February 10, 2016

Be prepared to guide your daughter through puberty by knowing what to expect.


For parents, and for teens, puberty can be a scary time. There are lots of changes going on that can be confusing, especially if you don’t know what to expect. For girls and boys, parents can serve as a great resource to help them prepare for the changes of puberty both before they start and as they’re happening. As a parent, being prepared and knowing what to expect can help you feel empowered to guide your child through these changing times. In addition, your teen’s healthcare provider can be a valuable resource during puberty to answer questions and help you talk with your teen about what’s happening to her body.

When will it start? Puberty starts earlier in girls than boys. It typically starts between 8 and 13 years of age. However, if you are worried that puberty started too soon or hasn’t started yet, you should speak with your child’s healthcare provider. Once puberty starts it will last about two years. Puberty “ends” when a girl gets her period, in that by then most of the physical changes of puberty have occurred. However there is still significant psychological and emotional growth (and changes!) in the years that follow.

What happens first? For most girls the first sign of puberty is breast development. This typically starts as a small “lump” beneath the nipple known as a breast bud. This can be painful for some girls and that is normal. It is also normal for one breast to grow before the other or for breasts to ultimately be different sizes. When you start to notice breast growth in your daughter, it is a good time to start to talk to her about what she can expect with the onset of puberty. It’s also a good time to talk about and even go purchase a first bra.

What about all that hair? For most girls, pubic hair will start to grow after breast development begins. However for some girls it can be the first sign of puberty. Pubic hair will start to grow fairly early in puberty and gradually thicken over time. Girls will develop hair under their arms towards the end of puberty. When you notice pubic hair developing on your daughter, you should talk to your daughter about the decision to shave this hair. There are no medical reasons for or against shaving pubic or underarm hair, but this is something your daughter will likely hear about from friends or online. You should talk to her about this to make sure she makes a safe and healthy decision.

When do periods begin? For most girls, periods begin 18 to 24 months after puberty begins. It is normal for periods to not follow a monthly pattern when they first begin. However, if your daughter is having excessive bleeding or pain with her period, or if you ever have any concerns about period patterns, you should talk to your daughter’s healthcare provider. Before their period begins, some girls will notice a white or yellow discharge coming from their vagina or in their underwear. This is normal and is part of the normal fluid that your vagina makes due to the hormones that are produced during pregnancy. If you or your daughter ever feel that the discharge is abnormal or notice any pain, odor or irritation in the vaginal area, you should talk to your daughter’s healthcare provider. Talking to your daughter about these changes and being prepared for the start of her period can help to make sure she is prepared and less anxious about all these changes.

What about some of the other changes that happen during puberty? Girls typically have a significant increase in height in the year before they start their period. There is some growth after menstruation but this is much less than before. You may also notice that your daughter’s body changes in shape as her hips widen due to the hormones being made during puberty. You should be sure to keep regular appointments with your daughter’s healthcare provider to make sure her height and weight are changing appropriately throughout puberty. Girls also will notice that their skin is oilier and their sweat has an odor. This is all normal. Talk to your daughter and help her purchase deodorant and face wash in order to prevent any embarrassment about these changes. You can also talk to your healthcare provider, particularly about skin changes and acne, if you are worried that additional treatment is needed.

How will she feel? Puberty can cause a lot of mixed emotions in teens. Your daughter may notice that her mood changes quickly or that she gets upset and doesn’t know why. Parents may also notice that teens suddenly become shy or embarrassed about their bodies, as well as pull away from their parents. All of this is a normal part of puberty. However, if your daughter’s strong emotions seem to be interfering with day-to-day activities, school or relationships, or if you ever become concerned, you should talk to your teen’s doctor.

Providing your teen with reassurance and information can help her through this difficult time and help her develop into a confident, healthy teenager.


Mary Romano, M.D., specializes in adolescent medicine at Monroe Carell Jr. Children’s Hospital at Vanderbilt. A mother of two, Romano loves taking care of adolescent patients and working with adolescents and their parents to keep them safe and healthy.


Vanderbilt’s Children’s After-Hours Clinics offer the convenience of a walk-in clinic with care provided by a board-certified pediatrician from Children’s Hospital. No appointment is necessary, but we recommend calling your pediatrician first. Learn more about services and find locations for Children’s Hospital After-Hours Clinics here.