Integrative Lifestyle expert Luke Coutinho says that hormonal, emotional, metabolic, neurological and social changes in a woman begin much before her first menstrual period. He says that menarche, or the first menstrual period, is not the beginning of puberty. It is one milestone that affects nearly every system in the body.

“Puberty begins in the brain. Not the ovaries. It starts when the brain activates a communication pathway called the Hypothalamic-Pituitary-Gonadal (HPG) Axis. This signals the ovaries to gradually increase estrogen production,” he said in a recent social media post.

The expert adds that estrogen influences far more than reproduction. The hormone supports bone growth, muscle development, fat distribution, brain maturation, sleep, emotions and future reproductive health.

He emphasises that puberty is not simply a reproductive event but a whole-body transition coordinated by the brain.

Stage 1: Thelarche

Breast budding, also known as thelarche, is often the first visible sign of puberty in girls between 8 to 13 years. Parents may notice small breast buds, tenderness, uneven breast growth and increased body awareness. Luke Coutinho says that it is completely normal for one breast to develop before the other.

He adds that thelarche marks not only a physical change but also the beginning of a girl's awareness that her body is entering a new stage of growth.

Stage 2: Adrenarche

Another stage, known as adrenarche, occurs when the adrenal glands begin producing higher levels of adrenal androgens. These hormones contribute to body odour, acne, oily skin and the growth of body hair.

While these changes may feel uncomfortable or embarrassing for children, Coutinho says they are normal signs of maturation. He urges parents to focus on helping girls understand and normalise these changes rather than feel self-conscious about them.

Stage 3: The Growth Spurt

Speaking about the third stage, Luke says, “The body enters one of the fastest periods of growth after infancy. It is one of the most nutritionally demanding periods of life because the body is literally building an adult.”

During puberty, the body builds a significant proportion of its future peak bone mass. Parents may observe rapid height gain, increased appetite, growing feet, greater need for sleep and temporary clumsiness.

“Growth is energy-intensive. Increased hunger is often a sign that the body needs more nourishment…not less,” he writes.

Stage 4: Body Begins Changing Shape

In this stage, girls notice wider hips, fuller thighs and continued breast development. “This is development. Not dysfunction,” Luke says.

He then cautions parents against viewing weight gain during puberty as unhealthy, noting that rising estrogen levels naturally increase body fat as part of normal growth and development.

Often months before the first period, girls may also notice vaginal discharge. “Teaching girls about this beforehand can prevent unnecessary fear and confusion,” he says.

Stage 5: Menarche

Finally, the first period arrives. “Not the beginning of puberty. It is evidence that the journey has already been underway for years,” Luke explains.

At the end, he says, “Supporting this transition requires more than buying period products. It requires supporting the body, brain, emotional health, hormones and environment that shape a girl's experience of puberty.”



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