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Tanner staging - Patient information sheet

Tanner staging of pubertal development

Boys

Tanner stage
Genitalia
Pubic hair
Growth
Other
Stage 1
Prepubertal - testes less than 2.5 cm.
Villus hair only.
Basal rate - 5 cm to 6 cm per year.
Adrenarche.
Stage 2
Thinning and reddening of scrotal skin (mean age 11.9 years).
Testes 2.5 cm to 3.2 cm.
Sparse growth base of penis (mean age 12.3 years).
Basal rate as above.
Reduction in total body fat.
Stage 3
Growth of penis (mean age 13.2 years).
Testes 3.3 cm to 4 cm.
Thicker hair - spreads to mons pubis (mean age 13.9 years).
Accelerated growth - 7 cm to 8 cm per year.
Gynaecomastia (mean age 13.2 years).
Voice break (mean age 13.5 years).
Increase in muscle mass.
Stage 4
Growth of penis and glans with darkening of scrotum (mean age 14.3 years).
Testes 4.1 cm to 4.5 cm.
Adult but no spread to medial thigh (mean age 14.7 years).
Peak velocity about 10 cm per year (mean age 13.8 years).
Axillary hair (mean age 14 years).
Voice change (mean age 14.1 years).
Acne (mean age 14.3 years).
Stage 5
Adult genitalia (mean age 15.1 years).
Testes greater than 4.5 cm.
Adult with spread to medial thigh but not linea alba (mean age 15.3 years).
Deceleration and cessation (about 17 years).
Facial hair (mean age 14.9 years).
Muscle mass increases further and beyond Stage 5.
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