Pubertal Growth Spurt

The pubertal growth spurt is the period of accelerated linear growth driven by rising sex steroids (estradiol), growth hormone (GH), and IGF-1 during puberty. In females peak height velocity (PHV) occurs earlier and is lower in magnitude than in males.

Timing (Females)

• Onset acceleration around Tanner Breast Stage 2.
• Peak Height Velocity (PHV) typically at Tanner Stage 3–4, about 6–12 months before menarche.
• Declines rapidly after menarche; residual growth 4–6 cm average.

Mechanisms

• Estradiol at low–moderate levels stimulates GH secretion and chondrocyte proliferation; higher sustained levels later induce epiphyseal fusion.
• GH/IGF-1 axis intensifies nocturnal pulses accompanying rapid skeletal elongation.

Magnitude

• PHV females: ~8–9 cm/year (range 6–11).
• Total height gain during pubertal years: ~20–25 cm.

Assessment

• Serial stadiometer measurements every 6 months.
• Growth velocity charts to detect deviation (excess acceleration in precocious puberty; deceleration in endocrine disorders).
• Bone age to compare skeletal vs chronological maturation. See bone_age.

Factors Influencing Growth

• Nutrition & chronic illness.
• Endocrine disorders (thyroid, GH deficiency/excess, sex steroid imbalance).
• Early estrogen exposure shortens growth window → reduced adult height; delayed exposure prolongs growth.

Related Topics

• puberty
• growth_hormone
• menarche