This leaflet was originally provided by Miriam Leach (4th year MB ChB, Manchester University), used here with permission.
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. 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.
What causes adrenarche to happen?
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 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 first begins to happen but it is thought that this is in preparation for puberty (which usually starts a few years later).
What does this mean?
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.
Do children experience all of these changes?
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. Occasionally the term 'premature adrenarche' is used when these changes are experienced a bit early (around 5-6 years) but despite this it is not actually thought to be out of the ordinary.
How is this different to puberty?
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.
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.
What can be done for a child who is going through adrenarche?
As described, adrenarche is a commonly experienced and 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.
Is there anything else I need to know?
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.
Further reading and references
Rege J, Rainey WE; The steroid metabolome of adrenarche. J Endocrinol. 2012 Aug214(2):133-43. doi: 10.1530/JOE-12-0183. Epub 2012 Jun 19.
Utriainen P, Laakso S, Liimatta J, et al; Premature adrenarche - a common condition with variable presentation. Horm Res Paediatr. 201583(4):221-31. doi: 10.1159/000369458. Epub 2015 Feb 7.