WH&Y authors: Professor Kate Steinbeck

Citation: Balzer BWR, Garden FL, Amatoury M, Luscombe GM, Paxton K, Hawke CI, Handelsman DJ, Steinbeck KS. Self-rated Tanner stage and subjective measures of puberty are associated with longitudinal gonadal hormone changes. Journal of Pediatric Endocrinology and Metabolism 2019;32:569-76



Introduction: In large community-based studies of puberty, Tanner staging by a clinician is often not possible. We compared self-rated Tanner staging and other subjective ratings of pubertal development with serum hormone levels measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to reassess the utility of self-rated pubertal stage using highly sensitive and specific hormone analysis.

Methods: Adolescents and their parents enrolled in the Adolescent Rural Cohort study of Hormones and health, Education, environments and Relationships (ARCHER) answered annual survey questions on pubertal development. Annually, adolescents provided blood samples for serum testosterone and estradiol measured by LC-MS/MS.

Results: Longitudinally, self-rated Tanner stage was positively associated with serum testosterone and estradiol levels in both sexes. Confirmation by adolescent and parent that puberty had commenced was associated with higher gonadal hormone levels in both sexes. Parent and adolescent responses demonstrated ‘fair’ to ‘moderate’ agreement.

Conclusions: Over a 3-year follow-up, self-rated Tanner staging and simple questions regarding pubertal onset and development are positively associated with adolescent gonadal hormone concentrations in serum measured by mass spectrometry. Thus, self-report of puberty stage still has a role in large community-based studies where physical examination is not feasible.

About The Authors


Kate Steinbeck is an endocrinologist and adolescent physician, and Professor and Medical Foundation ...