Mean Age Of Menarche Research Articles

Correlation of Menstrual Pattern with Body Mass Index in Young Female Students

Many factors play a role in regularity and flow of menstrual cycle which include hormonal changes, genetics and body mass index (BMI). To evaluate the effect of BMI on menstrual pattern in medical and dental students, 196 apparently healthy female students of first and second professional MBBS and BDS in the age group of 17-20 years were taken. The data was collected by a pre-designed pre-tested questionnaire and a detailed history and clinical examination. BMI (Body Mass Index) was calculated as (kg/m2 = weight (kg)/ height2 (m2). Haemoglobin was estimated by Sahli’s Haemoglobinometer and bleeding time and clotting were estimated by using Duke’s method and Capillary tube method. The mean age of menarche was 13.33+0.88 years. 87.8 % subjects had menstrual cycle interval of 21-25 days. The mean cycle duration was 4.68+0.94 days. 84.7% females had a normal menstrual flow. Dysmenorrhoea was experienced by 47.4% subjects, out of these 47.3 % females had a positive family history. The prominent pre-menstrual symptom was in the form of cramps in 54.1% subjects. Abdominal pain was seen as the most prevalent menstrual symptom. Only 9.1% females had irregular cycles. Based on BMI, 65.8% females were normal, 20.4% females were underweight, 13.3% were in the pre-obese category and 0.1% were obese. A highly significant correlation was present between the regularity of the cycle and BMI and between menstrual flow and BMI. Mean haemoglobin concentration was 11.47+1.87g/dl, mean bleeding time was 2.78+0.66 minutes and mean clotting time was 4.08+0.88 minutes The study concludes that a majority of the girls were found to be anemic. Majority of the girls (90.81%) had a regular menstrual pattern, normal BMI (65.8%) and were suffering from mild anemia. Increase in BMI led to an increased menstrual flow. Majority of the subjects with regular cycles had a normal BMI.

Premenstrual Symptoms among Students in Health Institutions in Zaria, Northern Nigeria

Introduction: About 90% of menstruating women get advanced warning of an approaching period because of the physical and/or psychological changes in the days before the period begins. Many women have mild symptoms and in a few it may be severe. This study intends to find the commonest symptoms among students in health institutions in Zaria, Northern Nigeria. Objective: To determine the commonest premenstrual symptoms among students in health institutions in Zaria. Methods: A cross sectional study was carried out in some health institution in Zaria Northern Nigeria over a three month period. A total of 300 students were interviewed using semi structured open ended questionnaires. Information about premenstrual symptoms were sought. The criteria for the diagnosis of (Premenstrual Syndrome) PMS was based on the Diagnostic and Statistical Manual of Mental Disorder (DSM IV Manual). Data was analyzed using computer software SPSS version 20. Results: Medical students constituted 42.7%, Nursing 28.6%, Medical Laboratory 27.8% and Medical Records 0.9%.Their age range was 18 to 29 years with a mean age of 20 + 3 years. The mean age of menarche was 13.7 years (SD 2.1).The prevalence of PMS was 40.7%. The major tribes (Hausa/ Fulani, Igbo and Yoruba) were more likely to have the above symptoms than both the Northern and Southern minorities. The commonest symptoms was abdominal pain/discomfort as seen in 180 (70.6%) of the respondents. Tiredness 158 (61.0%) and painful/tender breasts 149 (57.1%) were also common. Fifty seven percent (57.3%) 141 of them had severe symptoms warranting drug use while 8 (3.7%) had to be admitted in the hospital. The use of drugs for the above symptoms as well as the hospitalization rate was not statistically significant. Conclusions: Both physical and psychological premenstrual symptoms were found among these students which affected their quality of life. To what extent these symptoms affect studies and family life in our environment requires further research.

Relationship between Lumbar Bone Mineral Density (BMD) and Body Mass Index (BMI) in Pre-Menopausal Population. A Large Cohort Study

Background: Osteoporosis is a multifactorial disease. The body mass index (BMI) can affect bone density (BMD) with higher BMI scores that seems to be protective for osteoporosis in postmenopausal women. Primary aim of this study was to relate BMI and lumbar BMD in pre-menopausal females. Methods: We obtained from our local registry demographic and anthropometric data of females aged 20 years or older that performed their first DEXA in our Hospital between 2006 and 2014. Criteria for patient selection were: absence of known risk factors of Osteoporosis (e.g., smoke, alcohol, metabolic disease that affects bone, fractures), a concomitant or previous treatment of osteoporosis or corticosteroids or other drugs affecting bone (e.g., thyroid hormones, oral anticoagulant, immunosuppressant drugs). Data collection included also Calcium, PTH and 25-OH vitamin D levels and a structured data sheet covering the medical and drug use history, and lifestyle habits, including smoking, consumption of alcohol and coffee, physical activity and calcium intake. Patients with low or high BMI (over 95 percentile) were eligible. Osteopenia (low bone density) and osteoporosis (very low bone density) were defined by T- score <-1 and <-2.5, respectively. Results: 1197 DEXA scan analysed. Mean age was 34.2 ± 1.8 years (range 20.8 to 45.7). Mean BMI was 27.2 ± 3.9 kg/m2 (range 15 to 36). Mean menarche age was 16.3 ± 5 years (range 11-17). The prevalence of low bone density (T score between -1 and -2.6) and very low bone density (T score 30 kg/m2. Conclusion: Our study showed a peculiar relationship between BMI and BMD values in pre-menopausal women that look like a parabolic curve, with lower BMD at extreme BMI levels.

Age at menarche and eruption of permanent second molars: an investigation to determine a possible correlation.

Objective: Downward shifts in the mean menarcheal age and earlier emergence of permanent second molars have been observed worldwide during the past few decades. A positive correlation between the two would make menarche a biomarker for permanent second molar eruption or vice versa, making it a simple tool for monitoring oral status of adolescent girls. This study was conducted to find a correlation between attainment of menarche and eruption status of permanent second molars in girls aged 10-13 years. Material and Methods: A cross-sectional descriptive study was conducted on 470 female students from six randomly selected schools who consented to participate in the interview and oral examination. Data were analyzed using the Chi square (X2) test with a p-value of < 0.05 considered statistically significant. Results: Significant differences existed within the age groups with regard to attainment of menarche (p = 0.000) and eruption status of second molars (p = 0.000 for all four teeth). However, no correlation could be found between attainment of menarche and eruption status of the permanent second molars. Conclusion: Although this study failed to find a correlation between the two variables, a population based multicentric survey may give a concrete conclusion on this issue.

Mean Difference of Age at Menarche and Body Mass Index among Government and Private High-School Students of Mekelle City, Northern Ethiopia

Background: The mean age at menarche varies from one setting to another. Individual differences in timing of menarche are associated with age differences in the onset of sexual activity and first pregnancy. The study was conducted to determine the mean difference of age at menarche and body mass index (BMI) among government and private high-school students of Mekelle city. Method: A cross sectional study design was conducted in selected 6 governmental and private schools of Mekelle city. A total of 290 study subjects were interviewed. Systematic random sampling method was used to select study subjects. An independent sample t-test was done for two independent groups to compare age at menarche among governmental and private school girls in relation to various variables. One-way ANOVA and Pearson’s correlation analysis was conducted on the combined analysis for the relationship between age at menarche and independent variables. Result: The mean age at menarche was 14.24 year ±1.42 SD. The mean age at menarche was one year younger for private school girls compared with government school girls (t=6.2, P<0.001). Time spending sitting in a day (r= −0.25, p<0.001) duration of sleeping (r= -0.13, p=0.03), living in their own house (t= -2.42, P<0.05) were negatively correlated with age at menarche. There was significant difference of age at menarche among the participants maternal education (F=6.0, P<0.001), Father’s education (F=8.45, P<0.001), and father’s job (F=9.55, P<0.001). The mean BMI of the participants was 20.22 ± 2.66 SD. More than quarters of the participants were underweight (26.3%). Conclusion: The mean age of menarche found in this study was higher than the report from other African countries. The mean age at menarche was statically different among the government and private school girls. Time spending sitting, duration of sleeping, living in their own house were negatively correlated with age at menarche.

Menarche Age of Mothers and Daughters and Correlation between them in Saudi Arabia

Objective: Menarche is the hallmark maturation event of every female child. The menarcheal age of mothers is thought to be a good predictor of the menarcheal age of daughters. The aim of this study is to evaluate the current age at menarche of young girls and to examine its correlation with that of mother’s menarcheal age. Materials and methods: This was a questionnaire-based cross sectional study conducted at Jeddah in Saudi Arabia. The target study population included young girls between ages 12 and 16 years, experiencing Age at menarche. The sample size for analyzing the relationship between menarcheal age of daughters and mothers was 165. SPSS 16 was used to analyze the extracted data. Results: The mean menarche age for the mothers (12.97 ± 1.71 years) was significantly higher than the daughters (11.5 ± 1.48 years). In addition, a significant positive correlation was observed between mother's menarcheal age and daughter's menarcheal age (r=0.264, P=0.023). Conclusion: The results of the survey clearly demonstrated that a phenomenon of acceleration is involved. Various environmental and genetic factors are also involved which influences the age at menarche. It is essential to broaden the cross sectional study with regards to other factors such as body mass index and physical activity at Menarcheal age.

초등학생의 월경에 대한 태도와 증상 및 대처행위에 관한 연구

본 연구는 초등학생의 긍정적인 월경태도 형성을 위한 프로그램 개발의 기초연구로서, 초등학생의 월경에 대한 태도, 증상 및 대처방법을 파악하기 위해 시도된 서술적 조사연구이다. 초경의 평균연령은 12.3세였고, 월경에 대한 태도는 전체적으로 부정적인 태도를 보였으며 초경 경험군 2.93점으로, 비경험군 2.86점에 비해 상대적으로 긍정적인 태도를 보였으나 유의미한 차이는 없었다. 초경 경험군에서의 월경증상은 2.12점으로 중간점수인 3점보다 낮은 점수를 보여 월경 증상이 거의 없거나 보통으로 느끼고 있는 것으로 나타났으며, 월경증상의 하부요인 중 '통증'을 가장 많이 호소하였다. 또한 월경 시 대처방법으로 '따뜻한 물로 샤워한다', '휴식을 취하거나 잠을 잔다'를 가장 많이 선택하였으며, '비타민 B를 섭취한다', '진통제를 복용한다' 등의 약물복용 항목은 거의 선택하지 않았다. 본 연구의 결과를 토대로 하여 초등학생의 월경태도에 영향을 미치는 요인에 대한 깊이 있는 체계적인 후속연구와 월경에 대한 긍정적인 태도를 갖게 하기 위한 효과적인 월경에 대한 보건교육과 월경에 대한 증상과 대처방법을 선택하기 위한 교육 및 상담 등을 제언하고자 한다. This paper is a descriptive study that aims to investigate attitudes towards menstruation, symptoms and coping behaviors in order to develop a program for building positive attitudes toward menstruation in primary school students. The mean age of menarche was 12.3 years, and students generally showed negative attitudes towards menstruation. Students who experienced menarche had relatively more positive attitudes than those who did not. However, no significant difference was exhibited. Menstrual symptoms occurred rarely or at a moderate level by showing a low score of 2.12 points. Of all sub-factors, 'pain' was the most serious. The most common coping behaviors during menstruation was 'I take a warm shower' and 'I take a rest or nap', while respondents rarely checked 'I take vitamin B supplements' and 'I take painkiller'. Based on the above findings, the study intends to perform a systematic study to further identify the factors affecting menstrual attitudes in primary school students. In addition, this paper suggests effective healthcare education on menstruation to build positive attitudes towards menstruation and education and counseling programs for adopting appropriate coping strategies to deal with menstrual symptoms.

Marriage and child bearing in patients with transfusion-dependent thalassemia major.

With good care, patients with transfusion-dependent thalassemia major (TDTM) can reach older ages, marry and reproduce. This study was conducted by the Thalassemia Research Center. Medical notes of all TDTM patients and all non-transfusion-dependent thalassemia major (NTDTM) patients were reviewed from July to December 2012. Also, patients were interviewed. The questionnaire was made in consultation with research methodology experts and reliability was achieved by a pilot study of 12 patients, by the test-retest method (r = 0.9). Epidemiologic characteristics of patients and the pregnancy outcomes were recorded. Descriptive statistics were used with SPSS 17. Four hundred and nineteen medical records were reviewed. Three hundred and forty-five (82.5%) were TDTM. One hundred and seventy-five (50.7%) were female with a mean age of 25.4 ± 7.05 years and 42 (25%) had been married. Mean age of menarche and marriage was 15.4 ± 1.6 and 21.8 ± 4.5 years, respectively. Total number of live children is nine so far. Mode of delivery in female patients was cesarean section. Almost 78% of newborns weighed 2500-4000 g. Almost 22% of pregnancies were assisted. Male patients consisted of 170 (49.3%) and 55 (32.3%) of them had been married. Mean age at marriage was 24.27 ± 3.5 years. With better management, patients with TDTM can reach the age of reproduction. Medical teams should be prepared for this possibility.

Perceptions and practices regarding menstruation in adolescent girls in Yazd

Objective: Puberty is the most prominent stage of life. The purpose of this study was to evaluate effects of puberty health education on promoting of its awareness in girls. Methods: In an interventional quasi-experimental study (pre and post test), awareness, attitude and practice of 500 high school first grade student girls evaluated before and after health education in Yazd in 2004- 2005 . Results: Mean age of menarche was 13.46±1.12. Over ninty three percent (93.6%) of girls had a previous information about menstruation where mother was the major source (53%). Good and poor knowledge were seen in 36% and 28.6% respectively but practice was seen in 24.4% and 32.8% respectively. 85.2% of girls believed that menarche is evidence of health, but in 91.6% girl’s menarche was associated with worry and shame. Negative psychological attitude about menstruation was seen in 59.8%. The mean number of knowledge and practice before and after intervention was 5.3±2.9, 11.8±2.18 and 4.3± 1.8 and 10.2 ± 2.3 respectively (PV =0.0001). Conclusion: Educational programs are needed for girls and their mothers to correct misinformation about exercise, food restrictions and good health puberty and menarche. DOI: http://dx.doi.org/10.3126/njog.v3i2.10830 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 40-43

English

BACKGROUND: Menarche is most striking event in process of female puberty. Some girls seek medical attention for normal cycle variation. Others are unaware that their bleeding patterns are abnormal and may be attributable to significant underlying medical issues. Menstrual cycle, as a vital sign serves a powerful tool to assess normal development and to exclude pathologies. AIM: To find out age of menarche, menstrual pattern and types of menstrual disorders. METHOD: A cross sectional study was conducted among 80 nursing students of nursing college, linked with Peoples college of Medical Sciences and Research centre, Bhopal. All girls in study group were below 19 years of age. Information was obtained in a self-administered proforma after verbal consent. Questionnaire was analyzed by subject expert & statistical analyst. RESULTS: Mean age of menarche in this study was 11 years, 40% have regular cycle. Mean duration of bleeding was 4-6days.Day of heaviest flow was day 2 in 60%. Menstrual cycle was of 25 -45 days. Dysmenorrhoea was present in 40% of adolescent girls. 30% had dysmenorrhea since menarche. 30% had premenstrual symptoms. The most common premenstrual symptom was general fatigue in 46%. Absence from the college was observed in 20%. 40% girls taken menstruation as normal phenomenon. 78% had discussed menstrual problems with someone, most commonly with their peers. CONCLUSION: Pattern of menstrual bleeding in all adolescent girls in order to identify possible pathology and to improve their quality of life should be assessed routinely.

Abstract MP68: Age at Menarche is Inversely Associated with Liver Steatosis and Abdominal Fat Depots: CARDIA Study

Introduction: Age at menarche is associated with cardiometabolic disease risk later in life; whether hepatic steatosis (fatty liver) or regional depots of abdominal fat play a role in this association is unclear. In a community-based sample of African American and White women free of diagnosed liver disease, we tested the hypothesis that age at menarche is inversely associated with hepatic steatosis and abdominal fat depots in midlife, after control for demographic and lifestyle factors and early adult BMI. Methods: Women in the Coronary Artery Risk Development in Young Adults (CARDIA) study with complete measures of recalled age at menarche (at exam years 0 (1985-86) and 2), multiple slice abdominal CT (at year 25) of hepatic steatosis (HS), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IAT) were included. We defined nonalcoholic fatty liver disease as liver attenuation ≤ 48 Hounsfield units (HU) after excluding other causes of liver disease. We used multivariable linear regression (continuous outcomes) and Poisson regression (binary outcomes). Results: The mean (±sd) menarcheal age for the 1215 women eligible for this analysis was 12.6±1.5 y. A 1-year increment in age at menarche was associated with lower liver steatosis (0.8±0.2 HU; greater HU = less steatosis), VAT (-6.6±1.2 cc), IAT (-7.3±1.4 cc), SAT (-19.3±3.3 cc), and NAFLD prevalence (prevalence ratio=0.86; 95% CI: 0.78, 0.94) after confounder adjustment ( Table ). Associations remained after further adjustment for year 0 BMI (ages 18-30 y; all p for trend &lt;0.05), but were attenuated (all p for trend &gt;0.05) after adjustment for year 25 BMI (a mediator) when participants were 43-55 y. Conclusion: These findings indicate age at menarche is inversely associated with midlife liver steatosis and visceral and subcutaneous abdominal fat, independent of early, but not late, adult BMI. Whether these associations mediate the higher cardiometabolic disease risk observed in early maturing females needs to be determined.

Prevalence of metabolic syndrome in the family members of women with polycystic ovary syndrome from North India.

Background:Polycystic ovary syndrome (PCOS) is the most complex and common endocrine disorder of women in reproductive years. In addition to irregular menstrual cycles, chronic anovulation and hyperandrogenism, it has many metabolic manifestations such as obesity, hyperlipidemia, hyperinsulinemia, insulin resistance, dysglycemia, increased risk of cardiovascular disease or possibly endometrial cancer. Familial clustering of PCOS in consistence with the genetic susceptibility has been described.Materials and Methods:The present study assessed the clinical, biochemical and hormonal parameters including prevalence of metabolic syndrome by two different criteria in the first- degree relatives of patients with PCOS.Results:The average age of 37 index patients was 23 ± 3.6 years, with the mean age of menarche as 13.3 ± 1.2 years. The mean age and age of menarche in mothers (n = 22) was 48.8 ± 5.1 and 13 ± 1.3 years, respectively, whereas as it was 23.5 ± 4.7 and 13.3 ± 1.2 years in sisters (n = 22), respectively. Metabolic syndrome (MS) defined by International Diabetes Federation (IDF) criteria was present in 10 index patients, 1 brother, 4 sisters, 17 mothers and 15 fathers while as by Adult Treatment Panel III (ATP III) it was in 8 index patients, 5 sisters, 16 mothers and 11 fathers.Conclusion:The presence of MS or related metabolic derangements is high in the family members of women with PCOS.

Growth and sexual maturity pattern of girls with mental retardation

Background:Growth of mentally retarded children differs from that of normal children. However, the adolescent growth and development of Indian mentally retarded children has not been studied.Aim:This study was conducted to evaluate the physical growth and sexual development of adolescent mentally retarded girls in North Indian population and to compare it with that of normal girls of same age group.Materials and Methods:One hundred mentally retarded (intelligence quotient (IQ) less than 70) and 100 normal girls between 10 and 20 years of age were categorized into 1-year age groups. Their height was measured and the sexual development was assessed based on breast development (BD) and pubic hair growth (PH) stages 1-5 on the basis of Tanner scale. The data was then compared between the two groups using Student's t-test. The mean age of menarche was calculated by applying Probit analysis.Results:The mean height of mentally retarded girls was significantly retarded as compared to normal girls at all ages; however, the mean height gain during 11-20 years was same in both the groups. The mentally retarded girls also showed significant retardation in PH growth at 15-17 years and in BD at 15-16 years of age.Conclusions:The physical growth and sexual development of adolescent mentally retarded girls was retarded as compared to the normal girls. The physical growth retardation occurred during early childhood (before 11 years), however the retardation in sexual maturity occurred during middle adolescence, between 15-17 years of age.

A community based study on menstrual hygiene among reproductive age group women in a rural area, Tamil Nadu

Background : Women suffer due to their ignorance on hygienic requirement during menstruation. Hygiene‑related practices of women during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to reproductive tract infections (RTI). Aims: This study aims to assess the hygienic practices during menstruation and influence of socio-demographic factors on menstrual hygienic practices among women of reproductive age-group. Subjects and Methods: It is a cross‑sectional community‑based study conducted among 200 women of reproductive age group (15-45 years) in a rural field practice area, VMKV Medical college, Salem in Oct–Dec 2013 by using simple random sampling technique. Using structured pretested questionnaire, women were interviewed regarding their sociodemographic history and menstrual hygiene practices. Result: Majority of study population, 36% (72/200) belonged to the 21-30 year age group. About 75% (150/200) were married. Majority of women were unskilled workers 35% (70/200), had primary education 43.3% (86/200), and 54.3% (108/200) belonged to lower middle class. The mean age of menarche among the reproductive age‑group women was 13.15 years. Majority of women 51.8% (104/200) used cloth during menstruation; about 45.7% (91/200) used the same cloth by washing and reusing every month. There was a significant influence of sociodemographic factors and hygienic practices during menstruation (P < 0.001). Conclusion: Most women were found to follow unhygienic practices. Hence, efforts such as improving female literacy and health education regarding the various risk factors should be made by the policy makers to increase menstrual hygiene among rural population. Keywords: Menstrual hygiene, reproductive age‑group women, rural area

Age at menarche among secondary school girls in an urban population of Nigeria

Background: Menarche signals the beginning of reproductive years in women. In recent times, the age at menarche has shown a downward trend, and this may be potentially influenced by biosocial factors. Objective: The objective was to determine the current mean age at menarche among secondary school girls in Benin-city and the influence of biosocial factors. Materials and Methods: The study was a cross-sectional descriptive study of secondary school girls in Benin-city. Data collection was by use of pretested self-administered questionnaires. Biophysical parameters of the respondents were also obtained. Age at menarche was compared with social and biophysical indices. Results: Of the 1,408 respondents, 952 (67.6%) had attained menarche. Mean age at menarche of 12.3 ± 1.18 years was estimated. About 16.0% of the respondents attained menarche while still at primary school. Mean menarcheal age was influenced by the social status of parents, being lowest among girls from social class 1 (11.8 ± 1.25 years) and highest among girls from social class 5 (14.1 ± 1.14 years), P = 0.0001. Other factors that influenced mean menarcheal age included family type and size. Anthropometric parameters of postmenarcheal girls were also higher than those of their premenarcheal colleagues. Conclusion: In line with a global trend the age at menarche in Benin-city is lower in this study with reference to previous reports. This was positively influenced by some biosocial factors (such as higher weight/body mass index and mid-arm circumference). Furthermore, the observation of menarche even among primary school girls suggests a need for early initiation of enlightenment and education in adolescent reproductive health.

Menarche and Menopause among the Yanadi Tribal Women

Menarche and menopause are two important events in women’s life, and they are accompanied by many morphological and physiological changes in the body. The onset of menarche in girls signifies the attainment of sexual maturity. The period of menopause is also important, as it is marked by the arrest of ovulation and menstruation flow and indicates cessation of reproductive function. In the present study an attempt has been made to study the age at menarche and menopause among the Yanadi women of Nellore district, Andhra Pradesh. The mean menarcheal and menopausal age of Yanadi women was found to be 13.46 ± 1.094 years and 44.68 ± 2.765 years respectively.

The Impact of Menstrual Period on Physical Condition, Academic Performance and Habits of Medical Students

Background: Menstrual period is a critical time in the life of females. It influences different daily life aspects, including physical status, academic performance, mood, diet, exercise and sleep pattern. Few studies were conducted to investigate its impact on medical students. Objective: To determine the impact of the menstrual period on female medical students. Methods: This is a cross sectional study on Arabian Gulf University medical students. A self -administered questionnaire was developed for the purpose of this study. It included the following variables: socio-demographic characteristics, menstrual history, academic performance and habits (sleeping, appetite, exercise, mood and social relationships) during the menstrual period. The questionnaires were distributed to two hundred twenty-six female medical students during the academic year 2011-2012. Results: The mean age of menarche of the study population was 12.7 ± 1.5 years. The majority (90.7%) of the students experienced symptoms during their menstrual period, with the commonest five being abdominal cramps (90.7%), backache (82.7%), tiredness (80.4%), pelvic pain (74.0%) and bloating (65.2%) Pain was reported as the most common cause of exercise discontinuation during menstruation (42.86%). The menstrual period affected their amount of sleep (73.3%), sleep quality (60%), diet (73.8%) and exercise (60.7%). Academic performance was affected as well; study time (76.0%), concentration (65.8%), group activities (58.1%), examination performance (51.8%) and attendance (40.8%). Conclusion: It can be concluded that the menstrual cycle has different effects on female medical students’ physical conditions, academic performance and habits. Further research should be conducted to study the effect of menstruation on Arab females.

Abstract P2-14-06: Characterization of risk factors in breast cancer young adult patients

Abstract Background: Breast cancer diagnosis in the age group of 20-34 years represents 4% of breast cancer cases diagnosed at all ages in São Paulo state, Brazil. Risk factors in this age group of patients are little understood, especially in those not reporting familial history of breast/ovarian cancer syndrome (BOCS). Identification of predisposing factors and BRCA1/2 mutations (mut) in young Brazilian patients may contribute to characterize women with increased risk of breast cancer. Objective: Characterize familial history and risk factors for breast cancer in young adult Brazilian patients and germline mutations in BRCA1/2 genes. Methodology: Forty-five patients diagnosed with breast cancer at ages 18-35 years were interviewed using a comprehensive questionnaire. Genomic DNA was extracted from peripheral blood and BRCA1/2 mut were screened by Sanger sequencing of coding sequences, analyzed through Mutation Surveyor v.3.20 and searched in BIC Database, LOVD, LOVD-IARC and UMD. Results: Mean age of patients at time of diagnosis was 33 y (24-35y); mean age of menarche was 13 y (8-19y); 32 (71.1%) patients had at least one born child, median age of first pregnancy was 22 years; 86.7% never smoked; 71.1% were no regular alcoholic drinkers; mean of body mass index was 27.14 (overweight). Most patients were diagnosed with invasive ductal carcinoma (91.1%); grades II or III (95.5%); ER/PR positive (57.8%); triple-negative (TN: 31.1%) or HER2 positive (17.8%). Among them, 22.2% reported positive familial history (NCCN criteria for BOCS). Deleterious mutation in BRCA1/2 genes was found in 17.8% of the patients (BRCA1, n = 3; BRCA2, n = 5). Among 10 and 35 patients reporting or not BOCS familial history, 3 (30%) and 5 (14.3%) respectively, had BRCA1/2mut. All BRCA1mut patients had TN tumors; BRCA2mut patients had ER/PR positive (60%), HER2 positive (20%) or TN tumors (20%). Most patients reported one or two of the following risk factors: early menarche (&amp;lt;12y); current/previous use of oral contraceptive; no breast feeding and no parities. Among 30 patients reporting no familial history and presenting BRCA1/2 wild type, six (20%) and four (13.3%) reported three or four of these risk factors, respectively. Considering breast cancer protective factors, 17.8% of the patients breast fed &amp;gt;16 months and 24.4% were aged &amp;lt;20y at birth of first child. Diet habits are being analyzed. Conclusion: In young adults with breast cancer there is a trend towards a higher rate of positive familial history among whom there is a trend towards a higher chance of BRCA1/2 mutation. A better characterization of patients reporting no familial history is urgently needed. Financial Support: FAPESP. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-14-06.

Feritility and Attitudes To Fertility In a Cohort Of Women With Sickle Cell disease In South East London

Introduction Women with Sickle Cell Disease (SCD) have been reported to have delayed menarche, increased rates of miscarriage &amp; still birth. There is little evidence of the impact of SCD severity on fertility, or of patients’ attitudes towards their fertility. Methods Following IRB approval, an anonymised questionnaire was distributed to female patients over the age of 16 attending an SCD clinic. This included questions on menarche, fertility, reproductive history &amp; clinical severity. We also surveyed attitudes to fertility &amp; the role of fertility treatment. Results 101 women gave informed consent &amp; returned the survey of whom 68 (67%) had sickle cell anaemia (HbSS), 31 (31%) had HbSC &amp; 2 (2%) HbSß0 thalassaemia (HbSß0thal), the group mean age was 38yrs (range 17-74). 46 patients had severe disease phenotype (criteria for severity: ≥3 hospital admissions per year / ≥2 episodes of acute chest crisis/ ≥6 crisis at home per year or on Hydroxycarbamide (HU) therapy), 78% (36/46) had HbSS &amp; 49%(2/46) HbSC. 49% (22/46) were on HU, of whom 19 (86%) had HbSS &amp; 3 (14%) HbSC, the mean duration on HU was 4.7 years (range 2 weeks–15 years). 3 patients with HbSS, were on a chronic transfusion program, 1 as secondary stroke prevention &amp; 2 for disease severity. Mean age of menarche was 14 yrs (range 10-19). HbSC patients’ mean age of menarche was 13yrs (range 10-16), HbSS patients mean age of menarche was 14 yrs (range 10-19). 30% (30/101), (24 with HbSS &amp; 6 with HbSC), had never been pregnant. This group had a mean age of 28yrs (range 17-46), 1 never wanted children, 2 had previously been advised not to conceive, 1 was actively trying for a baby, &amp; 1 patient was awaiting in vitro fertilisation therapy (IVF). There was no difference in the severity of sickle disease in this group compared to the group with pregnancies. 70%(71/101) reported a total of 211 pregnancies, resulting in 111 (52%) successful deliveries (SDs) i.e. a live child/children. Further evaluation of 175 (81%) pregnancies revealed 98 (56%) SDs, (5 sets of twins &amp; 1 early neonatal death equating to 102 live births), 45 (26%) miscarriages, 27 (15%) terminations of pregnancy &amp; 5 (3%) still births (pregnancy loss at &gt; 24 weeks gestation). 52% (50/96) &amp; 63% (47/75) of pregnancies in women with HbSS &amp; HbSC resulted in SDs respectively, as did 25%(1/4) of pregnancies in HbSß0thal women. 74% (53/71) had at least 1 miscarriage (mean 1.7, range 1-7) there was no correlation between miscarriage &amp; sickle genotype or age at pregnancy. 46% (20/46) &amp; 63% (36/55) of patients with severe &amp; milder disease phenotype had miscarriages respectively (p = 0.01). The mean age at termination of pregnancy (26yrs) was lower, compared to 30yrs for women who had SDs or miscarriage &amp; stillbirth (31yrs). In total 41% (72/175) pregnancies were unplanned. 96% (26/27) of terminated pregnancies were unplanned, as were 32% (31/98) of SDs &amp; 28% (15/50) of miscarriages. 28% (28/100) of responders were currently using contraception. 12 (16%) of 71 women reporting pregnancies had no children, they had a total of 21 pregnancies (mean 1.75, range 1-7), 8 (67%) had HbSS, 3 (25%) HbSC. 18% (18/101) thought sickle may have affected their fertility, 93% (93/101) reported having children as being important, this included 28 (93%) of 30 women who had reported no pregnancies. 62% (63/101) would consider prenatal diagnoses (PND) if their partner had sickle cell trait, 59% (60/101) would consider pre implantation diagnosis (PIGD) &amp; 24% ( 24/101) would consider termination of an fetus with SCD. Discussion This study confirms that compared to the normal UK population, women with SCD, have a slightly increased rate of miscarriage &amp; a significantly elevated rate of stillbirth 3% vs 0.005%. Menarche is delayed by a year in patients with HbSS &amp; women with HbSC are more likely to have a successful pregnancy. Although 74% of the women had miscarriage &amp; only 56% of pregnancies resulted in a successful delivery, the majority of women were unaware of the effect of SCD on fertility. Most were not currently using any form of contraception, the rate of unplanned pregnancy was lower at 41% than that in the normal UK population of 50%. These women report having a child as being very important to them, &amp; though majority would consider PND &amp; PIGD only a minority (24%) would terminate a foetus diagnosed with SCD. This study is limited by being retrospective &amp; single centred, further multi-centre prospective studies are required to validate these results. Disclosures: Howard: Sangart: Membership on an entity’s Board of Directors or advisory committees.

Age at menarche among in-school adolescents in Sawla Town, South Ethiopia.

Although a declining trend in age at menarche has been observed in developed countries over decades commonly attributed to childhood excessive weight gain and sedentary life, little is known about this case in the developing countries. A cross-sectional study design and multistage sampling was used to include 660 school adolescents for analysis. Data collection included weight and height measurements. Multinomial logistic regression analyses were done for early and late age of menarche, in reference to average age at menarche, to measure the association of age at menarche with some socio-demographic variables and body habits. The mean age at menarche was 13.9±1.2 years (95%CI, 13.8-14.0). The menarche ages ranged between 10 and 12 years for 10.5%, 13 and 14 years for 54.5%, and 15+ years for 35%. Low menarche age was independently associated with high calorie consumption, high protein diet, more coffee intake, low physical activity and parents' low educational background. Low body mass index, low parents' income, exercise, and Amhara ethnic background were associated with late menarche age. The mean menarche age found in this study was higher than the report from developed countries. But, the proportion of adolescents with low menarche age was comparable with reports from developed countries. Inactive adolescents were more likely to see menarche earlier than average age. Healthy eating habits, regular exercise and nutrition education need to be promoted among school children.