Sequence of events during normal puberty in girls

As this schematic shows, menarche is a relatively late event in puberty, occurring after both breast and pubic hair development are well-advanced. On average, menarche occurs at 12.5 years old in White American girls and at 12 years old in African American girls.

Additional references:

Wu T, Mendola P, Buck GM. Ethnic Differences in the Presence of Secondary Sex Characteristics and Menarche Among US Girls: The Third National Health and Nutrition Examination Survey, 1988-1994. Pediatrics 2002; 110:752.
Herman-Giddens ME, Kaplowitz PB, Wasserman R. Navigating the Recent Articles on Girls' Puberty in Pediatrics: What Do We Know and Where Do We Go from Here? Pediatrics 2004; 113:911.

Adapted from: Tanner JM. The development of the female reproductive system during adolescence. Clin Obstet & Gynecol 1960; 3:135.

Graphic 82350 Version 10.0

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Sequence of events during normal puberty in girls