Allostatic load and age of menarche

Abstract

Although stress and cumulative wear on the body are hypothesized to be associated with reproductive function, little research has been conducted. This cross-sectional analysis examines whether early age of menarche is associated with allostatic load, a measure of cumulative wear, in young women. This analysis was conducted using data from 2471 women between the ages of 17 and 30 years from the Third National Health and Nutrition Examination Survey. The definition of allostatic load was based on that previously created by Crimmins et al. (2003). The allostatic load score is the sum of seven cardiovascular or metabolic markers (diastolic blood pressure, systolic blood pressure, glycated hemoglobin, body mass index, triglycerides, high density lipoproteins, total cholesterol) and four inflammation markers (albumin, C-reactive protein, urinary creatinine clearance, peak flow). Cutoffs were determined from clinical standards when available. Early menarche was defined as onset of menstruation before the age of 11 years. Thirty-one women who reported their age of menarche as between the ages of 10 and 12 years were not defined as early menarche. Confounders included education (less than high school; high school or GED; more than high school), poverty income ratio (0.0–0.49; 0.50–0.99; 1.00–1.49; 1.50–1.99; ≥2.00), race or ethnicity (white, non-Hispanic; black, non-Hispanic; Mexican American; other Hispanic; other), and age. Odds ratios were estimated using PROC RLOGIST. Statistical analyses were conducted using SAS and SUDAAN. Overall 7% of women reported an age of menarche before the age of 11. Among those with high allostatic load scores, 13% reported early menarche. After adjusting for age, race or ethnicity, poverty income ratio, level of education, smoking history and depression, increased allostatic load score was associated with an increase in the odds of early menarche (odds ratio = 2.24, 95% confidence interval = 1.33–3.78). Although cross-sectional, this analysis shows that in early life there is an association between cumulative physiologic dysregulation and reproductive function.