Age at Menarche and Factors that Influence It: A Study among Female University Students in Tamale, Northern Ghana

Age at menarche is inversely related to the prevalence of uterine cancer

OBJECTIVES

The objective of this study was to investigate the relationship between the age of menarche and the prevalence of malignancies of the uterus and ovaries.

METHODS

A total of 5540 women were screened from those who participated in the National Health And Nutrition Examination Survey (NHANES) questionnaire from 2007 to 2020, and their variable factors of age, race, education level, Poverty Impact Ratio (PIR), marital status, Body Mass Index (BMI), waist circumference, duration of moderate exercise, smoking habits, hypertension status, energy intake, diabetes and alcohol consumption habits were analysed statistically and by logistic regression.

RESULTS

Univariate and multivariate logistic regression analysis of the relationship between age at menarche and gynaecological cancer (uterus/cervix/ovary cancer, the following gynecologic cancers in the article refer to having at least one of these three cancers) prevalence showed a negative association between age at menarche and malignancies of the uterus and ovaries prevalence (OR: 0.82, 95% CI 0.69-0.97), with a statistically significant difference (p = 0.02). Regression results of the association between age at menarche and different types of malignancies of the uterus and ovaries found a negative association between age at menarche and prevalence in uterine cancers (P = 0.03) and no association between age at menarche and prevalence in cervical and ovarian cancers (P = 0.17, P = 0.29). Those with a younger age at menarche were more likely to develop uterine cancer (OR: 0.72, 95% CI 0.54-0.98).

CONCLUSIONS

There was a correlation between age at menarche and malignancies of the uterus and ovaries, with those who had menarche at an earlier age being at a higher risk of uterine cancer.

Intergenerational transitions in age at menarche: insights from Chandauli district, Uttar Pradesh, India

BACKGROUND

Menarche, a milestone in a woman's reproductive journey, is influenced by various factors such as lifestyle and dietary habits. Recent studies have corroborated this claim and prompted further investigation. This study explores the connection between menarche timing with lifestyle and dietary habits among three generations of women from the Sakaldiha block of Chandauli district and presents valuable insights into the role of diet and lifestyle in this crucial reproductive event.

METHODS

The study is based on primary data collected using multistage stratified random sampling. A comparative analysis of the mean age at menarche across independent variables has been conducted using the one-way analysis of variance (ANOVA) technique. Additionally, a multiple regression model has been developed to investigate the association between menarcheal age and various dietary, lifestyle and socio-economic factors among 400 respondents.

RESULTS

The average age of menarche for respondents was 14.29 years (95% CI: 14.12, 14.45), which has decreased by 1.66 years from 14.89 years (95% CI: 14.63, 15.15) in women over 40 years of age to 13.23 years (95% CI: 12.97, 13.49) in the < 20 years age group. The study additionally found that dietary and lifestyle factors had an impact on the age of menarche, with those who regularly consumed junk food, occasionally ate meat/fish or eggs, completely avoided curd or buttermilk and engaged in non-resting leisure activities experiencing an earlier onset of menarche.

CONCLUSION

The study shows that diet and lifestyle affect age at menarche, with current generations experiencing an earlier onset of menstruation. The effect of socioeconomic status remains inconclusive.

Menarche and pubertal progression: a cross-sectional analysis of timing and influencing factors in North-Eastern Ghana

Menarche and pubertal onset vary across populations but understanding age-at-menarche (AAM) and pubertal growth tempo is limited in low-income settings. Identifying factors influencing pubertal development is vital for creating targeted health and education programmes supporting adolescent girls' well-being. Baseline data (n = 1045) from the Ten2Twenty-Ghana study were analysed to examine menarche attainment, pubertal development, AAM, and the associated factors among girls aged 10-17 years in the Mion district, Ghana. The data collection methods included anthropometry, body composition, haemoglobin status, a qualitative 24-hour dietary recall, a food frequency questionnaire, and a pubertal development score (PDS). Binary logistic and linear regression analyses were used to model odds ratios for menarche attainment and regression coefficients for AAM and PDS. About 19.9% of the girls had experienced menarche, with a mean AAM of 13.4 ± 1.5 years. Among post-menarche girls (n = 205/1045), 12.2% and 15.1% experienced early (AAM < 12 years) and late menarche (AAM < 15 years), respectively. The mean PDS was 1.8 ± 0.7 out of 4. Among the adolescent girls, 36.2% were prepubertal, 17.0% early -pubertal, 18.6% mid-pubertal, 27.9% late pubertal, and less than 1% were in the post-pubertal stage. An increase in fat mass (FM), fat-free mass (FFM), height-for-age-z-score (HAZ), and body mass index-for-age-z-score (BAZ) was observed with puberty progression, but a steep decline in HAZ was noticed for girls in late puberty, increasing again post-puberty. Being older (adjusted odds ratio (AOR) = 2.06, 95% C.I.: 1.83, 2.31), stunted (AOR= 0.20, 95% C.I.: 0.10, 0.40), thin (AOR = 0.30, 95% C.I.: 0.11, 0.80), and overweight/obese (AOR = 7.29, 95% C.I.: 2.60, 20.43) were the significant predictors of menarche attainment. Being older (β = 0.39, P < 0.0001), stunted (β= -0.92, P = 0.01), thin (β = 1.25, P = 0.01), and having a literate mother (β = -0.72, P = 0.03) were significantly associated with AMM. A higher HAZ, FM, FFM, age, and Konkomba ethnicity were positively associated with higher PDS. This study highlights the complexity of factors influencing menarche and pubertal development. These insights are essential for developing targeted health and educational programmes that address nutritional and socio-demographic disparities to promote adolescent girls' well-being and healthy pubertal development.

Food craving, vitamin A, and menstrual disorders: A comprehensive study on university female students

BACKGROUND

Menstrual disorders, influenced by dietary habits like high fat intake and low fruit and vegetable consumption, are a global public health issue. This study assessed the prevalence of dysmenorrhea, premenstrual syndrome (PMS), and irregular menstrual cycle (IMC) among female university students in Bangladesh, focusing on food cravings and low vitamin A intake as risk factors.

METHODS

In this comprehensive study, data from randomly selected female university students were collected using a structured questionnaire. The associations were analyzed through chi-square tests and multivariable logistic regression, reported as adjusted odds ratios (AOR).

RESULTS

The most prevalent menstrual disorder was dysmenorrhea (68.3%) followed by PMS (33.8%), and IMC (24.3%). Food cravers for high-fat and sweet foods were likely to experience dysmenorrhea (AOR: 2.4, 95% CI: 1.5-3.9, P<0.001), suffer from PMS (AOR: 3.9, 95% CI: 2.3-6.6, P<0.001), and have IMC (AOR: 3.0, 95% CI: 1.6-5.3, P<0.001) vs. subjects who didn't. Subjects consuming vitamin A-rich plant foods had 40% (AOR: 0.6, 95% CI: 0.4-0.9, P < 0.01) and 60% (AOR: 0.4, 95% CI: 0.2-0.6, P<0.001) less likely suffering from dysmenorrhea and IMC vs. who didn't. Both underweight and overweight/obese subjects experienced more than 2-fold dysmenorrhea vs. normal-weight peers. The chance of IMC was nearly 3-fold among overweight/obese subjects. However, lower physical activity was associated with PMS and IMC whereas family history was associated with dysmenorrhea and PMS. Among the socio-demographic factors, maternal education, place of residence, and earlier menarche (≤12 years) were associated with dysmenorrhea while marital status was associated with IMC.

CONCLUSION

This study indicates that increasing the intake of vitamin A-rich plant foods and reducing high-fat, sweet foods can lower the risk of dysmenorrhea and IMC. Additionally, it highlights the need for regular exercise to mitigate the increased risk of PMS and IMC.

Exploratory Study into the Classification Agreement between Self-Reported Age of Menarche and Calculated Maturity Offset in Adolescent Girls: A Two-Year Follow-Up Study

Menarche is a significant pubertal event influencing girls' participation in physical activity. As menarche is a sensitive matter, a non-invasive substitute is needed to help classify girls' maturity status and provide physical literacy to them in this regard. The objective of this exploratory study was to investigate the classification agreement between self-reported age of menarche and calculated maturity offset in adolescent girls from South Africa by making use of various statistical methods. Fifty-eight girls, n = 13 pre- and n = 45 post-menarche (Status Quo method) aged 13.51 ± 3.51 years at baseline, were analyzed (2010-2012). Independent t-testing, cross-tabulation, Roc Curve statistics and logistic regression were used to analyze the classification agreement between markers. All four statistical methods revealed the potential to categorize different maturity groups through the maturity offset equation, although the accuracy declined with increased age. A realized power of 0.92 was found for the group in the first year of the study, with a gradual and significant decline over time. Cross-tabs showed a significant moderate predictive effectiveness (Chi-square = 0.042) during T1, closer to PHV (13.51 years) although also declining significantly with increased age (T2, 14.51 years) beyond PHV (Chi-square = 0.459). Although positive results were found, caution must be used when using maturity offset equations in different homogenic populations due to their unique growth characteristics.

The sexual and reproductive health covariates of early menarche among adolescent girls

INTRODUCTION

Research suggests that girls who reach menarche at an early age are at greater risk for negative sexual and reproductive health (SRH) outcomes than their later-maturing counterparts, but very little research has examined this issue in sub-Saharan Africa, especially in West Africa. The goal of the current study was to determine whether early menarche was associated with any SRH outcomes in a sample of Ghanaian girls.

METHODS

The study data were drawn from the baseline assessment of a longitudinal study involving two age cohorts (13-14 and 18-19 years) of 700 adolescent girls from Ghana. Logistic regressions were used to assess the association between early menarche (before age 13) and seven SRH outcomes (adolescent sexual activity, early sexual initiation, inconsistent condom use, transactional sex, sexual violence, multiple sexual partners, and adolescent pregnancy).

RESULTS

Early menarche was significantly associated with adolescent sexual activity (odds ratio [OR] = 6.4; 95% confidence interval [CI] 2.1-19.7), and sexual violence (OR = 3.2; 95% CI 1.6-6.2) in the younger cohort and early sexual initiation (OR = 3.2; 95% CI 1.19-8.61) and multiple sexual partners (OR = 3.7; 95% CI 1.39-9.87) in the older cohort. Early menarche was also associated with transactional sex and teen pregnancy in the full sample.

CONCLUSIONS

These findings suggest the need for special attention to the needs of early-maturing girls in SRH programming. Interventions are needed to delay adolescent sexual activity in girls with early menarche. Efforts to prevent sexual violence among adolescent girls in Ghana may benefit from targeting and addressing the specific needs of early-maturing girls.

Secular trend in age at menarche among Indian women

Age at menarche is not only a parameter that signifies biological characteristics for women but is also considered as an indicator to measure the quality of life of a population. Moreover, menarche has significant implications on women's health and information about menarcheal age is crucial for health policymakers. However, little is known about the trends in menarcheal age in India. Thus, in order to fill this research gap, the present study aimed to explore the age at menarche, its trend and regional heterogeneity among Indian women. A birth cohort approach was used by polling data from the 1st (1992-93), 4th (2015-16) and 5th (2019-21) rounds of NFHS. Descriptive statistics and bivariate analyses were performed to present the distribution of age at menarche and mean age at menarche across birth cohorts and each category of covariates. A multiple linear regression model was fitted to examine the trend in age at menarche and further to investigate the association of covariates with menarcheal age among Indian women. The analysis demonstrated that a majority of women (66.2%) attained menarche between the ages of 13-14 years. Moreover, about 17.2% of women experienced an early age at menarche, whereas 16.7% of women had a late age at menarche. The mean age at menarche for the sampled women was 13.49 years. The analysis also observed a secular declining trend in menarcheal age among Indian women and a significant variation in the mean age at menarche across birth cohorts. It also highlighted significant socio-economic patterning in menarcheal age among women.

Ten2Twenty-Ghana: a randomised controlled trial on the efficacy of multiple micronutrient-fortified biscuits on the micronutrient status of adolescent girls

Adolescent girls are an important target group for micronutrient interventions particularly in Sub-Saharan Africa where adolescent pregnancy and micronutrient deficiencies are common. When consumed in sufficient amounts and at levels appropriate for the population, fortified foods may be a useful strategy for this group, but little is known about their effectiveness and timing (regarding menarche), particularly in resource-poor environments. We evaluated the effect of consuming multiple micronutrient-fortified biscuits (MMB), sold in the Ghanaian market, 5 d/week for 26 weeks compared with unfortified biscuits (UB) on the micronutrient status of female adolescents. We also explored to what extent the intervention effect varied before or after menarche. Ten2Twenty-Ghana was a 26-week double-blind, randomised controlled trial among adolescent girls aged 10-17 years (n 621) in the Mion District, Ghana. Biomarkers of micronutrient status included concentrations of Hb, plasma ferritin (PF), soluble transferrin receptor (TfR) and retinol-binding protein (RBP), including body-iron stores. Intention-to-treat analysis was supplemented by protocol-specific analysis. We found no effect of the intervention on PF, TfR and RBP. MMB consumption did not affect anaemia and micronutrient deficiencies at the population level. MMB consumption increased the prevalence of vitamin A deficiency by 6·2 % (95 % CI (0·7, 11·6)) among pre-menarche girls when adjusted for baseline micronutrient status, age and height-for-age Z-score, but it decreased the prevalence of deficient/low vitamin A status by -9·6 % (95 % CI (-18·9, -0·3)) among post-menarche girls. Consuming MMB available in the market did not increase iron status in our study, but reduced the prevalence of deficient/low vitamin A status in post-menarcheal girls.

Age at menarche of adolescent girls and the neighbourhood socioeconomic status of their school area

PURPOSE

To assess the association between abnormal timing of menarche among adolescent girls and neighbourhood socioeconomic status of their school area.

MATERIALS AND METHODS

Our analysis included 187,024 girls aged 15-18 years from the Korea Youth Risk Behaviour Web-Based Survey (KYRBS) from 2007 to 2015. Early and late menarche were defined as menarche before 11 years and no menarche by age 14 years, respectively. The deprivation index values for the areas where the schools were located were used as an indicator of neighbourhood socioeconomic status based on the 2005 national census data. We calculated odds ratios (OR) for early and late menarche using a multinomial logistic regression model. Covariates included body mass index, parental education, single or stepparents, siblings, household wealth, year of birth, survey year, and urbanisation.

RESULTS

Mean age at menarche was 12 years. The overall proportions of early and late menarche were 11.3% and 3.3%, respectively. When divided into four quartile groups based on the socioeconomic deprivation index, 11.3% of girls in the most deprived quartile and 10.6% in the least deprived area showed early menarche. The prevalence of late menarche did not differ across the deprivation index quartiles of school area. Attendance at schools located in highly deprived areas was associated with up to 10% higher risk of early menarche. This positive association was not evident for late menarche.

CONCLUSION

Among contemporary Korean girls, socioeconomic deprivation of the school area was associated with earlier puberty. This finding highlights the potential role of the socioeconomic environment of schools in women's lifetime health.

Menstrual distress in females of reproductive age: a literature review

Menstrual-related issues have significant public-health ramifications. Women who are having menstruation troubles should get their mental health checked by healthcare specialists. In young women, a menstrual-related condition has serious health implications. Young females who have menstrual issues miss job and school, and their behavioural and mental development suffers as a result. Depression and anxiety have an impact on women's menstrual periods in adults. Symptoms like as cramps, tiredness, backache, swelling abdomen, and painful breasts have also been described in women with menstrual misery. Menstrual distress has been shown to impair women's daily activities, as well as their reproductive and psychological health, according to research. Menstrual periods are frequently accompanied by a variety of unpleasant symptoms, such as premenstrual syndrome, which includes symptoms such as mild cramping and exhaustion. The severity of these symptoms, on the other hand, differs from woman to woman, depending on their health, food, way of life, and other factors. Women with menstrual-related issues have also reported smoking, alcohol intake, and an increase in hunger. Furthermore, young women experience emotional disturbances such as melancholy, restlessness, and despair. It is a sign of an atypical menstrual cycle if there is no cycle or if the bleeding is atypical or light. As a result, it is critical to maintain contact with a gynaecologist in order to detect any significant changes in a regular menstrual cycle.

Early age at menarche is associated with post-menarche back pain: An analysis of the Raine Study

INTRODUCTION

Back pain (BP) experienced by females during adolescent years appears to predispose them to an increased likelihood of its presence in adulthood. Understanding this phenomenon by identifying risk factors of those at risk potentially fosters preventative strategies and effective treatments.

OBJECTIVES

To investigate for associations between post-menarche BP and low back pain (LBP) and age at menarche (AAM) in Australian adolescents using the Western Australian pregnancy cohort (The Raine Study).

METHODS

This study used data from a longitudinal cohort study. BP data were collected retrospectively using a questionnaire. Menarche data was split into three established age classifications early (<12-years), normal (≥12 to >14-years) and late (≥14-years). Logistic regression models examined the effect of AAM on BP.

RESULTS

666 female participants provided valid menarche data with 183 (27.5%) early AAM, 429 (64.4%) normal AAM and 54 (8.1%) with late AAM. The mean AAM was 12.59 years. BP was disclosed by 27.5% in the 14-year follow-up and 31.5% in the 17-year follow-up. Participants who had early AAM had 79% higher odds of experiencing BP compared to participants who had normal AAM, after adjusting for confounders at the 14-year follow-up (adjOR 1.79, 95% CI 1.18-2.64).

CONCLUSION

There is evidence of an association, in this cohort, of early AAM with post-menarche BP. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures.

SIGNIFICANCE

Age at menarche is related to a range of health issues. This study sought to investigate if it was a risk factor for spinal pain. We used an existing Australian data base to explore this possibility and found an association with early age onset and post-menarche back pain. This result identifies an area for future exploration, including understanding this mechanism which may lead to the development of effective intervention measures.

The influence of socioeconomic status on menarcheal age among Chinese school-age girls in Tianjin, China

The association between socioeconomic status and the onset age of menarche is still not conclusive. This cross-sectional study was conducted among primary and middle school girls aged 7 to 16 years old in Tianjin, China, to explore the distribution of menarcheal age and its association with socioeconomic status. A self-designed structured questionnaire was completed by students and their parents to collect information on socioeconomic status (i.e., family income, parental education level, living residence), menarcheal status, and covariates (weight status of girls and their parents, sleeping hours per day, physical activity). Information on menarcheal status included whether or not menarche had occurred (Yes/No) and the exact age at menarche. Linear regression analysis was used to explore the association between socioeconomic status and menarcheal age before and after covariate adjustment. Among 1485 eligible girls with complete information, 445 had experienced menarche, with an overall menarche rate of 30%. The mean age at menarche was 12.9 years (95% confidence interval 12.8-13.0). Urban girls experienced menarche earlier than rural girls did (12.1 years vs. 13.5 years). Univariate analysis showed that urban residence and higher parental education were associated with earlier onset of menarche. After covariate adjustment, the significance still existed. However, after adjusting further for residence, the significant association with the parental education disappeared. Only urban residence was still significantly associated, even after further adjustment for parental education and family income, with adjusted regression coefficients (95% confidence interval) of - 1.087 (- 1.340,-0.834), indicating that the onset age of menarche among urban girls was 1.087 years (0.834, 1.340) younger than that among rural girls. Family income was not related to the onset age of menarche in any analyses.Conclusion: Urban-rural differences played a more important role in the early onset of menarche than socioeconomic differences between families. What is Known: • The age at menarche varies by race and country, but the global trend is towards earlier onset as a result of changes in nutrition, family structure, socioeconomic status, and physical condition. What is New: • Urban girls experienced menarche earlier than rural girls, but this urban-rural difference could not be explained by family income, parental education, weight status of the participants and their parents, participants' physical exercise and sleeping hours. • Higher parental education was associated with earlier onset of menarche, but this association disappeared after adjustment for living residence.

Ten2Twenty-Ghana: Study Design and Methods for an Innovative Randomized Controlled Trial with Multiple-Micronutrient-Fortified Biscuits among Adolescent Girls in Northeastern Ghana

Investing in adolescent girls' nutrition is vital for health and for breaking the intergenerational cycle of malnutrition and deprivation, but limited knowledge on the type, timing, and efficacy of interventions delays progress. We describe the design of a 26-wk randomized placebo-controlled trial with multiple-micronutrient-fortified biscuits (MMBs) among adolescent girls in northeastern Ghana. Apparently healthy, premenarche (n = 312) and postmenarche (n = 309) girls (10-17 y) were randomly assigned to receive the following for 5 d/wk: 1) MMBs (fortified with 11 vitamins and 7 minerals) or 2) unfortified biscuits. Data included plasma micronutrient status, anthropometry, body composition, cognitive function, psychosocial health, fertility, dietary intake, and sociodemographic and socioeconomic covariates, complemented with in-depth interviews (n = 30) and 4 focus group discussions. We hypothesized an increase in plasma ferritin and retinol-binding protein with a resultant increase in hemoglobin, cognition, vertical height, and psychosocial health. Our study seeks to investigate the efficacy and optimal timing of a multiple-micronutrient food intervention program for adolescent girls. The RCT was registered prospectively with the Netherlands Clinical Trials Register (NL7487).

Growth and socio-economic status, influence on the age at menarche in school going girls

INTRODUCTION

Onset age at menarche has been considered an important indicator of reproductive maturity in females and reflects the health status of the population. The purpose of this study was to determine the mean menarcheal age and to examine whether anthropometric and socio-economic status (SES) influences age at menarche in the girls from Punjab province of Pakistan.

METHODS

In this population-based cross-sectional study, 10,050 school-going girls aged 8-16 years from 35 schools across 12 districts of Punjab were recruited. Menarcheal data was obtained by using a questionnaire, while the anthropometric data were obtained by the measurements of standing height, body weight, waist, and hip circumference. The anthropometric indices of pre- and post-menarcheal girls were compared. Student's t-test, ANOVA, and post-hoc Tukey's test was applied for comparison between two and multiple groups respectively, P < 0.05 was considered statistically significant.

RESULTS

There was a normal distribution of age at menarche and mean was 12.4 years in the study population. The girls who reached menarche were found to be taller and heavier with higher BMIs, having a greater waist and hip circumference as compared to their pre-menarcheal peers. Waist-hip-ratio was less, and the waist-to-height ratio was higher in post-menarcheal as compared to pre-menarcheal girls. The girls belonging to low SES had delayed onset of menarche as compared to those belonging to middle/high SES.

CONCLUSION

The age at menarche was associated with SES and changes in various anthropometric measurements reflecting the growth status of girls.

Association of Early Menarche with Adolescent Health in the Setting of Rapidly Decreasing Age at Menarche

STUDY OBJECTIVE

This study aimed to investigate the association between age at menarche (AAM) and adverse health indicators in adolescent girls.

DESIGN

A retrospective cohort study.

SETTING

Population-based survey data.

PARTICIPANTS

A total of 319,437 female participants aged 12-18 years from the Korea Youth Risk Behaviour Web-based Survey.

INTERVENTIONS AND MAIN OUTCOME MEASURES

We assessed associations between AAM (categorized as ≤10, 11, and ≥12) and health indicators (poor self-rated health, high psychological stress, unhappiness, sexual initiation, and pregnancy). Covariates were individual-level (bodyweight, living with family, parent's education, household wealth, and presence of parents and siblings) and community-level factors (year of birth, single-sex education and level of school, urbanization level of school area, year of survey, and regional deprivation). Odds ratios (ORs) for each adverse health indicator were examined by each AAM group using multivariable regression analyses. For pregnancy, we calculated relative risks (RRs) using a log-binomial regression model.

RESULTS

Age at menarche was <12 in 42% of our study population. Nearly one-half of the girls born in the early 2000s went through menarche before the age of 12 years, whereas only one-third of girls born in the early 1990s went through menarche before the age of 12 years. Girls who experienced menarche at age ≤10 or age 11 years were more likely to show self-rated poor health (AAM ≤ 10: OR, 1.28; 95% confidence intervals [CI], 1.22-1.34; AAM = 11: OR, 1.16; 95% CI, 1.12-1.21), high stress (OR, 1.19; 95% CI, 1.14-1.23, and OR, 1.10; 95% CI, 1.06-1.14), and sexual initiation (OR, 2.21; 95% CI, 2.05-2.38, and OR, 1.32; 95% CI, 1.23-1.41) compared to those with AAM ≥12 years when data were adjusted for all covariates. AAM ≤10 years was associated with consistently higher odds for poor health than AAM ≥12 years. The ORs of sexual initiation increased with earlier AAM. Risk of pregnancy was similar across AAM groups when individual- and community-level covariates were controlled for.

CONCLUSION

Early menarche, defined as <12 years, can be still a useful indicator in adolescent health interventions to identify high-risk groups in the setting of declining AAM.

Early age at menarche and its associated factors in school girls (age, 10 to 12 years) in Bangladesh: a cross-section survey in Rajshahi District, Bangladesh

Background

Early onset of menarche is one of the most important factors for breast cancer and other associated health hazards. The aim of this study was to investigate the early age at menarche and its associated factors in school girls (age, 10–12 years) in Rajshahi District, Bangladesh.

Methods

Data was collected from Rajshahi District, Bangladesh, using multistage random sampling. Independent sample t test and binary logistic regression model were used in this study. A total number of 386 school girls aged 10–12 years were considered as a sample for this study.

Results

This study revealed that more than 48% girls already attained menarche within the age of 12 years, among them 25.6%, 41.0%, and 58.3% girls experienced menarche at the age of 10, 11, and 12 years, respectively. It was observed that the menarcheal girls were significantly taller (p < 0.01) and heavier (p < 0.01) than non-menarcheal girls. The menarcheal girls’ mothers were heavier (p < 0.01), shorter (p < 0.01), had more BMI (p < 0.01), reached menarche (p < 0.05) earlier than non-menarcheal girls’ mothers. Menarcheal girls had less number of siblings (p < 0.01) and lower order of birth (p < 0.05) than non-menarcheal girls. After controlling the effect of other factors, multiple logistic regression model demonstrated that obese girls were more likely to attain menarche than under- [AOR = 0.279, CI 95% 0.075–0.986; p < 0.05] and normal [AOR = 0.248, CI 95% 0.082–0.755; p < 0.05] weight girls. Urban school girls had more chance to get menarche than rural school girls at same age (AOR = 0.012, 95% CI 0.003–0.047; p < 0.01).

Conclusions

Therefore, modern lifestyle changes may have the important factors for early age at menarche of the studied girls in Bangladesh.

The relationship between the duration of menstrual bleeding and obesity-related anthropometric indices in students

BACKGROUND

Many women of childbearing age suffer from problems such as dysmenorrhea and irregular menstruation.

OBJECTIVES

The objective of the study is to determine the relationship between the duration of menstrual bleeding and obesity-related anthropometric indices in students.

METHODS

This cross-sectional study was carried out on 250 students in 2016. Data were collected by a questionnaire composed of: 1) demographic information, 2) information concerning menstrual cycle and 3) obesity-related anthropometric parameters. Anthropometric parameters include height, weight, waist circumference, hip circumference, and arm circumference. Independent t-test, Pearson correlation coefficient, and multiple linear regressions with backward strategy were used.

RESULTS

The average age of students was 21/295 (±1/585) years. For most participants, the duration of menstrual bleeding was 3-7 days (87/2%, 218 people). None of the participants had menstrual bleeding <3 days, and the duration of bleeding was >7 days for 32 participants (12/800%). A significant relationship was observed between the intervals of menstruation and the waist-to-hip ratio (r = 0/136, P < 0/041). Based on multiple linear regression, hip circumference and waist-to-weight, hip-to-waist, arm-to-weight, hip-to-thigh, and arm-to-height ratios are predictors for menstrual duration.

CONCLUSIONS

In this study, a significant association was found between the anthropometric indices and menstrual characteristics. These findings suggest the need for modifying anthropometric indicators to control menstrual cycle problems.

Early menarche is independently associated with subclinical hypothyroidism: a cross-sectional study

Background Subclinical hypothyroidism (SH) is more frequent in females than males, with a female to male ratio ranging from 1.5 to 5 in the general population. The aim of this study was to evaluate for the first time the association of reproductive factors, particularly age at menarche, with SH risk. Materials and methods In a cross-sectional study, reproductive factors such as age at menarche, at menopause and at first birth, lactation, parity, full-term pregnancies, reproductive years, use of oral contraceptives and hormonal replacement therapy, somatometric data and insulin resistance parameters were recorded in 72 consecutive female patients with SH and 72 healthy female controls matched on age (±5 years) and date of diagnosis (±1 month). Results SH cases exhibited significantly younger age at menarche than controls (12.6 ± 1.2 vs. 13.3 ± 0.8 years, respectively, p < 0.001). Cases presented later age at first pregnancy with a lower number of full-term pregnancies (p = 0.04). Early age at menarche was independently associated with SH risk, above and beyond thyroid autoimmunity, body mass index (BMI), hip circumference (HC), homeostatic model assessment of insulin resistance and alcohol consumption [odds ratio (OR): 0.22, 95% confidence interval (CI): 0.11-0.44; p < 0.001]. Conclusions It is possible that an interplay of early exposure to estrogens, as expressed by early menarche, and induction of thyroid autoimmunity may be associated with SH risk. More prospective studies shedding light on the role of estrogens in SH are required to confirm these findings.

Does exposure to PM10 decrease age at menarche?

BACKGROUND

There has been a consistent decrease in age at menarche in South Korea. A potential risk factor for early menarche is exposure to particulate matter (PM), because endocrine-disrupting compounds emitted into air from anthropogenic sources may be incorporated into PM. The objective of this study was to examine the association between pre-menarcheal exposure to PM ≤ 10 μm in diameter (PM₁₀) and age at menarche in adolescents of South Korea using Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012 data.

METHODS

We used self-reported age at menarche of 639 girls aged 13-17 years in this study. The cut-off age for early menarche was set to 12 years. Based on each subject's address, 1-year, 2-year, and 3-year averages of annual mean PM₁₀ concentrations (models 1-3) were linked to KNHANES. Models were adjusted for body mass index (BMI), city size, household income level, maternal age at menarche, and second-hand smoke exposure at home. SURVEYREG and SURVEYLOGISTIC procedures were used to address the complex survey design of KNHANES.

RESULTS

Overall analysis showed that exposure to PM₁₀ has a significant effect on decreasing age at menarche. Multiple linear regression results suggested that each 1 μg/m³ increase in 1-year, 2-year, 3-year averages of annual mean PM₁₀ concentrations accelerated age at menarche by 0.046 years (95% CI: -0.064, -0.027; p < .0001), 0.038 years (95% CI: -0.059, -0.018; p = 0.0003),and 0.031 years (95% CI: -0.047, -0.015; p = 0.0002), respectively. Adjusted ORs for a 1 μg/m³ increase in PM₁₀ concentration were 1.08 (95% CI: 1.04 -1.12) for model 1, 1.06 (95% CI: 1.02 -1.10) for model 2, and 1.05 (95% CI: 1.01 -1.09) for model 3.

CONCLUSION

Our findings suggest that elevated PM₁₀ concentration can decrease age at menarche. This is the first study that investigates the association between exposure to PM₁₀ and age at menarche using a nationally representative sample of Koreans.

Rural-urban variations in age at menarche, adult height, leg-length and abdominal adiposity in black South African women in transitioning South Africa

Background: The pre-pubertal socioeconomic environment may be an important determinant of age at menarche, adult height, body proportions and adiposity: traits closely linked to adolescent and adult health.

Aims: This study explored differences in age at menarche, adult height, relative leg-length and waist circumference between rural and urban black South African young adult women, who are at different stages of the nutrition and epidemiologic transitions.

Subjects and methods: We compared 18–23 year-old black South African women, 482 urban-dwelling from Soweto and 509 from the rural Mpumalanga province. Age at menarche, obstetric history and household socio-demographic and economic information were recorded using interview-administered questionnaires. Height, sitting-height, hip and waist circumference were measured using standardised techniques.

Results: Urban and rural black South African women differed in their age at menarche (at ages 12.7 and 14.5 years, respectively). In urban women, a one-year increase in age at menarche was associated with a 0.65 cm and 0.16% increase in height and relative leg-length ratio, respectively. In both settings, earlier age at menarche and shorter relative leg-length were independently associated with an increase in waist circumference.

Conclusions: In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood.

Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study

OBJECTIVES

The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age.

METHODS

We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals.

RESULTS

Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity.

CONCLUSIONS

Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.