Development and cycle behavior in puberty and adolescence: what is normal and when should one intervene

The physiological course of puberty and adolescence extends over many years and causes many physical and psychosocial changes. Deviations in the timing of development have immediate consequences and are observed with great concern by affected girls and their parents. It is of particular relevance for the attending physician to be able to reliably distinguish normal variants of early or late development of puberty from the actual, treatment-relevant precocious puberty and delayed puberty. Not only the development during puberty and adolescence but also the menstrual cycle behavior during this period are relevant topics in gynecological consultations between the treating physician and girls. Girls present in the gynecology with primary or secondary amenorrhea, oligomenorrhea, continuous bleeding or dysmenorrhea for clarification. Normal variants of the menstrual cycle should be distinguished from relevant endocrine or organic disorders. The aim is to avoid unnecessary examinations that can possibly lead to psychological stress for girls, without, however, overlooking relevant conspicuous findings.