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13 years old. No sign of puberty. Have swollen and painful areola. Looking for suggestion

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Practicing since : 1991
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13 year female...Very small for sign of of her areola is swelled and hard to the touch.
Posted Mon, 7 Jan 2013 in General Health
Answered by Dr. G.Srinivasan 2 hours later

Welcome to XXXXXXX and thanks for your query.
I understand your concern on her growth and development.
The first physical sign of puberty in girls is usually a firm, tender lump under the center of the areola of one or both breasts, occurring on average at about 10.5 years of age. This is referred to as thelarche. By the widely used XXXXXXX staging of puberty, this is stage 2 of breast development (stage 1 is a flat, prepubertal breast). Within six to 12 months, the swelling has clearly begun in both sides, softened, and can be felt and seen extending beyond the edges of the areolae. This is stage 3 of breast development. By another 12 months (stage 4), the breasts are approaching mature size and shape, with areolae and nipples forming a secondary mound. In most young women, this mound disappears into the contour of the mature breast (stage 5), although there is so much variation in sizes and shapes of adult breasts that stages 4 and 5 are not always separately identifiable.
Pubic hair, menarche and other signs of puberty may appear earlier or later.
So in her case, the breast development has started first.
Please give more time to see how things shape up in the next few months.
Wishing her best health.
Best regards
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