Onset Of Menarche Research Articles

Secure Infant-Mother Attachment Buffers the Effect of Early-Life Stress on Age of Menarche

Prior research indicates that being reared in stressful environments is associated with earlier onset of menarche in girls. In this research, we examined (a) whether these effects are driven by exposure to certain dimensions of stress (harshness or unpredictability) during the first 5 years of life and (b) whether the negative effects of stress on the timing of menarche are buffered by secure infant-mother attachment. Results revealed that (a) exposure to greater harshness (but not unpredictability) during the first 5 years of life predicted earlier menarche and (b) secure infant-mother attachment buffered girls from this effect of harsh environments. By connecting attachment research to its evolutionary foundations, these results illuminate how environmental stressors and relationships early in life jointly affect pubertal timing.

A Study on Socio-Cultural Practices during Menstruation among Adolescent Girls of Jabalpur District

Background -Adolescence is defined by United Nations as the period of life from age 10 to 19 years Adolescents girls attain menarche during this phase. There are many socio cultural taboos practised during menstruation. Objective- To assess the socio cultural practices by adolescent girls during menstruation in rural and urban areas of Jabalpur district. Materials and Methods- A cross sectional study was conducted in rural and urban areas of Jabalpur district. 400 adolescent girls (200 rural and 200 urban) were randomly selected as study subjects. A predesigned questionnaire was used. Results- In our study average age of menarche in adolescent girls was 13.41 ± 1.015 years with the range of 10-16 years.. The social changes perceived by the adolescent girls after onset of menarche were mother becoming more strict, cessation of cooking, cessation of schooling, initiation of talk about marriage etc. Conclusion- Onset of menarche had imposed various restrictions on adolescent girls even within the household. This difference was probably due to the lack of awareness and due to the association of more stigmas with menstruation in the rural areas as compared to the urban areas.

Heavy Menstrual Bleeding as a Common Presenting Symptom of Rare Platelet Disorders: Illustrative Case Examples

Heavy menstrual bleeding (HMB) is a common symptom in patients who present to the obstetrician-gynecologist or adolescent medicine specialist and might result from an underlying inherited bleeding disorder. Whereas relatively common bleeding disorders such as von Willebrand disease are often included in standard laboratory assessments, rarer platelet function disorders can be challenging to diagnose. Additionally, HMB can be a particularly difficult symptom to manage in adolescents with platelet function disorders, and it is associated with decreased quality of life. We review the diagnostic and management issues of patients with platelet function disorders through the presentation of 2 patient case reports, with a focus on a diagnosis of Glanzmann thrombasthenia, an inherited qualitative disorder that affects platelet function. Whereas the first patient presented to the emergency department before the diagnosis of a bleeding disorder and required a hematologic referral and extensive laboratory assessments, the second patient had been diagnosed with Glanzmann thrombasthenia as a child but experienced severe management challenges at the onset of menarche. In both patients, collaboration between the obstetrician-gynecologist or adolescent medicine specialist and the hematologist was critical for achieving acute management of the bleeding symptoms and for ensuring optimal long-term disease management. Together, these cases highlight the importance of properly identifying females with HMB who might have an undiagnosed bleeding disorder and of consulting with a hematologist to determine an appropriate management plan throughout all life stages.

Age Pattern at Menarche as Results from a Puberty Survey

Background : Range age of menarche is 15 to 17 years old from 1950’s to 20th century. However, in the current generation, the menarche age ranges from 13 to 16 years old. The factors affecting the change in the age of menarche over time and individual variation are due to the genetic or environmental factors. This study was performed to determine age pattern at menarche in Jatinangor, Sumedang ,West Java, Indonesia. Methods : The data for this descriptive study was obtained from a puberty survey performed by faculty members of Faculty of Medicine Universitas Padjadjaran from April–September 2013 in Jatinangor, Sumedang, West Java. A total of 249 female respondents aged 11–70 years old were included in this study. The age and year onset of menarche was determined and analyzed using computer. Results : The range age of menarche in Jatinangor population from early 1963 until 2013 was 9–17 years old, with 0.8% (n=2) cases of precocious puberty in current generation (year onset of menarche, year 2004–2013). For the onset of menstruation, the current generation had a youngest age compared to the other older generations with a mean age of 12.28 years old. Furthermore, most of the respondents from the current generation reached menarche at the age of 12 years old (37.4%). Conclusions : The onset of menarche in current generation is earlier compared to the older generations with most of them reaching menarche at the age of 12 years old. [AMJ.2016;3(4):640–3] DOI: 10.15850/amj.v3n4.952

A study showing correlation between anaemia and common parasitological diseases among adolescent girls in villages of PHC Belkhera, Madhya Pradesh, India

Background: India continues to be one of the countries with the highest prevalence of anaemia, especially in rural population. Among adolescents, the girls constitute a more vulnerable group because it is a crucial period particularly with reference to reproductive health. The onset of menarche and early marriage predispose to anaemia. Worm infestation (poor hygiene, open field defecation) also blood loss through menstruation could be probable reason for anaemia in rural population of India. In order to prevent high maternal mortality and high incidence of low birth weight babies in India, there is a need to combat anaemia during adolescence.Methods:This was a Cross sectional (Observational) study carried out during period of August 2007 to July 2008.Results: A total of 200 adolescent girls of 10-19 years participated in this study. Prevalence of anaemia was very high in girls with excessive loss of blood during menses i.e. 80% as compared to girls with normal Bleeding (47%) (p<0.02). Prevalence of anaemia in girls going to open field for defecation was 57% (p<0.045). The prevalence of anaemia was also higher in girls ((83%) having worms in their stool as compare to other girls. It was also found statistically significant (p<0.046).Conclusions:We can infer that certain attributes that are prone to cause anaemia in adolescent girls can be modified by timely and periodically education, and therapeutic intervention.

Urban Rural Comparison of Anthropometry and Menarcheal Status of Adolescent School Going Girls of Jodhpur, Rajasthan, India.

Adolescence is the formative period of life. Poor adolescent health translates into poor maternal health leading to increased maternal morbidity with inter-generational consequences. To compare anthropometric, socio-demographic, menstrual and nutritional status of rural and urban adolescent school going girls of Western Rajasthan, India. A cross-sectional comparative study was conducted in two rural schools and one urban school of Jodhpur region. Anthropometric, socio-economic (family history, menstrual history, maternal education) and dietary habit data of 327 (137 urban and 190 rural) school going adolescent girls aged 11-16 years were collected using structured questionnaires by a school based survey after consent from parents and school officials. Height and weight were taken using the standard procedure. Stunting (height for age) and thinness [Body Mass index (BMI) for age] were calculated as per the National Center for Health and Statistics (NCHS) standards. Statistical analysis was done using student t-test, fisher-exact test and Chi-square test. Mean height was significantly higher in urban girls while mean BMI of adolescents was significantly higher in rural areas as compared to their urban counterparts. Growth spurt was between 12-13 years showing maximum increase in mean height, coinciding with or immediately post-menarche. Menarche was one year earlier in urban girls as compared to rural girls (p<0.001). Thinness was more prevalent among females in urban areas and stunting was more common amongst girls residing in rural areas. Life style habits (poor dietary habits, sedentary life style) of the urban girls may contribute to an early menarche but rural girls despite having a later onset of menarche; have a lower final height which may be attributed to their poor nutritional status. Improving nutrition of rural girls and modifying the life style of urban girls and educating their mothers will reduce the disparity and lead to better health and development of adolescent girls in this region and this could be expected to improve maternal health in future.

Dysmenorrhea among higher secondary schoolgirls of Imphal West district, Manipur: A cross-sectional study

Background: Dysmenorrhea is one of the common problems experienced by many adolescent girls after the onset of menarche. Objectives: This study had the following objectives: 1. To determine the prevalence of dysmenorrhea among adolescent girls; 2. To determine the association between dysmenorrhea and selected variables of interest; 3. To assess the effect of dysmenorrhea on quality of life; 4. To assess treatment-seeking practices for dysmenorrhea. Materials and Methods: This was a cross-sectional study conducted among higher secondary schoolgirls of Imphal West district, Manipur from December 2012 to September 2014. The sample size was calculated to be 660. Participants were selected by stratified two-stage cluster sampling. Data were collected using a self-administered questionnaire. Data were entered and analyzed using IBM SPSS version 20 (Armonk, New York, USA). Analysis was done using chi-square test and chi-square test for trend. Results: Among the 703 respondents, the prevalence of dysmenorrhea was 76.0%, and about one-fifth (21.2%) of the respondents were suffering from severe dysmenorrhea. Painful menstruation caused school absenteeism, poor exam grades, and poor interpersonal relationships, decreased concentration in class and affected daily physical activities in the majority of respondents. Only 37.5% of the dysmenorrheic girls were receiving treatment for painful menstruation, of which medication was the common, but only 13.1% of the dysmenorrheic girls took medication on prescription by a doctor. Conclusion: Health education on issues related to reproductive health should be incorporated early enough in the school curriculum to prepare girls for menstruation and inform them about available treatment options for dysmenorrhea.

A study of menstrual pattern and prevalence of dysmenorrhea during menstruation among school going adolescent girls in Lucknow district, Uttar Pradesh, India

Background: The world health organization (WHO) has defined adolescence as the age group of 10-19 years. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding, and dysmenorrhea. Objective of the study is to study the menstrual pattern and the prevalence of dysmenorrhoea among school going adolescent girls in Lucknow district of Uttar Pradesh, India. Methods: It was a school based cross-sectional study carried out in Lucknow district from October 2013 to September 2014. A total of 640 adolescent girls were included in the study. Data was collected, compiled and tabulated using Microsoft Excel and analysed using SPSS 17.0 version for calculation of percentages. Results: The overall prevalence of dysmenorrhoea was found to be 73.9% with 74.4% girls in urban schools and 72.7% girls in rural schools. Conclusions: The mean age at menarche was 12.87 years (S.D±1.45). In urban area it was 12.69 years (S.D±1.37) and 13.22 years (S.D±1.56) in rural areas. There is a need of health education for adolescents. Menstruation is an important milestone for adolescent girls and menstrual problems are common among adolescent girls.Education regarding menstrual.

Association of Age at Menarche with Anthropometric Measures in Punjabi Bania Girls.

Menarcheal age is the age at which menstruation begins. Menarcheal age is regarded as a sensitive indicator of physical, biological and psychological environment. 1) To determine the menarcheal age and to examine the relationship between current age at menarche with anthropometric measures in Punjabi bania girls. 2) To develop maturity standards for Bania girls. The present cross-sectional survey was carried out on 200 bania girls at the age of onset of menarche. Menarcheal data was obtained by status quo method by asking about whether menarche has been experienced or not. In the present survey adolescent girls were interviewed with the help of pre-designed questionnaire. Statistical analysis was carried out in SPSS software, version 16.0. The data were analysed using descriptive statistics and one-way ANOVA. Pearson's correlation coefficient was used for correlation studies. A total of 200 Punjabi bania girls were examined in the study. The median age of onset of menarche in these girls was 12.3 years. Menarcheal age was positively associated with bi-acromial width, bi-iliac width and arm span. The present research has revealed secular trend in the age of onset of menarche as indicated by median age of 12.3 years in Bania girls. The bi-acromial width, bi-iliac width and arm span were also correlated with the age of menarche.

Risk factors for acute knee injury in female youth football.

To prospectively evaluate risk factors for acute time-loss knee injury, in particular ACL injury, in female youth football players. Risk factors were studied in 4556 players aged 12-17 years from a randomised controlled trial during the 2009 season. Covariates were both intrinsic (body mass index, age, relative age effect, onset of menarche, previous acute knee injury or ACL injury, current knee complaints, and familial disposition of ACL injury) and extrinsic (no. of training sessions/week, no. of matches/week, match exposure ratio, match play with other teams, and artificial turf exposure). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated from individual variable and multiple Cox regression analyses. Ninety-six acute knee injuries were recorded, 21 of them ACL injuries. Multiple Cox regression showed a fourfold higher ACL injury rate for players with familial disposition of ACL injury (HR 3.57; 95% CI 1.48-8.62). Significant predictor variables for acute knee injury were age >14 years (HR 1.97; 95% CI 1.30-2.97), knee complaints at the start of the season (HR 1.98; 95% CI 1.30-3.02), and familial disposition of ACL injury (HR 1.96; 95% CI 1.22-3.16). No differences in injury rates were seen when playing on artificial turf compared with natural grass. Female youth football players with a familial disposition of ACL injury had an increased risk of ACL injury and acute knee injury. Older players and those with knee complaints at pre-season were more at risk of acute knee injury. Although the predictive values were low, these factors could be used in athlete screening to target preventive interventions. II.

The Epidemiology and Genetics of Uterine Leiomyoma

Uterine leiomyomas (fibroids) are the most common benign neoplasms in premenopausal women, which confer significant morbidity during the reproductive years and represent a significant public health issue. The incidence of fibroids has been associated with African-American race, early onset of menarche, early parity, and environmental/dietary exposures. These sex steroid-responsive uterine tumors are characterized by de novo transformation of the myometrium into fibroids via excessive formation of the extracellular matrix (ECM). Cytogenic anomalies, mutations in mediator complex subunit 12 (MED 12), and aberrant DNA methylation/demethylation have been observed, but have not been reported as direct mediators of fibroid development. Recent advances in epigenetics have implied a functional role of G protein-coupled receptor 10 (GPR10) overexpression and irregular microRNA expression in the pathobiology of fibroids that require future investigation. Herein, the impact of epidemiologic and genetic factors on the incidence and development of fibroids is reviewed.

Age at menarche and the risk of diabetic microvascular complications in patients with type 1 diabetes.

The aim of this study was to evaluate the relationship among age at onset of diabetes, age at onset of menarche and risk of diabetic nephropathy and laser-treated retinopathy in type 1 diabetes. Data related to age at menarche were collected through questionnaires and were available for 1,304 women who participated in the Finnish Diabetic Nephropathy Study (FinnDiane). A possible association between age at menarche and diabetic nephropathy and retinopathy was investigated. There was an inverse relationship between the age at onset of diabetes and age at menarche: the younger the age at onset of diabetes, the higher the age at menarche (p < 0.0001). A non-linear relationship between the age of menarche and risk of diabetic microvascular complications was found in patients with diabetes onset before menarche, but there was no such association in patients with diabetes onset after menarche. Women with delayed menarche (> mean age + 2 years) had a 2.30 (95% CI 1.27, 4.17; p < 0.006) times higher risk of nephropathy compared with the women who underwent menarche at the mean age ± 2 years. Delayed menarche also increased the risk of retinopathy (OR 2.34 [95% CI 1.36, 4.01]). After excluding patients with nephropathy, the OR for retinopathy was 2.11 (95% CI 1.15, 3.90). Earlier menarche (< mean age - 2 years) did not have any effect on this risk. Delayed menarche was associated with an increased risk of diabetic nephropathy and retinopathy, whereas early menarche was not. Delayed menarche may be used as a new tool to identify women at risk of diabetic microvascular complications.

Age at menarche and its association with the metabolic syndrome in Taiwan

The average age at menarche in the Taiwanese population is falling. Contrarily, the prevalence of metabolic syndrome (MetS) showed a worldwide increase in the past two decades. The aim of this study was to examine the association between age at menarche and MetS. A total of 3292 women aged 19-91 years old were enrolled in two databases from 2004 to 2008. MetS was defined according to American Heart Association's criteria. Age at menarche was obtained from self-reported questionnaires. Multiple logistic regression analyses were used to estimate the association between age at menarche and MetS with adjustment for potential confounding variables. The prevalence of MetS increased with age. After adjusting age, lifestyle status, and reproductive factors as variables, subjects who had menarche at a younger age showed significantly higher risk of MetS. The adjusted odds ratio of having MetS in <12 and 12-14 years old menarche age groups were 1.71 (1.07-2.71) and 1.22 (1.00-1.50), respectively. The significant increase in odds ratio for MetS in early age menarche also reveals a dose-response effect. Early onset of menarche is an important risk factor of MetS and may help identify women at risk of MetS.

Pattern of teen menstruation among secondary school girls in south east Nigeria.

Menstruation in the teenage age has assumed variable trends which is been influenced by several variables. This study is aimed at determining the pattern and trend of menstruation among teens attending secondary school in south east Nigeria and associated factors. Menstruation patterns were investigated using a stratified random sampling method of teens from junior secondary schools in Enugu, south east Nigeria. A self-administered questionnaire was developed and data analyzed using SPSS version 19. A total of 897 female teenagers aged 9-18 years completed the questionnaire with a mean age of 13.9±1.9 years. The mean age (SD) at onset of menarche was 12.5±1.2 years. Teenage girls with higher BMI achieved menarche earlier at age 8 and 9 when compared with their counterparts with lower BMI and this is statistically significant. F=7.60, df=8, p<0.001. Teens with a 14-day cycle had a higher BMI when compared with teens with longer cycle but this is not statistically significant. F=1.05, df=4, p=0.381. There is a statistical significance difference between teens duration of menstrual flow and BMI. Those with higher BMI had longer duration(4-5 days) compared with those with lower BMI. F=3.329, df=4, p=0.01 CONCLUSIONS: This study revealed that the mean age at onset of menarche was 12.5±1.2 years showing a continuing decreasing trend. Teens with higher BMI attain menarche earlier and had longer days of periods when compared with their counterpart with lower BMI.

Assessment of age at menarche and its relation with body mass index in school girls of Riyadh, Saudi Arabia

Aims and Objectives: Increase of childhood obesity prevalence and rapid changes in socio-economic status resulted in a decline in age at menarche, which contributes, to a number of diseases affecting women’s future health. The objective of this study is to assess the mean age at menarche in girls of ages 9-16 and observe its relationship with their body mass index and other covariates in Riyadh, Saudi Arabia.Materials and Methods: A cross-sectional study was conducted among 304 female students of both private and governmental schools in Riyadh, Saudi Arabia, during March –May 2013. Data on demographics, socioeconomic status, physical activity, diet, and age at menarche were collected from students and their mothers, using self-administered questionnaires. Physical examinations were conducted to collect the anthropometric measurements. Results: Out of 304 students with a mean age (SD) of 12.52(2.08), 165 (54.3%) attained menarche. Mean menarcheal age (SD) for the girls was 12.08 (1.28). The mother’s mean age at menarche was positively correlated with their daughters (r=0.411, P&lt;0.001). There was no significant correlation between BMI and age at menarche (P&gt;0.05). Governmental school students attained menarche at a higher age (12.34) than private school students (11.59), and the difference between them was statistically significant (P&lt;0.001).Conclusion: Schoolgirls in our study attained menarche at an early age with a mean menarcheal age of 12.08 years. Our data follows the globally and regionally observed declining trends of age at menarche. When assessing BMI as an influencing factor of onset of menarche, our results showed no correlation. Further longitudinal studies are encouraged to monitor factors influencing the onset of menstruation, in order to prevent the potentially adverse consequences of early menarche.Asian Journal of Medical Sciences Vol.7(2) 2015 5-12

Socioeconomic development and secular trend in height in China

The objective of this study was to examine the effect of socioeconomic development on secular trend in height among children and adolescents in China. Body height and spermarcheal/menarcheal ages were obtained from two periodic large-scale national representative surveys in China between 1975 and 2010. Chinese socioeconomic development indicators were obtained from the United Nations world population prospects. The effects of plausible determinants were assessed by partial least-squares regression. The average height of children and adolescents improved in tandem with socioeconomic development, without any tendency to plateau. The increment of height trend presented larger around puberty than earlier or later ages. The partial least-squares regressions with gross national income, life expectancy and spermarcheal/menarcheal age accounted for increment of height trend from 88.3% to 98.3% for males and from 82.9% to 97.3% for females in adolescence. Further, through the analysis of the variable importance for projection, the contributions of gross national income and life expectancy on height increment were confirmed to be significant in childhood and adolescence, and the contribution of spermarcheal/menarcheal age was superior to both of them in adolescence. We concluded that positive secular trend in height in China was significantly associated with socioeconomic status (GNI as indicator) and medical and health conditions (life expectancy as indicator). Earlier onset of spermarche and menarche proved to be an important role in larger increment of the trend over time of height at puberty for a population.

Two-Stage Repair of Complex Utero Cervico Vaginal Anomaly with Fish-Mouth Technique and Full-Thickness Skin Graft.

Description of successful correction of complex Mullerian anomaly, in stages using Full thickness skin graft, prior to the onset of menarche.

In Utero Exposure To Atrazine Analytes And Early Menarche In The Avon Longitudinal Study Of Parents And Children

Introduction: Atrazine is a suspected endocrine disrupting compound, and although animal studies have associated atrazine exposure to reproductive cancers and delayed puberty, its role in endocrine-regulated reproductive outcomes, such as menarche onset, in humans has not been examined. We determine the association between in utero exposure to atrazine analytes and earlier menarche attainment in a nested case-control study of the population-based Avon Longitudinal Study of Parents and Children (ALSPAC). Methods: Cases were girls who reported menarche before 11.5 years while controls were girls who reported menarche at or after 11.5 years. Seven atrazine analytes were measured in maternal gestational urine samples for 123 cases and 147 controls using on-line solid phase extraction-isotope dilution-high performance liquid chromatography-tandem mass spectrometry. The association between in utero pesticide exposure and early menarche was evaluated using multivariate logistic regression. We classified exposure to analytes detected in = 50% of study participants into three categories: &lt; limit of detection (LOD); LOD - =median compared to girls with exposure

Association of Obesity with Onset of Puberty and Sex Hormones in Chinese Girls: A 4-Year Longitudinal Study.

ObjectiveTo examine the influence of childhood obesity on the early onset of puberty and sex hormones in girls.MethodsHealthy girls with different percentages of body fat at baseline (40 obese, 40 normal, and 40 lean) were recruited from three elementary schools in Shenyang, China. These girls (mean age 8.5 years) were also matched by height, school grade, Tanner stage, and family economic status at baseline. Anthropometry, puberty characteristics, and sex hormone concentrations were measured at baseline and at each follow-up visit. The generalized estimating equation model and analysis of variance for repeated measures using a generalized linear model were used to determine the differences in puberty characteristics and sex hormones among three groups.ResultsOver 4 years, mean age of breast II onset was earlier among obese girls (8.8 years) than normal girls (9.2 years) and lean girls (9.3 years). The prevalence (%) of early-maturation in the obese, normal, and lean groups was 25.9%, 11.1%, and 7.4%, respectively. Obesity was associated with an increased risk for breast stage II (year 2: RR, 6.3; 95% CI, 1.9–21.1 and year 3: RR, 6.9; 95% CI, 0.8–60.1). None of the girls experienced menarche in the first year; however, by the fourth year 50.0% of obese girls had menarche onset, which was higher than normal weight (27.5%) and lean girls (8.1%). The mean estradiol level increased with age in the obese, normal, and lean groups. The mean estradiol concentration was higher in obese girls than in normal and lean girls throughout the 4-year period (P<0.05).ConclusionsChildhood obesity contributes to early onset of puberty and elevated levels of estradiol in girls.

On the threshold of adulthood: A new approach for the use of maturation indicators to assess puberty in adolescents from medieval England.

This study provides the first large scale analysis of the age at which adolescents in medieval England entered and completed the pubertal growth spurt. This new method has implications for expanding our knowledge of adolescent maturation across different time periods and regions. In total, 994 adolescent skeletons (10-25 years) from four urban sites in medieval England (AD 900-1550) were analyzed for evidence of pubertal stage using new osteological techniques developed from the clinical literature (i.e., hamate hook development, cervical vertebral maturation (CVM), canine mineralization, iliac crest ossification, and radial fusion). Adolescents began puberty at a similar age to modern children at around 10-12 years, but the onset of menarche in girls was delayed by up to 3 years, occurring around 15 for most in the study sample and 17 years for females living in London. Modern European males usually complete their maturation by 16-18 years; medieval males took longer with the deceleration stage of the growth spurt extending as late as 21 years. This research provides the first attempt to directly assess the age of pubertal development in adolescents during the 10th-17th centuries. Poor diet, infections, and physical exertion may have contributed to delayed development in the medieval adolescents, particularly for those living in the city of London. This study sheds new light on the nature of adolescence in the medieval period, highlighting an extended period of physical and social transition.