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Puberty is a time of growth, and it can be a confusing and awkward time for parents and girls alike. Often parents don’t want to see their little girls growing up, and girls can be scared about all the changes.

The first time a teen comes in with her parent or guardian, sometimes the adult does most of the talking. Here are the three most common questions that I’m asked.

1. How do I know if puberty has started?

The first sign of puberty in a young girl is breast development. The average age of breast development is 10, though some girls develop later and some develop earlier.

Puberty is a process. After breast development starts, there are a series of changes that involve pubic hair and underarm hair growth, growth spurts, and her first period.

2. How old will my daughter be when she has her first period?

The average age of menarche (when a girl gets her first period) in the United States is about 12 and a half. On average, a girl’s first period is 2 years after breast development begins. If breast development starts earlier, it’s possible she may start her period earlier. If breast development is later, she may start her period later. The whole process varies from girl to girl.

3. Will my daughter grow taller after she starts her period?

A girl’s largest growth spurt is typically just before she starts her period. A girl may grow slightly after she starts her period, but her major growth spurt is finished before the first period.

First ob-gyn visit

We recommend that a girl’s first ob-gyn appointment be between ages 13 and 15. This office visit allows a teen to get her questions answered and to start a relationship with the gynecologist. A lot of times these conversations also allow us to address any risky behaviors that might be on a girl’s mind, like drinking or vaping. Most girls don’t need a pelvic exam during their first visit.

[See 21 Reasons to See a Gynecologist Before Age 21]

Also, we want you to have the right information as a parent. There’s so much that’s available in the age of the internet, but it’s hard to know if what you read is accurate. When you get information straight from a medical professional, you’ll know that what you’re hearing is as correct and up to date as possible.

Asking questions

It’s also important that girls talk with parents, guardians, or trusted adults to learn more about the changes they are going through. There are also a lot of good books out there, so if it’s hard to start that conversation with family, a book is a great way to begin.

Some teens feel awkward talking about puberty. I encourage girls not to be shy, whether they’re talking with an ob-gyn or their parents. But girls should have some time alone with their doctor, without parents in the exam room, so they can ask questions that they may feel are personal.

We want girls to ask all of the questions they have. There are no wrong questions, and we as ob-gyns are here to help. We want to make sure every girl has the information she needs to understand her body and to take charge of her health – now and in the future.

Published: October 2020

Last reviewed: September 2022

Copyright 2023 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

About the Author
Rupa DeSilva, MD
Dr. Rupa DeSilva

Dr. DeSilva is an obstetrician–gynecologist who specializes in pediatric and adolescent gynecology. She serves as a clinical professor at the University of Texas Southwestern Medical Center, in the Division of Pediatric and Adolescent Gynecology. She is a fellow of the American College of Obstetricians and Gynecologists.