Pubarche

Pubarche is the appearance of sexual (pubic) hair, typically following thelarche in female puberty but with variable sequence. Average onset is around ages 10–12 in girls.

Hormonal Basis

Driven primarily by adrenal androgens (DHEA, DHEAS, androstenedione) produced during and after adrenarche; relatively independent of gonadal estradiol.

Clinical Sequence

1. Sparse, lightly pigmented hair along labia (Tanner Pubic Hair Stage P2).
2. Coarser, more pigmented hair spreading over mons (P3–P4).
3. Adult distribution with lateral / medial extension (P5).

In ~15% of girls pubarche may precede thelarche; evaluate for premature adrenarche or hyperandrogenism if markedly early (<8 years) or accompanied by rapid virilization.

Distinctions

• Premature adrenarche: early pubarche/body odor without breast development or growth acceleration.
• Central precocious puberty: pubarche plus breast development and advanced growth.

Related Topics

• adrenarche
• thelarche
• gonadarche
• puberty