Adrenarche
Date issued: May 2023
Review date: May 2025
Ref: C-367/GS/Child Health/ Adrenarche v3
PDF: adrenarche leaflet final May 2023 v3.pdf [pdf] 153KB
Normal Puberty
True puberty starts when the brain signals to the ovaries in girls, or the testes in boys, to start producing oestrogen or testosterone. This results in either enlargement of breast tissue in girls or the genitals in boys. Hair growth usually follows. In the UK it is considered normal for these changes to start any time after the age of 8 for girls and 9 for boys. Once a girl starts to show these early changes, on average it is at least 2 years before periods start. In some ethnic groups normal puberty can start even earlier than this.
Adrenarche/ Premature Adrenarche
In the tummy, above the kidney, are small glands called the adrenals. These glands produce hormones called androgens which are similar to testosterone. In adults both men and women have androgens. Androgens make the body produce pubic hair and body odour. They can cause acne.
For a reason we do not understand in some children the androgens wake up early and can produce these changes (hair, body odour, spots) in the absence of true puberty. This is known as adrenarche.
Premature adrenarche often occurs in girls who are taller or heavier than their classmates.
Is Adrenarche Harmful?
No. It is not the same as true early puberty and so it is not treated. Adrenarche does not decrease your eventual adult height. There is known to be an association between adrenarche and polycystic ovarian syndrome in some women. We expect that children with adrenarche will go into puberty earlier but usually this is at a normal age (i.e. after 8 for girls and 9 for boys).
Some parents of children with adrenarche report that their children are more moody. We do not know the true effect of adrenarche on mood.
What tests will be done?
Usually we can make the diagnosis of adrenarche without many tests by simply examining your child. Often we send a urine sample for testing. This looks for rare inherited disorders which result in overproduction of adrenal hormones and can present in a similar way.
Do I need to look out for anything?
If your child suddenly shows new signs that could be true puberty developing (girls, breast development and boys, genital enlargement) please ask your GP to refer them back to the clinic. Remember it is normal to see these signs any time after the age of 8 for girls and 9 for boys.