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Adrenarche

This leaflet was originally provided by Miriam Leach (written when a 4th year MB ChB student at Manchester University), used here with permission.

At a glance

  • Adrenarche is a normal bodily process that occurs before puberty, usually between ages 6 and 8.

  • During adrenarche, adrenal glands produce more 'male' hormones (androgens) in children.

  • This can cause new hair growth, body odour, some acne, and mood swings.

  • All children are different; some may notice many changes, others only a few or none.

  • Seek medical advice if a child has early breast or testicular development, headaches, or vision changes.

  • Also, consult a doctor if you are worried about any other symptoms.

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What is adrenarche?

Adrenarche (ad-ren-ar-ke) is known to be an ordinary bodily process that happens to boys and girls as they begin to make the transition to being a teenager.

When does adrenarche start?

It is a development that happens before puberty, usually between the ages of 6 and 8 years. During this time certain hormones (biological messengers) begin to increase. They may either go unnoticed or can cause changes in the body like new hair growth and body odour.

Adrenarche

Adrenarche image

On top of the kidneys is a pair of specialised glands called the adrenal glands. The adrenal glands produce a few different hormones that cause a wide variety of things to happen in the body. These include regulating how much salt there is in the body, sending out stress signals and contributing to growth.

Adrenarche is a period of time when more of a group of hormones called androgens (the 'male' hormones) begin to be produced in boys and girls. It's not fully understood why adrenarche begins to happen but it is thought that this is in preparation for puberty (which usually starts a few years later).

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Androgens from the adrenal gland may cause a variety of things to begin to happen to the body including:

  • An effect on hair-producing cells causing some children to experience their first pubic hair and/or armpit hair growth.

  • An effect on the glands that produce sweat as well as the glands that produce an adult body odour, meaning some children may notice their body beginning to smell differently.

  • Additionally, some children may notice a change in their skin as these hormonal changes can result in a kind of acne called micro-comedonal acne.

  • They can also have an effect on mood and cause mood swings and tearfulness.

Everybody is different and some children may notice several changes during adrenarche, others may not notice anything different and some may experience only one or two differences.

It is important to know that it is as natural to experience all of these changes as it is for a child to experience none.

What is premature adrenarche?

Occasionally the term 'premature adrenarche' is used when adrenarche changes are experienced a bit early (around 5-6 years) but despite this it is not actually thought to be out of the ordinary.

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Puberty tends to occur a few years after adrenarche in the teen years. Puberty relates to the changes that happen to the body as a child begins to reach sexual maturity. These include growth of the testicles in boys and breast development in girls.

Onset of adrenarche can happen anytime after the age of 6 years and will not cause any development beyond those described above. If a child begins to have early testicular or breast development, or any unusual symptoms like headaches or changes in their vision, it is important that advice is sought, as these are not part of normal adrenarche.

As described, adrenarche is a normal process and there is no reason to be concerned. It is important to reassure children who are experiencing changes during adrenarche and encourage them to talk to you (or their doctor) if they are worried. There are several other things you can do that might be helpful:

  • You might want to discuss with teachers (particularly PE or sports coaches) about privacy at changing times.

  • Discuss washing regularly, showering and using deodorants if they are worried about body odour.

  • If they are particularly worried or embarrassed about body hair you could discuss hair removal with them.

  • Ask your GP for treatment for spots if this becomes a problem.

Occasionally, male hormone excess can be caused by problems other than adrenarche and your child may need to have some tests. If your child experiences any symptoms that you are worried about, or if you have any concerns at all, it is important you seek the advice of their GP or paediatrician.

Copyright for this leaflet is with Miriam Leach.

Frequently asked questions

Can adrenarche affect how my child feels emotionally?

Yes, the hormonal changes during adrenarche can sometimes lead to an effect on mood, potentially causing mood swings and tearfulness in some children.

My child is experiencing body odour. Is this normal for adrenarche, and what can help?

Yes, it is normal for adrenarche. The hormonal changes can affect the glands that produce sweat and an adult body odour, meaning some children may notice their body beginning to smell differently. You can discuss washing regularly, showering, and using deodorants if they are concerned about body odour.

My child is 5 years old and already showing signs. Is this too early?

Occasionally, adrenarche changes are experienced a bit early, around 5-6 years, which is sometimes referred to as 'premature adrenarche'. Despite the term, this is not actually thought to be out of the ordinary.

My child is developing spots. Is this related to adrenarche?

Yes, some children may notice a change in their skin during adrenarche. These hormonal changes can result in a type of acne called micro-comedonal acne. If spots become a problem, you can ask your GP for treatment.

Should I be concerned if my child's friends are experiencing changes but my child isn't?

No, there's no need to be concerned. Every child is different. Some children may experience several changes during adrenarche, others may not notice anything different, and some may experience only one or two differences. It is as natural to experience all of these changes as it is for a child to experience none.

When should I seek medical advice about my child's development?

Adrenarche is a normal process, but if your child starts to show signs of early testicular or breast development, or any unusual symptoms like headaches or changes in their vision, it's important to seek advice, as these are not part of normal adrenarche. Also, if you have any concerns about symptoms your child is experiencing, it's important to seek advice from their GP or paediatrician.

Further reading and references

  • Utriainen P, Laakso S, Liimatta J, et al; Premature adrenarche - a common condition with variable presentation. Horm Res Paediatr. 2015;83(4):221-31. doi: 10.1159/000369458. Epub 2015 Feb 7.
  • Rosenfield RL; Normal and Premature Adrenarche. Endocr Rev. 2021 Nov 16;42(6):783-814. doi: 10.1210/endrev/bnab009.

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About the authorView full bio

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Dr Toni Hazell, MRCGP

MBBS, BSc, MRCGP, DFSRH, Dip GU med, DRCOG, DCH (London, UK, 2000)

Dr. Toni Hazell qualified from St. Mary’s Hospital Medical School and did her VTS at Northwick Park Hospital.

About the reviewerView full bio

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Dr Rosalyn Adleman, MRCGP

MRCGP

Dr Rosalyn Adleman, is an NHS GP working in north London.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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