Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 30 P52

BSPED2012 Poster Presentations (1) (66 abstracts)

Puberty phases: an evaluation of a new system for rating puberty in paediatric practice

Gary Butler , Tim Cole , Victoria Dublon , Charlotte Wright & Charlotte RCPCH Expert Working Group


UCL Institute pof Child Health, London, UK.


Background and aims: Estimating puberty using Tanner stages is usually done unconfidently by general paediatricians. Self-assessment methods are not reliable. As assessment of growth on the new UK growth charts necessitates establishing pubertal status, we have designed and evaluated a simpler non-invasive approach.

Methods: The new system has three Phases– Pre-Puberty (Tanner stage 1), In-Puberty (stages 2/3) and Completing-Puberty (stages 4/5).

Pre-puberty All of the followingIn puberty Any of the followingCompleting puberty All of the following
GirlsNo signs of areolar (nipple) or breast developmentAny breast enlargement so long as nipples also enlargedStarted periods (menarche)
No pubic hairAny pubic or axillary (armpit) hair growthWith breast pubic and axillary hair development
BoysHigh voiceSlight deepening of the voice Reddening of the scrotumVoice fully changed (broken)
No growth of testes or penisAny testicular or penile enlargementEarly moustache and facial hair growth
No pubic hairAny pubic or axillary hair growthAdult size of penis and testes with adult pubic and axillary hair growth

The Phase system was tested amongst 28 specialist nurses, 100 general paediatric trainees and 19 consultant general paediatricians after basic training. They evaluated puberty phase and Tanner stage on 10 standard line drawings.

Results: Recognising pubertal development was performed more accurately and fully by each group when using Puberty Phases. Most errors arose due to a failure to recognise the start of puberty.

Mean (range)Correct %Tanner stageCorrect % phases
General consultants43 (0–90)79 (50–100)
General trainees48 (0–90)78 (30–100)
Specialist nurses54 (30–80)79 (50–100)

Conclusions: The new simpler puberty phase approach was well accepted and allowed a clearer rating of pubertal development, a new requirement for the correct interpretation of the UK growth charts. User education is still required.

Volume 30

40th Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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