Menses typically begins 2.5 yr after the onset of puberty at an average age of

(D). in females, typically the first visible sign of puberty and the hallmark of SMR 2 is the appearance of breast buds (thelarche), between 8 and 12 yr of age. A significant minority of females develops pubic hair (pubarche) prior to thelarche. Less visible changes include enlargement of the ovaries, uterus, labia, and clitoris, and thickening of the endometrium and vaginal mucosa. A clear vaginal discharge may be present prior to menarche (physiologic leukorrhea). Menses typically begins 2.5 yr after the onset of puberty, during SMR 3-4 (average age: 12.5 yr; normal range: 9-15 yr)