Early Menarche and Subjective Health Complaints: A Pooled Cross-National Study

Abstract

Background: Subjective health complaints (SHCs) are often reported in adolescents and emerging as a public health of international concern. However, the research on early menarche with multiple SHCs is scarce. This study explores the associations between early menarche and SHCs with multiple indicators in a large-scale multinational sample of European and North American adolescent girls. Methods: We obtained the data on adolescent girls with age of menarche and eight kinds of SHCs the past 6 months from the 2002, 2006, 2010, and 2014 cycles of the Health Behaviour in School-aged Children study in 41 European and North American countries. We investigated the associations of early menarche with SHCs and multiple recurrent SHC using multivariable logistic regression models and calculated the predicted probabilities. Findings: The sample included 298,000 adolescent girls. The weighted prevalence of early menarche (<11 years) ranged from 3.77% to 5.24%. More than 10% of adolescent girls reported stomachache, backache and dizziness. More than one in five experienced headache, depressed mood, and sleeping difficulties. Nearly a quarter complained of irritability and nervousness. About 40% suffered from multiple recurrent SHC. Early menarche (<11 years or <12 years) was positively associated with each kind of SHCs and multiple recurrent SHC in each cycle and the pooled sample. Interpretation: We observed that European and North American adolescent girls with early menarche are at elevated risks of each kind of SHCs and multiple recurrent SHC. Early menarche may be viewed as a potential trigger of SHCs and an indicator for early supportive interventions in adolescent girls. Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Declaration of Interests: We declare no competing interests.