Prepubertal

Prepubertal is a descriptive term used in pediatrics and endocrinology to denote the developmental stage before the onset of puberty, in which sexual maturation has not yet begun. The prepubertal period spans from early childhood up to the beginning of pubertal development, and it ends at the appearance of pubertal signs, typically Tanner stage 2.

Typical timing varies by sex and population; in many contemporary cohorts, girls begin puberty around ages 8 to 13 and boys around 9 to 14, with substantial individual variation. The end of the prepubertal phase corresponds to activation of the hypothalamic-pituitary-gonadal axis and rising gonadotropin and sex steroid levels, leading to sexual maturation.

Endocrinologically, the prepubertal axis is relatively quiescent compared with puberty; gonadotropin and sex steroid secretion are low, and gonadal or adrenal maturation has not yet produced secondary sexual characteristics. Adrenarche, the maturation of the adrenal zona reticularis, can occur during the prepubertal period and contributes to body hair and odor before true gonadal puberty.

Growth during prepuberty proceeds at a steady rate, without the pronounced pubertal growth spurt. Height velocity gradually declines in early childhood and then increases again with puberty, influencing final adult height in combination with genetics, nutrition, health, and endocrine factors.

Clinical assessment uses growth charts and, when indicated, Tanner staging. Abnormal timing of puberty—precocious puberty or delayed puberty—has different clinical implications and may prompt endocrine evaluation.