiol, an aromatized C18 steroid with hydroxyl group at 3-beta- and 17-beta-position. Estradiol-17-beta is the most potent form of mammalian estrogenic steroids. Noncontraceptive Estrogen and Progestins, prolactina
  • Comienzo: 7–14 años de edad

Pubarquia

  • Crecimiento de vello púbico y axilar
  • Hormonas participantes: testosterona, 5α-dihidrotestosterona
  • Comienzo: 8–15 años de edad

Crecimiento acelerado

  • Comienzo:
    • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum promedio, 2 años antes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niñas que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños
    • Aproximadamente 1 año después de los LOS Neisseria 1ros indicadores de la pubertad
  • 3–10 cm de crecimiento por año
  • Hormonas participantes:
    • La liberación de esteroides sexuales conduce a la producción de hormonas de crecimiento.
    • Conduce a la producción de factor de crecimiento similar a la insulina-1 en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hígado

Menarquia

  • 1er sangrado menstrual
  • Debido a la retirada de estrógenos sin ovulación anterior
  • Comienzo:
    • Entre 9 y 16 años
    • Aproximadamente 1 año después de un crecimiento acelerado
  • Normalmente ocurre más tarde que otros signos de la pubertad.

Etapas de Desarrollo de Tanner

La “escala de Tanner” es una escala que mide el desarrollo físico/sexual en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños y adolescentes. Esta técnica de estadificación implica la evaluación de los LOS Neisseria genitales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hombres, las mamas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las mujeres y el vello púbico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ambos.

Tabla: Etapas de Tanner en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres
Tanner 1 Tanner 2 Tanner 3 Tanner 4 Tanner 5
Edad Prepuberal 8–11,5 años 11,5–13 años 12–15 años > 15 años
Vello púbico Solo vello fino Pelo escaso a lo largo de los LOS Neisseria labios Pelo áspero y rizado cubriendo el pubis. Pelo adulto que no se extiende hasta el muslo Pelo adulto que llega al AL Amyloidosis muslo
Mamas Elevación de papila solamente Los LOS Neisseria botones mamarios son palpables (1er signo de pubertad en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las mujeres) y las areolas están agrandadas. El tejido mamario crece sin contorno ni separación. Las mamas se agrandan y las areolas forman un montículo secundario sobre el seno. Los LOS Neisseria contornos de las mamas adultas están presentes. Solo se levanta la papila.
Otras observaciones Adrenarquia y crecimiento ovárico Agrandamiento del clítoris, pigmentación labial, crecimiento del útero Vello axilar, acné Menarquia y desarrollo de la menstruación. Genitales adultos
Tabla: Etapas de Tanner en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hombres
Tanner 1 Tanner 2 Tanner 3 Tanner 4 Tanner 5
Edad Prepuberal 8–11,5 años 11,5–13 años 12–15 años > 15 años
Vello púbico Solo vello fino Pelo escaso en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la base del pene Aparece pelo áspero y rizado sobre el pubis. Pelo adulto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el área púbica, respetando el muslo Pelo adulto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el área púbica, llegando hasta el muslo
Genitales
  • Testículos < 2 cm
  • Sin crecimiento del pene
  • Testículos: 2,5–3,2 cm
  • Adelgazamiento y enrojecimiento del escroto
  • Testículos: 3,3–4 cm
  • Aumento de la longitud del pene.
  • Testículos: 4,1–4,5 cm
  • Crecimiento del pene, oscurecimiento del escroto
  • Testículos > 4,5 cm
  • Tamaño genital adulto
Otras observaciones Adrenarquia Disminución de la grasa corporal Ginecomastia, quebrantamiento de la voz, aumento de la masa muscular Vello axilar, cambio de voz, acné Vello facial, aumento de la masa muscular

Relevancia Clínica

  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types ferropénica: condición que afecta a niñas adolescentes debido al AL Amyloidosis sangrado menstrual y la ingesta insuficiente de hierro. Los LOS Neisseria hombres son menos propensos a la anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types porque la testosterona aumenta la eritropoyesis.
  • Ginecomastia: agrandamiento o inflamación del tejido mamario en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hombres. La ginecomastia afecta aproximadamente al AL Amyloidosis 50% de los LOS Neisseria adolescentes varones a una edad promedio de 13 años. La ginecomastia es causada por el aumento de la producción o la acción de los LOS Neisseria estrógenos, el aumento de la sensibilidad del tejido mamario a los LOS Neisseria estrógenos o la disminución de la producción o la acción de los LOS Neisseria andrógenos.
  • Acné vulgar: trastorno de la unidad pilosebácea debido a hiperqueratinización folicular, producción excesiva de sebo, colonización folicular por Cutibacterium acnes Cutibacterium acnes A bacteria isolated from normal skin, intestinal contents, wounds, blood, pus, and soft tissue abscesses. It is a common contaminant of clinical specimens, presumably from the skin of patients or attendants. Acne Vulgaris e inflamación. La gravedad del acné se asocia con niveles séricos elevados de sulfato de dehidroepiandrosterona.
  • Sangrado uterino disfuncional: sangrado endometrial excesivo, prolongado y/o irregular, a menudo observado durante el 1er año de la menarquia. El sangrado uterino disfuncional ocurre debido a ciclos anovulatorios como resultado de la inmadurez del eje hipotálamo-hipófisis-ovárico, que no produce gonadotropinas ( LH LH A major gonadotropin secreted by the adenohypophysis. Luteinizing hormone regulates steroid production by the interstitial cells of the testis and the ovary. The preovulatory luteinizing hormone surge in females induces ovulation, and subsequent luteinization of the follicle. Luteinizing hormone consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle y FSH FSH A major gonadotropin secreted by the adenohypophysis. Follicle-stimulating hormone stimulates gametogenesis and the supporting cells such as the ovarian granulosa cells, the testicular sertoli cells, and leydig cells. Fsh consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. Menstrual Cycle) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cantidades y proporciones adecuadas para inducir la ovulación.
  • Pubertad precoz: inicio de la pubertad con el desarrollo de los LOS Neisseria caracteres sexuales externos antes de los LOS Neisseria 8 años de edad. La pubertad precoz puede deberse a la activación temprana del eje hipotálamo-hipófisis-ovárico o a la secreción excesiva de esteroides sexuales de los LOS Neisseria ovarios o cuando se obtienen de fuentes exógenas.
  • Pubertad retrasada: falta de agrandamiento testicular en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria niños a los LOS Neisseria 14 años y la falta de desarrollo de las mamas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las niñas a los LOS Neisseria 13 años. La etiología de la pubertad retrasada varía y generalmente se clasifica como central o gonadal. Aproximadamente el 2,5% de los LOS Neisseria niños sanos experimentan pubertad tardía.

Referencias

  1. Herman-Giddens M., et al. (1997). Secondary sexual characteristics and menses in young girls seen in office practice: A study from the Pediatric Research in Office Settings Network. Pediatrics. https://pubmed.ncbi.nlm.nih.gov/9093289/
  2. Tanner, J.M., Davies, P.S. (1985). Clinical longitudinal standards for height and height velocity for North American children. The Journal of Pediatrics. https://pubmed.ncbi.nlm.nih.gov/3875704/
  3. Karpati, A.M., Rubin, C.H., Kieszak, S.M., Marcus, M., Troiano, R.P. (2002). Stature and pubertal stage assessment in American boys: The 1988-1994 Third National Health and Nutrition Examination Survey. The Journal of Adolescent Health. https://pubmed.ncbi.nlm.nih.gov/11869928/ 
  4. Cutler, G.B. Jr, Loriaux, D.L. (1980). Andrenarche and its relationship to the onset of puberty. Federation proceedings. https://pubmed.ncbi.nlm.nih.gov/6445284/

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