ABSTRACT
Puberty is an important phase of development involving multiple physical, social, and behavioral changes, which occur as a child develops reproductive capabilities. This process occurs in phases that include growth, development of secondary sexual characteristics, and menstruation. Health-care providers play an important role during this time in monitoring that the process is occurring within normal parameters and providing evaluation if concerns in development arise. It is essential to understand what is normal and abnormal throughout this process to discern when further evaluation is warranted. There have been changes in the timing of puberty, which seem to be multifactorial. Environmental factors, obesity, and other health conditions may play a role in pubertal timing. It is also important to understand normal and abnormal menstrual patterns, which are very useful markers for overall health. Using the menstrual cycle as a vital sign, which includes information about past menstrual periods and menstrual patterns at each health-care visit, can help providers detect underlying health issues when they occur.
