Abstract

This cross-sectional, observational, and descriptive study was conducted to evaluate the association between age at menarche in the adolescent population and the age at sexual initiation, age at first pregnancy, and experience of sexual violence in the adolescent population visiting a primary health unit in Brazil. We recruited 201 female adolescents who visited the gynecology outpatient clinic of a Basic Health Unit in the Federal District of Brazil. These adolescents answered a questionnaire with regard to sexual and reproductive health during doctor's appointments. To calculate the association, we recorded data for age at menarche, age at first sexual intercourse, age at first pregnancy, and experience of sexual violence. Pearson and Mann–Whitney correlation coefficient statistical tests were performed to evaluate the association between these variables. Mean age at menarche was lower among adolescents who became pregnant (p = 0.0004) and those who experienced sexual violence (p = 0.0008). Further, there was a strong association between age at menarche and age at first sexual intercourse (p < 0.0001). This study also demonstrated that the earlier the age at menarche, the earlier was the age at sexual initiation and age at first unintended pregnancy and the greater was the risk of experiencing sexual violence. Early menarche may be considered a vulnerability factor during adolescence.

Highlights

  • Menarche, or the first menstrual bleeding, is a significant event in the reproductive life of a woman

  • The results of this study corroborate the literature, confirming that there is a progressive tendency toward precocity of sexual maturation

  • This is an important medical and social problem, as it can result in increased morbidity and mortality in adult life [1,2,3]

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Summary

Introduction

The first menstrual bleeding, is a significant event in the reproductive life of a woman. Hormonal regulation of sexual maturation is susceptible to several factors from the beginning of prenatal life. Age at menarche is one of the most significant features commonly used for retrospective epidemiological studies on female sexual maturation in a population [1]. According to Karapanou and Papadimitriou [2], variability in the date of the first menstruation is due to complex interactions between genetic characteristics and environmental factors. Genetic factors contribute to age at menarche by approximately 57–82% [2, 3]. These factors include prenatal and postnatal determinants of menarcheal age, such as ethnic differences, maternal history, maternal weight gain during pregnancy, gestational diabetes, prematurity, and birth weight [4, 5]

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