Q: I am 20 and my body has not yet developed into that of a woman. I consider my body to be around stage two or three on the Tanner scale, which measures the stages of puberty. Why has my body not developed?
A: Puberty is a process leading to physical and sexual maturation, along with the development of secondary sexual characteristics.
In girls, puberty involves breast and pubic hair development, changes in body composition and psychosocial maturation. The start of menstruation, or menarche, is a single identifiable point during the process. The average Singaporean girl has her menarche between 12 and 13 years old.
A girl usually takes after her family members in the age at which she experiences puberty.
If one of her parents had a delay in puberty, she is likely to experience puberty at a later age too.
Before menarche occurs, the girl may rapidly shoot up in height, growing 5cm to 7cm in a year. Her breasts will also develop. She will notice the appearance of armpit and pubic hair, and may feel that she is developing body odour. Some girls may also get acne.
In addition, the girl will have white or clear vaginal discharge before her menarche starts.
A girl who has not developed any breast buds and has no pubic hair when she reaches 14 years old, or has not achieved menarche by 16, will require medical evaluation for delayed puberty.
Such a delay can happen to people with chronic diseases, chromosomal disorders like Turner's syndrome and, sometimes, hormonal disorders, such as pituitary and thyroid disorders.
The Tanner scale is often used by healthcare professionals to evaluate and document the stages of puberty. It ranges from stage one (pre-pubertal) to stage five (maturity). Some people may do a pubertal self-assessment using the Tanner scale at home to avoid consulting a healthcare professional.
However, studies have shown that self-reported Tanner pubertal assessments often do not correspond to those done by healthcare professionals.
With regard to your question, more information on your breast development, presence of pubic and armpit hair and your height would be needed.
Most importantly, are you having regular menstrual periods?
If you have not had menstruation and have no breast and pubic hair development, you will need a gynaecological evaluation.
However, if you had your first menstrual period before you reached 16, and are having regular menstrual cycles, do consider checking with a doctor regarding your breast development and lack of pubic hair.
DR RUKSHINI PUVANENDRAN
This article was first published on July 28, 2015.
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