Breast development is the first sign of puberty at 8-13 years, which is controlled by hormone levels and heredity. Pubic hair appearance starts shortly after breast growth begins. By this time, the vagina has already begun to lengthen and the uterus is slowly enlarging. Menarche – onset of menstruation usually occurs as breast growth nears completion and almost invariably comes after the peak growth spurt. Menarche is influenced by socio economic factors, climate, heredity, family size and nutrition. The age at menarche varies from 8-14 years (Indian girls commonly attain menarche by 9-11 yrs) Rising hormone levels, during puberty contribute to an activation of sexual sensations and erotic thoughts and dreams.