In females, changes in the primary sex characteristics involve growth of the uterus, vagina, and other aspects of the reproductive system. Menarche, the beginning of menstruation, is a relatively late development which follows a long series of hormonal changes. Generally, a girl is not fully fertile until several years after menarche, as regular ovulation follows menarche by about two years. Unlike males, therefore, females usually appear physically mature before they are capable of becoming pregnant.

What term is the beginning of menstruation given?