Adrenarche refers to which phenomenon?

• A. Onset of gonadal hormones
• B. Onset of estrogen production
• C. Completion of puberty
• D. Pseudopuberty of the adrenal gland that is independent of pubarche; onset of adrenal androgen production

Answer: (D)

Adrenarche is the adrenal-driven phase of puberty, where the adrenal cortex begins producing androgens (primarily DHEA, DHEA-S, and androstenedione). This is independent of the gonads, so it represents a separate track from gonadarche driven by ovarian or testicular hormones. The adrenal androgens contribute to early pubertal changes such as pubic (and sometimes axillary) hair and body odor, without the full set of gonadal steroid-driven changes like breast development or menarche. That’s why describing a pseudopuberty of the adrenal gland with the onset of adrenal androgen production best captures adrenarche. The other options refer to gonadal hormone onset, estrogen production, or completion of puberty, which are not adrenarche.