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Multiple Choice Questions « Return to contents list Chapter 2, Question 1.1. Please identify which of the following are true with regard to pubertal development. A Pregnancy is not possible until regular menstruation occurs. B Adrenarche is the beginning of breast development. C Menarche, or onset of menstruation, is the first manifestation of puberty in the female. D Development of a menstrual cycle is dependent upon GnRH pulses increasing in amplitude and frequency. E In a Western population, the onset of menstruation occurs, on average, by age 13. F None of the above.