Education

Tanner Stages

12 Jun 2025 • 1 min read

Assesses pubertal development based on secondary sexual characteristics
Rated from Stage I (prepubertal) to Stage V (adult maturity)
Focus areas:
- Males: genital development and pubic hair
- Females: breast development and pubic hair

Males

Testicular enlargement is the first sign of puberty in boys (Tanner II)
Stage I:
- Prepubertal; no genital growth
- No pubic hair
Stage II:
- Enlargement of testes and scrotum; scrotal skin reddens and thins; no penis growth
- Sparse, long, slightly pigmented hair at base of penis
Stage III:
- Penis begins to lengthen; further testicular and scrotal enlargement
- Darker, coarser, curlier hair spreading over pubic junction
Stage IV:
- Increased penile breadth and glans development; testes and scrotum enlarge further; scrotal skin darkens
- Adult-like hair in type but not yet full distribution
Stage V:
- Adult genitalia
- Adult distribution (including inner thighs)

Thelarche (breast development) is usually the first sign of puberty in girls (Tanner II)
Menarche typically occurs at Tanner stage III-IV
Stage I:
- Prepubertal; no breast tissue
- No pubic hair
Stage II:
- Breast bud stage - small mound with areolar enlargement
- Sparse, lightly pigmented hair along labia
Stage III:
- Enlargement of breast and areola without separation
- Darker, coarser, curlier hair over pubic region
Stage IV:
- Areola and papilla form a secondary mound
- Adult-like hair, limited in area
Stage V:
- Adult breast contour; areola recedes to general contour, papilla projects
- Adult quantity and type, extends to medial thighs

Precocious puberty: Onset of Tanner stage II before age

Delayed puberty: No Tanner stage II by age