Onset Of Menarche Research Articles

СТРУКТУРА ВРОЖДЁННЫХ ПОРОКОВ РАЗВИТИЯ ЖЕНСКОЙ РЕПРОДУКТИВНОЙ СИСТЕМЫ (ПО ДАННЫМ ТАДЖИКСКОГО НИИ АКУШЕРСТВА, ГИНЕКОЛОГИИ И ПЕРИНАТОЛОГИИ)

Objective: To study the structure of congenital malformations of the reproductive organs in adolescent girls and women of early, and active reproductive age, according to their appeal to the Tajik Scientific Research Institute of Obstetrics, Gynecology, and Perinatology. Methods: 182 teenage girls and women of reproductive age (from 14 to 26 years), with isolated and combined congenital malformations of the reproductive organs and anomalies of the urinary system, were examined. All patients were: history collection (mothers and relatives), general clinical (general and gynecological) examination, abdominal cavity examination, rectum, vaginal probing, endoscopic (hysteroscopy, diagnostic and therapeutic laparoscopy) study, evaluation of the condition of the mammary glands according to the Tanner scale, hormonal screening, genetic and urologist consultation, determination of sex chromatin, echographic methods for examining the uterus and ovaries, magnetic resonance imaging of the pelvic organs. Results: In 29 (15.9%) patients noted different types of vagina malformations with impaired menstrual blood flow; congenital anomaly of the body and cervix were in 86 (47.3%) patients (saddle uterus – 43 (23.6%), two-horned uterus – in 23 (12.6%), single-horned uterus – 8 (4.4%), complete doubling of the uterus and cervix – in 7 (3.8%) and rudimentary functioning uterus – in 5 (2.7%) cases). Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome was detected in 22 (12.1%) patients, while in all cases female sex chromatin (46, XX) was diagnosed, 5 (2.7%) patients suffered from female false hermaphroditism and 4 (2.2%) – masculine false hermaphroditism. In 36 (19.8%) patients, genital malformations were combined with anomalies of the urinary system Conclusion: Identified various forms of congenital malformations of reproductive organs, clinically manifested with the onset of menarche, or – sexual life. In the structure of these defects, the developmental anomaly of the uterus and cervix prevailed over other congenital malformations and accounted for 47.3% of cases. Keywords: Congenital malformations of the vagina and uterus,, atresia of the hymen, violation of gender identification.

Dietary exposures, epigenetics and pubertal tempo.

Gene expression changes mediated by DNA methylation may play a role in pubertal tempo regulation, and availability of methyl donor nutrients affects these pathways. We examined first trimester maternal and adolescent diet patterns that may be associated with DNA methylation at long interspersed nucleotide (LINE-1) repetitive elements in adolescence using least absolute shrinkage and selection operator (LASSO) and calculated an ‘Epigenetics-Associated Diet Score’ (EADS) for each pattern; then tested the associations of these scores with pubertal tempo among adolescent boys and girls. The analytic sample included 118 boys and 132 girls aged 10–18 years. DNA methylation at LINE-1 repetitive elements was quantified. Typical maternal and adolescent nutrient intakes were estimated using food frequency questionnaires. Interval-censored time to event and ordinal regression models were used to examine associations EADS scores with pubertal tempo using physician-assessed Tanner stages and self-reported menarche, respectively, adjusted for confounders. We observed associations between maternal EADS and pubertal onset, but not pubertal progression. Each standard deviation (SD) greater maternal EADS was associated with 52% higher odds of having later onset of menarche in both cross-sectional and prospective analysis (P = 0.031 and 0.028, respectively). In contrast, we observed associations between adolescent EADS and pubertal progression, but not pubertal onset. Among boys, for each SD higher adolescent EADS, there was 13% increase in odds of slower genital progression (P = 0.050), as well as 26 and 27% increase in odds of slower left and right testicular development, respectively (P = 0.001). Epigenetic-associated diet influences pubertal tempo in a sex- and timing-specific manner.

Associations of the Oral Microbiota with Obesity and Menarche in Inner City Girls

Objective: Alterations of the oral microbiome have been associated with obesity, possibly based on inflammatory processes mediated by bacteria. Specific bacterial strains have been associated with obesity and periodontal disease. Little is known about the oral microbiome in children. Understanding the relationship between oral health and childhood growth could help identify preventable factors contributing to obesity and related conditions, including onset of menarche which is associated with obesity. Methods: In this pilot study, we investigated the saliva microbiome among 25 girls 7-15 years old (mean 11.1) and their mothers in an inner city dental clinic in New York City. The main outcome measures were body size, presence or absence of menarche and dental practices. We examined associations of microbiome richness, diversity, and relative abundance with pubertal and demographic factors and oral health. Results: Girls had good dental health and a typical rich oral microbiome, based on the Shannon Index of all species detected. Older girls flossed more often and younger girls had more frequent dental check–ups. Microbiome richness among girls was similar to their mothers’, but diversity was greater among mothers than girls. Richness was reduced among mothers with gum bleeding, flossing and increased teeth brushing. Overweight girls had greater diversity and less richness than normal weight girls. Certain bacterial species differed in abundance with respect to whether girls had reached menarche (Flavobacteria, Actinobacteria), overweight (Megasphaera, Lactorbacillales, Lactobacillus) and gingivitis in the girls (Scardovia, Bifidobacteriales, Gemellaceae). Conclusions: Differences found in specific bacteria in the oral microbiome were related to body size and menarche. With increasing interest on studying microbiome variability related to the multifactorial etiology of obesity in children, saliva is capable of providing clinically informative markers of this and related conditions.

Age of Menarche in Females of Al-Ramadi City/Iraq

Aim of the study: Estimate the age of menarche in females of Al-Ramadi city/Iraq. Methodology: This is a retrospective descriptive cross sectional study carried out in Al Ramadi city from the 1stof March to the 1st of May 2017. Data were collected from 404 secondary school girls selected randomly from different secondary schools according to the population density of Ramadi city areas. Age of menarche divided in to early menarche (8- less than 11 years age), normal menarche (11-14 years), and late menarche (14-16 years). Questionnaire was filled by the family and included female's age, age of onset of her menarche, father and mother's job, education, residency, economic, psychological status and the level of stress the family during onset of menarche. Results: The age range of the studied females was 12 to 18 years. Their mean age of menarche was 13.25 years. About 89% of the respondents were found to be within normal age of menarche, 10.3% of late menarche, and 0.5% had early menarche. The most frequent age of starting menarche was at 13 years (39.1%) followed by 14 years. Normal age menarche was found to be more prevalent among urban dwellers, females of house wife mothers, employed fathers, educated parents, living in their owned houses, and of less life stress. Conclusion: The mean age of menarche in Ramadi city was 13.25 and was higher than age recorded in Baghdad and consistent with ages recoded in many other neighboring and far countries.

Abnormal Uterine Bleeding among Adolescents: A Neglected Problem

Onset of menstruation is an important indicator of puberty among girls. A large number of adolescents suffer from abnormal uterine bleeding (AUB) during the initial months after the onset of menarche. Although menstrual problems seen among most of the adolescents are physiological, however, a large proportion of adolescents suffer from pathological AUB. The knowledge of magnitude and causes of abnormal uterine bleeding among adolescents, pathological as well as physiological, is important to plan strategies for management of this problem. Review of literature was done manually as well as electronically through PubMed, Google Scholar, Cochrane library, IndMed, Embase and WHO databases. Relevant studies conducted in India as well as other countries were searched. The most common cause (72-80%) of AUB among adolescents is anovulatory cycles due to immature hypothalamic-pituitary-ovarian axis. Other causes include bleeding disorders, thyroid disorders, and Polycystic Ovarian Disease. AUB is an important health concern among the adolescents. There is a need to create awareness regarding the physiological and pathological causes of menstrual problems among adolescents. The health care providers also need to be trained for identification and management of this problem.

ANALYSIS OF THE OBSTETRIC AND GYNECOLOGICAL ANAMNESIS IN WOMEN WITH A THREATENED ABORTION AFFECTED BY THE ENDOTHELIAL DYSFUNCTION

ANALYSIS OF THE OBSTETRIC AND GYNECOLOGICAL ANAMNESIS IN WOMEN WITH A THREATENED ABORTION AFFECTED BY THE ENDOTHELIAL DYSFUNCTION

Cluster randomized evaluation of the Nia Project: study protocol

BackgroundThe onset of puberty and menarche is a specifically vulnerable time for girls, during which they begin to show interest in the opposite sex, while becoming exposed to a myriad of external pressures, including sexual coercion or harassment from boys and men, expectations to marry from their families, and the need to perform well in primary school in order to qualify for secondary school. According to several qualitative studies in Africa, such pressures are exacerbated by girls’ lack of knowledge of their bodies, their rights, and the implications of their decisions, and by their inability to manage puberty and adolescence safely and comfortably with appropriate menstrual health and hygiene management (MHM) products. The evaluation of the Nia Project is one of the first to analyze the individual and combined contributions of sanitary pads and provision of comprehensive reproductive health education on girls’ education and reproductive health outcomes.MethodsThe design for the evaluation of the Nia Project is a longitudinal, cluster-randomized controlled trial consisting of a baseline survey with a cohort of Class 7 girls, a school quality survey, qualitative data collection, school attendance tracking, and an endline survey at the completion of the 18-month intervention period with the same cohort. The study involves 140 public primary schools in three rural sub-counties (Magarini, Kaloleni and Ganze) of Kilifi County in the Coastal area of Kenya. The research sample includes 3489 girls, with about 25 girls per school on average. Before program implementation, the schools were stratified by sub-county and randomized to one of four study arms (35 schools per arm): 1) control, 2) disposable sanitary pads distribution, 2) reproductive health education, and 4) sanitary pad distribution and reproductive health education.DiscussionThe evidence provided will inform program investment and design, and contribute to the literature on the effect of menstrual health-based interventions on girls’ agency, safety and life outcomes.Trial registrationISRCTN10894523. Trial Registration Date: August 22, 2017.

Parametric survival analysis of menarche onset timing among Nigerian girls

BackgroundThis study was a response to the dearth of information on the timing of menarche in low-income countries, and the need to update knowledge on the condition. It thereby enables the provision of adequate support to young girls during menarche. The study determined the timing and range of onset of menarche and identified the factors influencing the timing. MethodsWe used data on girls' sexual and reproductive processes from a nationally representative population survey of girls aged 15–24 years in Nigeria. Descriptive statistics, and survival analysis techniques were used for data analysis at p = 0·05. FindingA quarter of the respondents (26%) had commenced menstruation by age 12. Almost all, (90%) had experienced menstruation by age 17. Girls aged 20–24 years reported later menarche (time ratio 1·066, 95% CI: 1·045-1·087) compared to those aged 15–19 years. An increase of respondents age by one year resulted in 0·8% delay in onset timing. Significant differences were also found in the zone of residence among the sampled population. Compared with girls from the South East, the timing of menstruation was generally delayed among the girls from South-South by 5%, North Central by 9%, South West by 10%, North East by 16% and 17% among girls from the North West. InterpretationThere was a wide range in menarcheal age in Nigerian girls with a peak at 13–14 years and the possibility of a secular trend in the timing of onset. Early family life education is recommended.

Onset of menarche is not delayed in Slovenian patients with celiac disease

ObjectiveCeliac disease (CD) is an autoimmune disorder associated with numerous health problems, including reproductive disorders. This study was performed to analyze the association between CD and the menstrual cycle in a group of patients with CD and compare these patients’ characteristics with those of healthy women.MethodsThe study included 145 patients with CD (age, 15–51 years) and 162 healthy women (age, 18–55 years). Age at menarche and characteristics of the menstrual cycle were obtained by an anonymous questionnaire developed for the study.ResultsThe age at onset of menarche was 12 to 14 years in 72.9% of the patients with CD and 77.3% of the healthy controls. For most patients (74.2%), the length of the menstrual cycle was around 27 to 28 days with 4 to 5 days of bleeding. Furthermore, 8.4% of patients versus 5.9% of controls experienced bleeding between cycles.ConclusionsOur results suggest that in Slovenia, the age at menarche in patients with CD is 12.7 years, which is comparable with that in healthy women. We conclude that CD (treated or untreated) may not be associated with late menarche.

Declining age at menarche in Indonesia: a systematic review and meta-analysis.

There has been much research on the average age at menarche onset. In higher income countries the lowering in average age at menarche is earlier than in middle-income countries and lower income countries. Indonesia as a middle-income country also has some research experience related to the average age at menarche for girls. This study aimed to review the lowering of the average age at menarche in Indonesia and to predict changes in average age at menarche. This study provides a systematic review and meta-analysis using references from Google Scholar, PubMed and Popline databases on the trend of age at menarche in Indonesia and other data sources from local and national survey reports. Metaprop command in STATA was used to do the meta-analysis of proportion of early age at menarche and time series with auto-regressive integrated moving average (ARIMA) models were used in analyzing the trend and predicting the age at menarche. The results show that in Indonesia the timing of age at menarche onset has significantly lowered during the 40 years before 2010. There was meaningful decrease of age at menarche, which changed from 14.43 years [confident interval (CI) 95%: 14.42, 14.44] to 13.63 years (CI95%: 13.63, 13.64). Using the ARIMA model, mean age at menarche onset for the next year predicted that the coefficient regression would be -0.0245 (CI95%: -0.0275, -0.0215). The predicted average age at menarche shows a decrease of 0.0245 years (8-9 days) each year. The findings indicate a significant lowering of age at menarche in Indonesian girls that has continued as a predictable trend through time until the present, paralleling recent socioeconomic changes. These predictions provide key indicators of a girl's future healthy transition from childhood into young adulthood.

Onset of Early Menarche as A Predictor of The Metabolic Syndrome Formation Among Women of Reproductive Age

Purpose: To provide an analysis of clinical, hormonal-metabolic and molecular-genetic associations among Russian women of reproductive age with early menarche, obesity and metabolic syndrome.

In Utero Dioxin Exposure and Age at Menarche in the Seveso Second Generation

Introduction: In utero exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a widespread environmental contaminant and potent endocrine disrupting compound, is associated with delayed pubertal development in animal studies. On July 10, 1976, an explosion at a chemical plant near Seveso, Italy exposed nearby residents to high levels of TCDD. The Seveso Women’s Health Study (SWHS), initiated in 1996, is the only study to date of TCDD’s health effects in a female population with the unique benefit of individual TCDD measured in blood collected near the time of the explosion. In 2014, we enrolled SWHS offspring (those exposed in utero to TCDD) in the Seveso Second Generation study. We examined the relationship of in utero TCDD exposure with reported age at onset of menarche among SWHS daughters.Methods: Age at onset of menarche (in years) was collected by maternal or self-report at interview in 341 SWHS daughters. We defined in utero TCDD exposure as initial (1976) maternal serum TCDD level and TCDD extrapolated to pregnancy. Data were analyzed using Cox proportional hazards models.Results: At interview, 287 daughters were postmenarche, averaging 25.6 (±8.0) years of age. The mean reported age at menarche was 12.1 (±1.3) years. Overall, we found no change in risk of menarche onset with a 10-fold increase in initial maternal TCDD (Hazard Ratio (HR) = 0.91, 95% CI 0.79, 1.06) or TCDD estimated at pregnancy (HR = 0.86, 95% CI 0.72, 1.03). When we considered maternal menarche status at explosion as a potentially sensitive developmental exposure window, TCDD estimated at pregnancy (log10) was associated with later age at menarche among daughters whose mothers were premenarche at explosion (HR = 0.71, 95% CI 0.50, 1.00) but not postmenarche at explosion (HR = 0.87, 95% CI 0.71, 1.07).Conclusions: These results suggest in utero exposure to TCDD may alter pubertal timing among daughters of women who were prepubescent at the time of the Seveso accident.

Impact of In Utero and Adolescent Phthalate Exposure on Sexual Maturation Progression

Phthalates are endocrine disrupting compounds commonly found in consumer products, exposure to which may influence reproductive maturation in adolescence. Differential effects from exposure in utero versus later in life are understudied. We examined sex-stratified longitudinal associations between the geometric mean of 3 trimester-specific spot urine phthalate measurements and sexual maturation at two points in adolescence (8-14, 9-18 years), as well as cross-sectional associations at 9-18 years. Sexual maturation was assessed using Tanner stages and menarche onset for girls (N=246) and Tanner stages and testicular volume for boys (N=226). Generalized estimating equations for correlated ordinal multinomial responses were used to model relationships between phthalates and odds of transitioning to the next Tanner stage, while generalized additive (GA) mixed models were used to assess the odds of menarche. Cross-sectional analyses employed GA models (female N=281; male N=264). Among girls, MEP in utero exposure was associated with increased odds of being at a higher Tanner stage for breast development at 8-14 years, but with slower progression of breast development over the follow-up period (OR=0.74 per year; 95% CI: 0.57, 0.96) after adjustment for child age, BMI z-score and time between study visits. Similar results were found for breast development with in utero exposure to MEOHP, MBzP, and MCPP. There were no significant associations of in utero exposures with pubertal stage among boys, but concurrent MEP exposure was associated with lower odds of progression of genital development (OR=0.87; 95% CI: 0.76, 0.99). These results suggest in utero exposure to phthalates may disrupt estrogenic pathways to impact breast development during puberty, and that exposure results in earlier onset but slower progression of sexual development. In addition, MEP exposure during late adolescence may impede genital development among boys.

A study on menstrual hygiene practices and problems amongst adolescent girls in Udaipur, Rajasthan, 2018

Background: Adolescence in girls has been recognized as a special period in life cycle. This period is marked with onset of menarche. It is linked with several perceptions and practices, which sometimes results in adverse health outcomes. So, this study was carried out to assess practices of menstruation in adolescent girls, to find out its related problems and socio-cultural beliefs.Methods: A cross sectional study was carried out during January-February 2018 in two schools of Udaipur using convenient sampling method with 440 sample size. Participants were adolescent girls of 9 to 12 standard. Girls were asked to fill a pre formed, pre tested semi-structured questionnaire.Results: Here 68.41% girls gave history of abdominal pain as premenstrual symptoms (PMS). School absenteeism was found 44.54% due to menstruation related problems. Sanitary Napkins were used by 50.22% girls. And 66.54% girls were using water to clean genitals during menstruation. Restriction from attending religious functions was high (91.59%). Associations of absorbents used by participants with absorbents used by their mothers and sisters were statistically significant.Conclusions: Abdominal pain was main PMS. Restrictions due to menstruation were very highly imposed. There were all chances that same types of the adsorbent were used by the adolescent girls, which were used by their mothers and sisters.

Study of anemia among adolescent school girls and young adults

Background: The world’s adolescent population (age 10–19 years) is estimated to stand at more than 1 Billion, yet adolescents remain largely neglected, difficult-to-measure, and hard-to-reach. Population in which the needs of adolescent girls, in particular, are often ignored. Anemia during adolescence limits growth and delays the onset of menarche, which in turn may later lead to cephalopelvic disproportion. In armed forces young serving soldiers make the backbone of forces, anemia in this group affects man hour badly. So, study was planned to assess prevalence of anemia in these two groups.Methods: A prospective study was carried out with 340 girls and 500 serving adults and prevalence of anemia was carried out with respect to different prevailing factors.Results: The prevalence of severe, moderate and mild anemia in girls was 0.5%, 10.6% and 27.9% respectively and in serving soldiers prevalence of anemia was 1.8%, 2.8% and 3.4 % respectively.Conclusions: In the present study, the prevalence of anemia was found to be 39% in adolescent girls and 8% in serving soldiers. Strongest predictor to anemia in adolescent girls was history of excessive menstrual bleeding and vegetarian diet. Age group, age at menarche and BMI did not affect anemia prevalence. Strongest predictor to anemia in soldiers was age.

Anemia, a moderate public health concern among adolescents in South Ethiopia.

BackgroundAdolescence is characterized by rapid growth and development and iron requirements increase during this time. Adolescents with poor diet in early childhood and/or females with an early onset of menarche may be at greater risk for developing anemia due to the rapid depletion of iron stores in their bodies.ObjectiveThe objective of this study was to assess the prevalence and severity of anemia among school adolescents in Wonago district, Gedeo Zone, South Ethiopia.MethodsA school based cross-sectional study was conducted among 443 randomly selected school adolescents across 15 schools (2 secondary schools and 13 primary schools) in the district. Hemoglobin concentration from a capillary blood sample was determined by portable hemoglobin meter (HemoCue). Descriptive statistics were computed for prevalence of anemia, anthropometric measurements, socio-economic and socio-demographic variables. A hierarchical multivariable logistic regression analysis was done to identify determinants of anemia among adolescents.ResultsThe prevalence of anemia among adolescents in the study area was 22%. Anemia was higher among those in early adolescence period (10–13 years) (AOR: 4.75, CI: 1.69–13.35) compared to late adolescence (17–19 years) and among those with height for age z-score less than -2 (AOR: 6.23, CI: 1.98–19.62). Similarly, anemia was higher among those in households with a family size greater than five members (AOR: 9.82, CI: 2.42–39.88), adolescents from rural areas (AOR: 4.37, CI: 1.54–12.46) and families who purchase food needed for daily consumption (AOR: 3.25, CI: 1.42–7.45). On the other hand, adolescents from middle wealth quintiles (AOR: 0.26 (CI: 0.07–0.98)) and female adolescents (AOR: 0.34 (CI: 0.15–0.79) were less likely to be anemic in this study.ConclusionsThe prevalence of anemia in this population is of moderate public health concern, adolescents of both sexes are among groups at risk for the development of anemia. The need for further assessment of the etiology of anemia should be considered to design pragmatic intervention programs.

Abstract 1193: The impact of rapid changes in reproductive factors on the increased incidence of breast cancer in Korea

Abstract Introduction The age-standardized incidence rates of Korean breast cancer have significantly increased from 26.1 in 1999 to 63.9 in 2014, which coincides with changes in lifestyle, especially reproductive factors. We examined the contribution of temporal changes in reproductive factors to the increased incidence of breast cancer in Korea. Methods We estimated the means of age at menarche, number of pregnancy, age at first pregnancy and duration of breastfeeding by birth cohort using the nationwide Korean National Health and Nutrition Examination Survey 2007-2015 (n=20,522 women aged between 20 and 69 years with no history of cancer). Cohorts were divided into a ten-year interval of birth year from 1940s to 1970s. Analyses took into account the complex sample design by incorporating weights, stratification and clustering. The percent increase in breast cancer incidence due to a specific factor was calculated as 100 x (RRd - 1) (RR, relative risk for a specific factor; and d, difference in the mean of a risk factor among birth cohorts). Results Weighted proportion of birth cohorts was 12.1% in 1940s (mean age=64.9y), 24.1% in 1950s (56.1y), 31.9% in 1960s (46.8y), and 31.9% in 1970s (36.9y). We observed notable changes in reproductive factors over time: younger menarche, lower number of pregnancies, older age at first pregnancy and shorter duration of breastfeeding. A decrease in the number of pregnancies from 5.0 in 1940s to 2.7 in 1970s cohorts contributed to an 18.3% increase in breast cancer incidence. Shorter duration of lactation, earlier onset of menarche and older age at first pregnancy also contributed to 16.5%, 10.7%, and 7.1% increase in the incidence rates, respectively. Conclusion We found that significant changes in reproductive factors in Korean women had appreciable impacts on the increase in breast cancer in Korea. Further study is warranted to evaluate the burden of breast cancer due to other modifiable risk factors such as adiposity, alcohol drinking and physical activity. Table. Changes in risk factors by birth cohorts and their contribution to incidence changeRisk factorsBirth cohortRR (/unit)Contribution to incidence change (1940s vs. 1970s)1940s1950s1960s1970sAge at menarche (years)16.0515.4014.4613.570.9610.65%Number of pregnancy (n)4.983.923.412.660.9318.34%Age at first pregnancy (years)23.8024.5326.0627.421.1 (/5 years)7.14%Duration of breastfeeding (months)50.5327.5313.7112.830.98 (/5 months)16.54% Citation Format: Seho Park, Hyunsoon Cho, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Young Up Cho, Byeong-Woo Park, Graham A. Colditz, Yikyung Park. The impact of rapid changes in reproductive factors on the increased incidence of breast cancer in Korea [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1193.

Menarche and menstrual problems are associated with non-suicidal self-injury in adolescent girls.

Menstrual problems and non-suicidal self-injury (NSSI) are common in adolescent girls. This study examined whether onset of menstruation and menstrual problems were related to NSSI in Chinese female adolescents. A total of 5696 adolescent girls participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. A structured questionnaire was used to ask about participants' lifetime and last-year NSSI, age at menarche, menstrual cycle interval, menstrual flow length, menstrual irregularity, period pain, body weight and height, and demographics. Impulsivity was assessed by the Eysenck I7 impulsiveness scale. Internalizing and externalizing problems were measured by the Youth Self-Report of Child Behavior Checklist. The mean age of the sample was 15.0years (SD = 1.4). The prevalence of lifetime and last year NSSI were 28.1% and 21.4% in Chinese adolescent girls. After adjusting for adolescent and family covariates (age, body mass index, impulsivity, internalizing and externalizing problems, paternal education, and family economic status), onset of menstruation was significantly associated with increased risk of lifetime NSSI (OR = 1.62, 95%CI = 1.20-2.20) and last year NSSI (OR = 1.92, 95%CI = 1.37-2.67). Among adolescent girls who had menarche, often irregular menstruation and period pain were significantly and independently associated with lifetime NSSI (OR = 1.36, 95%CI = 1.03-1.79; OR = 1.29, 95%CI = 1.05-1.58) and last year NSSI (OR = 1.46, 95%CI = 1.07-1.98; OR = 1.29, 95%CI = 1.03-1.61). Our findings suggest that onset of menarche, irregular periods, and period pain appear to be associated with increased risk of NSSI. These findings highlight the importance of menstruation hygiene education and treatment of menstrual problems to reduce the risk of NSSI among adolescent girls.

Female reproductive history and risk of type 2 diabetes: A prospective analysis of 126 721 women.

To examine the prospective associations between aspects of a woman's reproductive history and incident diabetes. We pooled individual data from 126 721 middle-aged women from eight cohort studies contributing to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE). Associations between age at menarche, age at first birth, parity and menopausal status with incident diabetes were examined using generalized linear mixed models, with binomial distribution and robust variance. We stratified by body mass index (BMI) when there was evidence of a statistical interaction with BMI. Over a median follow-up of 9 years, 4073 cases of diabetes were reported. Non-linear associations with diabetes were observed for age at menarche, parity and age at first birth. Compared with menarche at age 13 years, menarche at ≤10 years was associated with an 18% increased risk of diabetes (relative risk [RR] 1.18, 95% confidence interval [CI] 1.02-1.37) after adjusting for BMI. After stratifying by BMI, the increased risk was only observed in women with a BMI ≥25 kg/m2 . A U-shaped relationship was observed between parity and risk of diabetes. Compared with pre-/peri-menopausal women, women with a hysterectomy/oophorectomy had an increased risk of diabetes (RR 1.17, 95% CI 1.07-1.29). Several markers of a woman's reproductive history appear to be modestly associated with future risk of diabetes. Maintaining a normal weight in adult life may ameliorate any increase in risk conferred by early onset of menarche.

The association between menarche, intensity of training and passive joint ROM in young pre-professional female dancers: A longitudinal follow-up study

ObjectivesTo determine the association between the status of menarche (yes/no), the intensity of training and the potential to improve passive joint range of motion (ROM) over a 12-month period of dance training. DesignProspective cohort study. SettingDance studio. ParticipantsFifty-nine female dancers aged 12.8 ± 0.5. Main outcome measuresThe dancers were asked about their dance intensity and screened for anthropometric parameters and passive joint ROM in Grades 7 and 8. ResultsAlong the 12 months of dance training, we found significantly increased ankle-foot en-pointe, hip abduction, and hip external rotation (ER); significantly decreased hip internal rotation (IR); and significant increased hip ER:IR ratio. In Grade 7, 26 dancers (44.1%) reached menarche (Yes menarche); in Grade 8 an additional 23 dancers (39.0%) reached menarche (No/Yes menarche); and 10 dancers (16.9%) had not reached menarche (No menarche). MANOVA (mixed models) with repeated measures to compare joint ROM between the three menarche groups (Yes; No/Yes; No), with h/week dance practice as a co-variant, showed that hip ER, ankle-foot en-pointe, and ER:IR were significantly correlated with h/week in all three menarche groups. ConclusionsMost passive joint ROM can be improved over 12 months of dancing around the age onset of menarche. H/week of dance practice is a main factor contributing to improved hip ER, ankle-foot en-pointe and ER/IR ratio.