Age at menarche in relation to nutritional status and critical life events among rural and urban secondary school girls in post-conflict northern Uganda.

PubMed

Odongkara Mpora, Beatrice; Piloya, Thereza; Awor, Sylvia; Ngwiri, Thomas; Laigong, Paul; Mworozi, Edison A; Hochberg, Ze'ev

2014-05-09

Menarche age is an important indicator of reproductive health of a woman or a community. In industrial societies, age at menarche has been declining over the last 150 years with a secular trend, and similar trends have been reported in some developing countries. Menarche age is affected by genetic and environmental cues, including nutrition. The study was designed to determine the age at menarche and its relation to childhood critical life events and nutritional status in post-conflict northern Uganda. This was a comparative cross-sectional study of rural and urban secondary school girls in northern Uganda. Structured questionnaires were administered to 274 secondary school girls, aged 12 - 18 years to determine the age at menarche in relation to home location, nutritional status, body composition and critical life events. The mean age at menarche was 13.6 ± 1.3 for rural and 13.3 ± 1.4 years for urban dwelling girls (t = -1.996, p = 0.047). Among the body composition measures, hip circumference was negatively correlated with the age at menarche (r = -0.109, p = 0.036), whereas height, BMI and waist circumference did not correlate with menarche. Paternal (but not maternal) education was associated with earlier menarche (F = 2.959, p = 0.033). Childhood critical life events were not associated with age at menarche. Age at menarche differed among urban and rural dwelling school girls and dependent on current nutritional status, as manifested by the hip circumference. It was not associated with extreme stressful childhood critical life events.

Genetic and environmental effects on age at menarche, and its relationship with reproductive health in twins.

PubMed

Jahanfar, Shayesteh; Lye, Munn-Sann; Krishnarajah, Isthrinayagy S

2013-04-01

Menarche or first menstrual period is a landmark in reproductive life span and it is the most prominent change of puberty. The timing of menarche can be under the influence of genes as well as individual environmental factors interacting with genetic factors. Our study objectives were (a) to investigate the heritability of age of menarche in twins, (b) to obtain the association between age of menarche and childhood factors, and reproductive events/behavior, (c) to examine whether or not having a male co-twin affects early/late menarche. A group of female-female identical (n = 108, 54 pairs), non-identical twins (n = 68, 34 pairs) and 17 females from opposite-sex twin sets were identified from twin registries of Malaysia and Iran. Genetic analysis was performed via two methods of Falconers' formula and maximum likelihood. Heritability was found to be 66% using Falconers' formula and 15% using univariate twin analysis. Model analysis revealed that shared environmental factors have a major contribution in determining the age of menarche (82%) followed by non-shared environment (18%). Result of this study is consistent with that of the literature. Timing of menarche could be under the influence of shared and non-shared environmental effects. Hirsutism was found to have a higher frequency among subjects with late menarche. There was no significant difference in age of menarche between females of opposite-sex twins and females of same-sex twins. It is concluded that twin models provide a powerful means of examining the total genetic contribution to age of menarche. Longitudinal studies of twins may clarify the type of environmental effects that determine the age of menarche.

Food insecurity and age at menarche among adolescent girls in Jimma Zone Southwest Ethiopia: a longitudinal study.

PubMed

Belachew, Tefera; Hadley, Craig; Lindstrom, David; Getachew, Yehenew; Duchateau, Luc; Kolsteren, Patrick

2011-09-13

Age at menarche is the reflection of cumulative pre-adolescent exposure of girls to either adverse environment such as food insecurity or affluent living conditions. Food insecurity could result in inadequate nutrient intake and stress, both of which are hypothesized to have opposing effects on the timing of menarche through divergent pathways. It is not known whether food insecure girls have delayed menarche or early menarche compared with their food secure peers. In this study we test the competing hypothesis of the relationship between food insecurity and age at menarche among adolescent girls in the Southwest Ethiopia. We report on 900 girls who were investigated in the first two rounds of the five year longitudinal survey. The semi-parametric frailty model was fitted to determine the effect of adolescent food insecurity on time to menarche after adjusting for socio-demographic and economic variables. Food insecure girls have menarche one year later than their food secure peer (median age of 15 years vs 14 years). The hazard of menarche showed a significant decline (P = 0.019) as severity of food insecurity level increased, the hazard ratio (HR) for mild food insecurity and moderate/severe food insecurity were 0.936 and 0.496, respectively compared to food secure girls. Stunted girls had menarche nearly one year later than their non-stunted peers (HR = 0.551, P < 0.001). Food insecurity is associated with delay of age at menarche by one year among girls in the study area. Stunted girls had menarche one year later than their non-stunted peers. Age at menarche reflects the development of girls including the timing of sexual maturation, nutritional status and trajectory of growth during the pre-pubertal periods. The findings reflect the consequence of chronic food insecurity on the development and well-being of girls in the study area.

Association of timing of menarche with depressive symptoms and depression in adolescence: Mendelian randomisation study

PubMed Central

Sequeira, Maija-Eliina; Lewis, Sarah J.; Bonilla, Carolina; Smith, George Davey; Joinson, Carol

2017-01-01

Background Observational studies report associations between early menarche and higher levels of depressive symptoms and depression. However, no studies have investigated whether this association is causal. Aims To determine whether earlier menarche is a causal risk factor for depressive symptoms and depression in adolescence. Method The associations between a genetic score for age at menarche and depressive symptoms at 14, 17 and 19 years, and depression at 18 years, were examined using Mendelian randomisation analysis techniques. Results Using a genetic risk score to indicate earlier timing of menarche, we found that early menarche is associated with higher levels of depressive symptoms at 14 years (odds ratio per risk allele 1.02, 95% CI 1.005–1.04, n = 2404). We did not find an association between the early menarche risk score and depressive symptoms or depression after age 14. Conclusions Our results provide evidence for a causal effect of age at menarche on depressive symptoms at age 14. PMID:27491534

Age at menarche and the reproductive performance of Saudi women.

PubMed

Babay, Zainab A; Addar, Mohammed H; Shahid, Khalida; Meriki, Naema

2004-01-01

Saudi Arabia has undergone substantial development in the recent past with concomitant changes in living conditions, and economic and general health status that have affected the age at menarche in Saudi women. We evaluated the current age at menarche and reproductive events among Saudi women. Age, age at menarche, age at marriage, age of first pregnancy, number of children, and number of abortions were collected for Saudi women attending King Khalid University Hospital (KKUH) over a 3-month period in 2002. For 989 Saudi women, the mean age at menarche was 13.05 years. There was a decrease in the age of menarche over the past 20 years, an increase in the age of marriage, age of first pregnancy, and a decrease in the number of children and abortions. Compared with data from two decades, the age at menarche decreased significantly from 13.22 to 13.05 years. The decrease in the age of menarche among Saudi women indicates better socioeconomic status and improvements in health.

Age of onset, nutritional determinants, and seasonal variations in menarche in rural Bangladesh.

PubMed

Rah, Jee H; Shamim, Abu Ahmed; Arju, Ummeh T; Labrique, Alain B; Rashid, Mahbubur; Christian, Parul

2009-12-01

Menarche is an important milestone in the development of female adolescents. The study assessed the age at menarche using recall, its seasonality, and association with marital and nutritional status (using mid-upper arm circumference [MUAC]) among 3,923 female adolescents aged 12-19 years in a rural area of Bangladesh. At the time of assessment, most (88%) adolescents had attained menarche at the mean (standard deviation [SD]) age of 12.8 (1.4) years. Age of onset of menarche among married adolescents (13%) occurred earlier than in those who were unmarried (12.6 +/- 1.3 years vs 12.9 +/- 1.4 years, p < 0.01). Age at menarche was negatively associated with MUAC after adjusting for age and marital status (beta = -0.10, p < 0.01). More than 50% of the adolescents had an onset of menarche during winter (chi2 = 634.97; p < 0.001), with peaks in December and January. In this rural population, the current age at menarche was found to be slightly lower than the previous estimates of 13.0 years in Bangladesh. An early onset of menarche was associated with season and better nutritional status of the female adolescents and may be associated with early marriage.

Is age of menarche among school girls related to academic performance?

PubMed

Al-Mathkoori, Radhia; Nur, Ula; Al-Taiar, Abdullah

2017-06-17

Background There is strong evidence that the mean age of menarche has declined over the last few decades in developed and developing countries. This is of a major concern because of its enormous public health implications. This study aimed to estimate the age of menarche in Kuwait and investigate the association between menarcheal age and academic performance among high school girls in Kuwait. Methods A cross-sectional study was conducted on randomly selected female high school students from private and public high schools in all governorates in Kuwait. Data on the age of menarche were collected by self-administered questionnaire from the students, while data on academic performance were extracted from the students' academic records. Results Of the 907 students we selected, 800 (88.2%) responded. The mean age of menarche was 12.33 [95% confidence interval (CI) 12.18-12.49] years. There was no evidence for significant association between age of menarche and students' academic performance before or after adjusting for potential confounders. Conclusion The calculated age of menarche among contemporary girls in Kuwait is similar to that of the girls in industrialized countries. Early menarcheal age is unlikely to lead to adverse behavior that may affect academic performance in our setting.

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

PubMed

Nili, Steinberg; Shay, Tenenbaum; Myriam, Stern; Aviva, Zeev; Itzhak, Siev-Ner

2018-05-05

To 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. Prospective cohort study. Dance studio. Fifty-nine female dancers aged 12.8 ± 0.5. The dancers were asked about their dance intensity and screened for anthropometric parameters and passive joint ROM in Grades 7 and 8. Along 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. Most 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. Copyright © 2018 Elsevier Ltd. All rights reserved.

Age at Menarche and Factors that Influence It: A Study among Female University Students in Tamale, Northern Ghana

PubMed Central

Ameade, Evans Paul Kwame; Garti, Helene Akpene

2016-01-01

Introduction Age at menarche reflects the health status of a population. This marks the beginning of sexual maturation and is affected by nutritional status and prevailing environmental conditions. This study measured the menarcheal age of female undergraduate students in northern Ghana and explored factors that could impact on the onset of menarche. Method GraphPad 5.01 was used to analyze data collected from 293 randomly selected female university students in a cross-sectional study using a semi-structured questionnaire. Association between different variables was tested using appropriate statistical tests. Results The mean recall age at menarche of participants in this study was 13.66 ±1.87 years for a female population of mean age, 23.04±5.07 years. Compared to female students who lived in rural settings, urban and suburban areas dwellers significantly recorded earlier menarche (p = 0.0006). Again, females from high income earning families experienced menarche earlier than those who were born to or lived with lower income earners (p = 0.003). Lower menarcheal age increased risk of experiencing menstrual pain prior to menses rather than during menstrual flow for dysmenorrhic females. (13.52±2.052 vrs 13.63±1.582 year; χ2 = 7.181, df = 2, p = 0.028). Conclusion Mean menarcheal age of female university students in northern Ghana was 13.66 years. Females from urban areas and high income families had earlier menarche. Compared to the very first Ghanaian study reported in 1989, the menarcheal age decline was 0.11 year per decade. PMID:27171234

Age at Menarche and Factors that Influence It: A Study among Female University Students in Tamale, Northern Ghana.

PubMed

Ameade, Evans Paul Kwame; Garti, Helene Akpene

2016-01-01

Age at menarche reflects the health status of a population. This marks the beginning of sexual maturation and is affected by nutritional status and prevailing environmental conditions. This study measured the menarcheal age of female undergraduate students in northern Ghana and explored factors that could impact on the onset of menarche. GraphPad 5.01 was used to analyze data collected from 293 randomly selected female university students in a cross-sectional study using a semi-structured questionnaire. Association between different variables was tested using appropriate statistical tests. The mean recall age at menarche of participants in this study was 13.66 ±1.87 years for a female population of mean age, 23.04±5.07 years. Compared to female students who lived in rural settings, urban and suburban areas dwellers significantly recorded earlier menarche (p = 0.0006). Again, females from high income earning families experienced menarche earlier than those who were born to or lived with lower income earners (p = 0.003). Lower menarcheal age increased risk of experiencing menstrual pain prior to menses rather than during menstrual flow for dysmenorrhic females. (13.52±2.052 vrs 13.63±1.582 year; χ2 = 7.181, df = 2, p = 0.028). Mean menarcheal age of female university students in northern Ghana was 13.66 years. Females from urban areas and high income families had earlier menarche. Compared to the very first Ghanaian study reported in 1989, the menarcheal age decline was 0.11 year per decade.

Skeletal Benefits of Pre-Menarcheal Gymnastics Are Retained After Activity Cessation

PubMed Central

Scerpella, Tamara A.; Dowthwaite, Jodi N.; Gero, Nicole M.; Kanaley, Jill A.; Ploutz-Snyder, Robert J.

2015-01-01

Mechanical loading during childhood and adolescence may yield skeletal benefits that persist beyond activity cessation and menarche. At 1 year pre- and 2 years post-menarche, non-dominant forearm areal bone mineral density (aBMD), bone mineral content (BMC) and projected area (area) were compared in gymnasts (n=9), ex-gymnasts (n=8) and non-gymnasts (n=13). At both observations, gymnasts and ex-gymnasts had higher forearm aBMD, BMC and area than non-gymnasts. gymnasts had higher post-menarcheal means than ex-gymnasts for all three parameters. Childhood mechanical loading yields skeletal advantages that persist at least 24 months after loading cessation and menarche. Continued post-menarcheal loading yields additional benefit. PMID:20332537

Childhood hair product use and earlier age at menarche in a racially diverse study population: a pilot study.

PubMed

James-Todd, Tamarra; Terry, Mary Beth; Rich-Edwards, Janet; Deierlein, Andrea; Senie, Ruby

2011-06-01

Previous studies suggest that hair products containing endocrine disrupting chemicals could alter puberty. We evaluated the association between childhood hair product use and age at menarche in a racially diverse study population. We recruited 300 African-American, African-Caribbean, Hispanic, and white women from the New York City metropolitan area who were between 18-77 years of age. Data were collected retrospectively on hair oil, lotion, leave-in conditioner, perm, and other types of hair products used before age 13. Recalled age at menarche ranged from 8 to 19 years. We used multivariable binomial regression to evaluate the association between hair product use and age at menarche (<12 vs. ≥12), adjusting for potential confounders. African-Americans were more likely to use hair products and reached menarche earlier than other racial/ethnic groups. Women reporting childhood hair oil use had a risk ratio of 1.4 (95% confidence interval [CI]: 1.1-1.9) for earlier menarche, adjusting for race/ethnicity and year of birth. Hair perm users had an increased risk for earlier menarche (adjusted risk ratio = 1.4, 95% CI: 1.1-1.8). Other types of hair products assessed in this study were not associated with earlier menarche. Childhood hair oil and perm use were associated with earlier menarche. If replicated, these results suggest that hair product use may be important to measure in evaluating earlier age at menarche. Copyright © 2011 Elsevier Inc. All rights reserved.

Micronutrient status in middle childhood and age at menarche: results from the Bogotá School Children Cohort.

PubMed

Villamor, Eduardo; Marín, Constanza; Mora-Plazas, Mercedes; Oliveros, Henry

2017-12-01

Childhood intake of animal foods is associated with age at first menstrual period (menarche). It is unknown whether the micronutrients present in these foods could explain this association. Our objective was to investigate the associations of micronutrient status biomarkers in middle childhood with age at menarche. We quantified circulating Hb, ferritin, mean corpuscular volume, Zn, vitamin B12, erythrocyte folate and retinol in 1464 pre-menarcheal girls aged 5-12 years in Bogotá, Colombia, and followed them for a median 5·7 years for the occurrence and date of menarche. We estimated median age at menarche and hazard ratios (HR) with 95 % CI by levels of each biomarker with use of Kaplan-Meier survival probabilities and Cox regression, respectively. Median age at menarche was 12·4 years. Middle childhood Hb was inversely related to age at menarche whereas plasma ferritin was positively associated with this outcome in a linear manner. HR of menarche for every 1 sd of Hb (11 g/l) and ferritin (23·2 µg/l) were 1·11 (95 % CI 1·04, 1·18; P=0·001) and 0·94 (95 % CI 0·88, 0·99; P=0·02), respectively, after adjustment for baseline age, C-reactive protein concentration, maternal age at menarche and parity and socioeconomic status. The association with ferritin was stronger in girls aged 9-10 years at baseline. Additional adjustment for baseline height- and BMI-for-age did not change the results. We conclude that higher Fe status in middle childhood is related to later age at menarche whereas Hb concentrations are inversely associated with age at onset of menses.

ERICA: age at menarche and its association with nutritional status.

PubMed

Barros, Bruna de Siqueira; Kuschnir, Maria Cristina Maria Caetano; Bloch, Katia Vergetti; Silva, Thiago Luiz Nogueira da

2018-01-18

To estimate the mean age at menarche and its association with nutritional status in Brazilian adolescents. The study sample included female adolescents aged 12-17 who participated in a multicenter, school-based, country-wide, cross-sectional study entitled The Study of Cardiovascular Risk in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes [ERICA]). Mean and median ages at menarche in Brazil were estimated. The association of age at menarche with sociodemographic data and nutritional status were described as means and their respective 95% confidence intervals. Survival analysis was used to assess the age at menarche according to nutritional status categories and the log-rank test was used to compare the medians. Bivariate and multivariate analyses were performed using Cox regression to verify the association between menarche and other variables. A total of 73,624 students were evaluated, comprising 40,803 girls, of whom 37,390 reported menarche at a mean age of 11.71 years and a median of 12.41 years. Median age at menarche was lower in overweight and obese girls (p<0.001). The multivariate analysis showed that excess weight (HR=1.28; 95% CI 1.21-1.36; p<0.001) and studying in a private school (HR=1.06; 95% CI 1.02-1.10; p=0.003) were associated with menarche. This is a pioneering study in Brazil with national and regional representativeness to estimate the mean and the median age of occurrence of menarche. Adolescents with excess weight had an earlier menarche than their peers, even after adjustment for confounding factors. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Change in postmenarche anthropometric indicators in indigenous and nonindigenous adolescents from Chile.

PubMed

Lara, Macarena; Bustos, Patricia; Amigo, Hugo

2017-09-10

To analyze the change in anthropometric indicators between menarche and 36 months after menarche among indigenous and non-indigenous adolescents from the Araucanía Region of Chile. This was a concurrent cohort study. Of 8,504 girls interviewed, 114 indigenous adolescents and 123 nonindigenous adolescents who had recently experienced menarche were selected. Body mass index (BMI), BMI by age (BMI z-score), waist circumference (WC) and body fat percentage (BF%) were evaluated at menarche and 6, 12, 18, 24, 30, and 36 months postmenarche. Linear models estimated with generalized estimating equations were used to quantify disparities adjusted for baseline anthropometric values, age at menarche, place of residence, and socioeconomic level. Indigenous girls presented menarche 4 months later than nonindigenous girls and had significantly higher BMI (1.5 kg/m 2 ), BMI z-score (0.4), WC (2.9 cm), and BF% (1.7%) at menarche. Adjusted results did not show an association between being indigenous and post-menarche anthropometric variables: BMI = 0.1 kg/m 2 (CI = -0.3; 0.5), BMI z-score = 0 (CI = -0.1; 0.1), WC = 0.7 cm (CI = -0.6; 2.0), and BF% = 0.5% (CI = -0.2; 1.3). It is important to mention that the mean BMI z-score of both groups were in the overweight category. At menarche, indigenous girls had higher values than nonindigenous girls for all anthropometric variables, and this trend remained after menarche, with no further change in ethnic disparity over the subsequent three years. This reinforces the need to implement interventions to prevent or control excess weight prior to menarche, with emphasis on indigenous girls. © 2017 Wiley Periodicals, Inc.

Relationship between age at menarche and skeletal maturation stages in Taiwanese female orthodontic patients.

PubMed

Lai, Eddie Hsiang-Hua; Chang, Jenny Zwei-Chieng; Jane Yao, Chung-Chen; Tsai, Shih-Jaw; Liu, Jen-Pei; Chen, Yi-Jane; Lin, Chun-Pin

2008-07-01

The age at menarche reflects a pubertal girl's physiologic maturity. The aims of this study were to evaluate the relationship between the age at menarche and skeletal maturation in female orthodontic patients. Hand-wrist radiographs and lateral cephalometric radiographs from 304 adolescent female subjects (age, 8-18.9 years) were selected from the files of the Department of Orthodontics, National Taiwan University Hospital (NTUH). Hand-wrist bone maturation stages were assessed using the NTUH Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages (CVMS) were determined using the latest CVMS Index. Menarcheal ages were self-reported by the patients and verified by the patients' mothers. The relationships between the NTUH-SMI or CVM stages and menarcheal status were investigated. More than 90% of the 148 subjects who had already attained menstruation had skeletal maturation beyond the NTUH-SMI stage four or CVMS III. However, the subjects who had never experienced menarche mostly had skeletal maturation before NTUH-SMI stage five or CVMS IV. During the period of orthodontic treatment, 19 females experienced their menarche. The mean age at menarche for the 167 female patients in total was 11.97 years. In average, menarche occurred between NTUH-SMI stages four and five or between CVM stages III and IV. The percentage of girls with menses increased from 1.2% at age 9 to 6.6% at age 10, 39.5% at age 11, 81.4% at age 12, 97% at age 13, and 100% at age 14. Compared with the results obtained 20 years previously, we found a downward shift of 0.47 years per decade for the mean age at menarche in female orthodontic patients. The majority of female orthodontic patients have passed the pubertal growth spurt when they experience their menarche. Menarche usually follows the pubertal growth spurt by about 1 year and occurs after NTUH-SMI stage four or CVMS III.

Relationships between age at menarche, walking gait base of support, and stance phase frontal plane knee biomechanics in adolescent females

PubMed Central

Grannis, Kimberly A.; Sherwood, Richard J.; Duren, Dana L

2016-01-01

Background Age at menarche impacts patterns of pubertal growth and skeletal development. These effects may carry over into variation in biomechanical profiles involved in sports-related traumatic and overuse knee injuries. The present study investigated whether age at menarche is a potential indicator of knee injury risk through its influence on knee biomechanics during normal walking. Objective To test the hypothesis that earlier menarche is related to post-pubertal biomechanical risk factors for knee injuries, including a wider, more immature gait base of support, and greater valgus knee angles and moments. Design Cross-sectional observational study. Setting University research facility. Participants Healthy, post-menarcheal, adolescent females. Methods Age at menarche was obtained by recall questionnaire. Pubertal growth and anthropometric data were collected using standard methods. Biomechanical data were taken from tests of walking gait at self-selected speed. Reflective marker position data were collected using a three-dimensional quantitative motion analysis system, and three force plates recorded kinetic data. Main Outcome Measures Age at menarche; growth and anthropometric measurements; base of support; static knee frontal plane angle; dynamic knee frontal plane angles and moments during stance. Results Earlier menarche was significantly correlated with abbreviated pubertal growth and post-pubertal retention of immature traits, including a wider base of support. Earlier menarche and wider base of support were both correlated with more valgus static knee angles, more valgus knee abduction angles and moments at foot-strike, and a more valgus peak knee abduction angle during stance. Peak knee abduction moment during stance was not correlated with age at menarche or base of support. Conclusions Earlier menarche and its effects on growth are associated with retention of a relatively immature gait base of support and a tendency for static and dynamic valgus knee alignment. This biomechanical profile may put girls with earlier menarche at higher risk for sports-related knee injuries. PMID:27485675

Consumption of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche12

PubMed Central

Mueller, Noel T; Jacobs, David R; MacLehose, Richard F; Demerath, Ellen W; Kelly, Scott P; Dreyfus, Jill G; Pereira, Mark A

2015-01-01

Background: Early menarche has been linked to risk of several chronic diseases. Prospective research on whether the intake of soft drinks containing caffeine, a modulator of the female reproductive axis, is associated with risk of early menarche is sparse. Objective: We examined the hypothesis that consumption of caffeinated soft drinks in childhood is associated with higher risk of early menarche. Design: The National Heart, Lung, and Blood Institute Growth and Health Study recruited and enrolled 2379 (1213 African American, 1166 Caucasian) girls aged 9–10 y (from Richmond, CA; Cincinnati, OH; and Washington, DC) and followed them for 10 y. After exclusions were made, there were 1988 girls in whom we examined prospective associations between consumption of caffeinated and noncaffeinated sugar- and artificially sweetened soft drinks and early menarche (defined as menarche age <11 y). We also examined associations between intakes of caffeine, sucrose, fructose, and aspartame and early menarche. Results: Incident early menarche occurred in 165 (8.3%) of the girls. After adjustment for confounders and premenarcheal percentage body fat, greater consumption of caffeinated soft drinks was associated with a higher risk of early menarche (RR for 1 serving/d increment: 1.47; 95% CI: 1.22, 1.79). Consumption of artificially sweetened soft drinks was also positively associated with risk of early menarche (RR for 1 serving/d increment: 1.43; 95% CI: 1.08, 1.88). Consumption of noncaffeinated soft drinks was not significantly associated with early menarche (RR for 1 serving/d increment: 0.88; 95% CI: 0.62, 1.25); nor was consumption of sugar-sweetened soft drinks (RR for 1 serving/d increment: 1.15; 95% CI: 0.95, 1.39). Consistent with the beverage findings, intakes of caffeine (RR for 1-SD increment: 1.22; 95% CI: 1.08, 1.37) and aspartame (RR for 1-SD increment: 1.20; 95% CI: 1.10, 1.31) were positively associated with risk of early menarche. Conclusion: Consumption of caffeinated and artificially sweetened soft drinks was positively associated with risk of early menarche in a US cohort of African American and Caucasian girls. PMID:26178725

Consumption of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche.

PubMed

Mueller, Noel T; Jacobs, David R; MacLehose, Richard F; Demerath, Ellen W; Kelly, Scott P; Dreyfus, Jill G; Pereira, Mark A

2015-09-01

Early menarche has been linked to risk of several chronic diseases. Prospective research on whether the intake of soft drinks containing caffeine, a modulator of the female reproductive axis, is associated with risk of early menarche is sparse. We examined the hypothesis that consumption of caffeinated soft drinks in childhood is associated with higher risk of early menarche. The National Heart, Lung, and Blood Institute Growth and Health Study recruited and enrolled 2379 (1213 African American, 1166 Caucasian) girls aged 9-10 y (from Richmond, CA; Cincinnati, OH; and Washington, DC) and followed them for 10 y. After exclusions were made, there were 1988 girls in whom we examined prospective associations between consumption of caffeinated and noncaffeinated sugar- and artificially sweetened soft drinks and early menarche (defined as menarche age <11 y). We also examined associations between intakes of caffeine, sucrose, fructose, and aspartame and early menarche. Incident early menarche occurred in 165 (8.3%) of the girls. After adjustment for confounders and premenarcheal percentage body fat, greater consumption of caffeinated soft drinks was associated with a higher risk of early menarche (RR for 1 serving/d increment: 1.47; 95% CI: 1.22, 1.79). Consumption of artificially sweetened soft drinks was also positively associated with risk of early menarche (RR for 1 serving/d increment: 1.43; 95% CI: 1.08, 1.88). Consumption of noncaffeinated soft drinks was not significantly associated with early menarche (RR for 1 serving/d increment: 0.88; 95% CI: 0.62, 1.25); nor was consumption of sugar-sweetened soft drinks (RR for 1 serving/d increment: 1.15; 95% CI: 0.95, 1.39). Consistent with the beverage findings, intakes of caffeine (RR for 1-SD increment: 1.22; 95% CI: 1.08, 1.37) and aspartame (RR for 1-SD increment: 1.20; 95% CI: 1.10, 1.31) were positively associated with risk of early menarche. Consumption of caffeinated and artificially sweetened soft drinks was positively associated with risk of early menarche in a US cohort of African American and Caucasian girls. © 2015 American Society for Nutrition.

Nutritional Status and Age at Menarche on Female Students of Junior High School

ERIC Educational Resources Information Center

Juliyatmi, Rihul Husnul; Handayani, Lina

2015-01-01

Menarche is the first menstrual period as one of the sign of puberty. There are many factors may affect the age at menarche such as nutritional status, genetic, environmental conditions, socioeconomic status, and education. The purpose of this research is to determine the relationship between nutritional status and age of menarche on female…

Relation of Early Menarche to Depression, Eating Disorders, Substance Abuse, and Comorbid Psychopathology among Adolescent Girls.

ERIC Educational Resources Information Center

Stice, Eric; Presnell, Katherine; Bearman, Sarah Kate

2001-01-01

Used interview data from a community study to test whether early menarche partially accounts for increased depression, eating pathology, substance abuse, and comorbid psychopathology among adolescent girls. Found that menarche prior to 11.6 years related to elevated depression and substance abuse. Findings support assertion that early menarche is…

Genome-wide association study of age at menarche in African-American women

PubMed Central

Demerath, Ellen W.; Liu, Ching-Ti; Franceschini, Nora; Chen, Gary; Palmer, Julie R.; Smith, Erin N.; Chen, Christina T.L.; Ambrosone, Christine B.; Arnold, Alice M.; Bandera, Elisa V.; Berenson, Gerald S.; Bernstein, Leslie; Britton, Angela; Cappola, Anne R.; Carlson, Christopher S.; Chanock, Stephen J.; Chen, Wei; Chen, Zhao; Deming, Sandra L.; Elks, Cathy E.; Evans, Michelle K.; Gajdos, Zofia; Henderson, Brian E.; Hu, Jennifer J.; Ingles, Sue; John, Esther M.; Kerr, Kathleen F.; Kolonel, Laurence N.; Le Marchand, Loic; Lu, Xiaoning; Millikan, Robert C.; Musani, Solomon K.; Nock, Nora L.; North, Kari; Nyante, Sarah; Press, Michael F.; Rodriquez-Gil, Jorge L.; Ruiz-Narvaez, Edward A.; Schork, Nicholas J.; Srinivasan, Sathanur R.; Woods, Nancy F.; Zheng, Wei; Ziegler, Regina G.; Zonderman, Alan; Heiss, Gerardo; Gwen Windham, B.; Wellons, Melissa; Murray, Sarah S.; Nalls, Michael; Pastinen, Tomi; Rajkovic, Aleksandar; Hirschhorn, Joel; Adrienne Cupples, L.; Kooperberg, Charles; Murabito, Joanne M.; Haiman, Christopher A.

2013-01-01

African-American (AA) women have earlier menarche on average than women of European ancestry (EA), and earlier menarche is a risk factor for obesity and type 2 diabetes among other chronic diseases. Identification of common genetic variants associated with age at menarche has a potential value in pointing to the genetic pathways underlying chronic disease risk, yet comprehensive genome-wide studies of age at menarche are lacking for AA women. In this study, we tested the genome-wide association of self-reported age at menarche with common single-nucleotide polymorphisms (SNPs) in a total of 18 089 AA women in 15 studies using an additive genetic linear regression model, adjusting for year of birth and population stratification, followed by inverse-variance weighted meta-analysis (Stage 1). Top meta-analysis results were then tested in an independent sample of 2850 women (Stage 2). First, while no SNP passed the pre-specified P < 5 × 10−8 threshold for significance in Stage 1, suggestive associations were found for variants near FLRT2 and PIK3R1, and conditional analysis identified two independent SNPs (rs339978 and rs980000) in or near RORA, strengthening the support for this suggestive locus identified in EA women. Secondly, an investigation of SNPs in 42 previously identified menarche loci in EA women demonstrated that 25 (60%) of them contained variants significantly associated with menarche in AA women. The findings provide the first evidence of cross-ethnic generalization of menarche loci identified to date, and suggest a number of novel biological links to menarche timing in AA women. PMID:23599027

CHARACTERIZATION OF SPONTANEOUS AND INDUCED PUBERTY IN GIRLS WITH TURNER SYNDROME.

PubMed

Folsom, Lisal J; Slaven, James E; Nabhan, Zeina M; Eugster, Erica A

2017-07-01

To characterize puberty in girls with Turner syndrome (TS) and determine whether specific patient characteristics are associated with the timing of menarche. We also sought to compare spontaneous versus induced puberty in these patients. Medical records of girls followed in our Pediatric Endocrine clinic for TS from 2007 to 2015 were reviewed. Fifty-three girls were included, of whom 10 (19%) achieved menarche spontaneously and 43 (81%) received hormone replacement therapy (HRT). Of girls receiving HRT, a younger age at estrogen initiation correlated with a longer time to menarche (P = .02), and a mosaic karyotype was associated with a shorter time to menarche (P = .02), whereas no relationship was seen for body mass index, estrogen regimen, or maternal age at menarche. Nineteen girls (44%) receiving HRT had bleeding on estrogen alone at a wide dose range and were more likely to be on transdermal than oral preparations (P = .01). Girls with spontaneous puberty achieved menarche at a younger age (P<.01) and were more likely to have mosaic TS (P = .02). Significant variability in the timing of menarche exists among girls with TS. However, age at pubertal induction and karyotype were significantly correlated with age at menarche in our patients. A wide range of estrogen doses is seen in girls who bleed prior to progesterone, suggesting extreme variability in estrogen sensitivity among patients with TS. Girls achieving spontaneous menarche are younger and more likely to have a mosaic karyotype than those with induced menarche. Large-scale prospective studies are needed to confirm these results. BMI = body mass index; HRT = hormone replacement therapy; TS = Turner syndrome.

Age of menarche and nutritional status of indigenous and non-indigenous adolescents in the Araucanía Region of Chile.

PubMed

Amigo, Hugo; Bustos, Patricia; Muzzo, Santiago; Alarcón, Ana María; Muñoz, Sergio

2010-08-01

Early onset of menarche has been linked to prevalence of obesity; however, this may differ for indigenous females. To analyse the relationship between age of menarche and nutritional status among indigenous and non-indigenous girls. The design of this study was cross-sectional. Date of menarche was determined through interviews, and all responses were confirmed by the girls' mothers. A total of 8504 adolescents were screened for recent menarche. One hundred and thirty-one girls of Mapuche (indigenous) and 143 girls of Chilean-Spanish background were identified and evaluated by anthropometric measurements. Median age of menarche was 150 months, interquartile range (IR) 143-157 in indigenous, and 145.5 months, IR 139-153 in non-indigenous girls (p = 0.04). The indigenous females showed a higher prevalence of overweight (36.4% vs 23.1%), although the frequency of obesity was similar (16.8% vs 16.3%). For indigenous girls, age of menarche was delayed by 2.69 months (confidence intervals (CI) -0.38 to 5.77). It was observed that girls with overweight experienced age of menarche 7.59 months earlier than those with normal weight, CI -10.78 to -4.41. In the analysis of obesity, the effect on age of menarche was similar, with onset 7.53 months earlier than for the normal weight, CI -11.34 to -3.72. Age of menarche is younger than has been previously reported and occurs earlier in girls with overweight and obesity, while being indigenous was not related.

Influence of menarche on the relation between diurnal cortisol production and ventral striatum activity during reward anticipation

PubMed Central

LeMoult, Joelle; Colich, Natalie L.; Sherdell, Lindsey; Hamilton, J. Paul; Gotlib, Ian H.

2015-01-01

Adolescence is characterized by an increase in risk-taking and reward-seeking behaviors. In other populations, increased risk taking has been associated with tighter coupling between cortisol production and ventral striatum (VS) activation during reward anticipation; this relation has not yet been examined, however, as a function of adolescent development. This study examined the influence of pubertal development on the association between diurnal cortisol production and VS activity during reward anticipation. Pre- and post-menarcheal girls collected diurnal cortisol and completed an functional magnetic resonance imaging-based monetary incentive delay task, from which we extracted estimates of VS activity during the anticipation of reward, anticipation of loss and anticipation of non-incentive neutral trials. Post-menarcheal girls showed greater coupling between the cortisol awakening response and VS activation during anticipation of reward and loss than did their pre-menarcheal counterparts. Post-menarcheal girls did not differ from pre-menarcheal girls in their cortisol-VS coupling during anticipation of neutral trials, suggesting that puberty-related changes in cortisol-VS coupling are specific to affective stimuli. Interestingly, behavioral responses during the task indicate that post-menarcheal girls are faster to engage with affective stimuli than are pre-menarcheal girls. Thus, post-menarcheal girls exhibit neurobiological and behavioral patterns that have been associated with risk taking and that may underlie the dramatic increase in risk-taking behavior documented during adolescence. PMID:25678549

Secular trend of menarche in Zagreb (Croatia) adolescents.

PubMed

Veček, Nenad; Veček, Andrea; Zajc Petranović, Matea; Tomas, Zeljka; Arch-Veček, Branka; Skarić-Jurić, Tatjana; Miličić, Jasna

2012-01-01

To study the secular trend of menarche in high-school urban adolescent girls (Zagreb, Croatia) over the last two decades, and to evaluate the possible impact of worsening of socio-economic conditions on age at menarche during the Croatian War of Independence (1991-1995). Three surveys of female adolescents aged 15-19 years: (a) 523 girls interviewed in 1990, (b) 888 girls interviewed in 1997, and (c) 399 girls interviewed in 2010. Self-reported age at menarche (in decimal years) was presented by age groups and year of interview. Differences in mean age at menarche between adolescent age groups as well as between surveys were tested using One-way ANOVA. The mean age at menarche was 12.82 years in 1990, 12.92 years in 1997 and 12.31 years in 2010. It increased by 0.10 years from 1990 to 1997 (p=0.290) and then declined by 0.61 years from 1997 to 2010 (p<0.001). Over the 20-year period, the overall mean age at menarche declined by 0.51 years (p<0.001). The age at menarche in Zagreb adolescents continued to decline significantly from 1990 to 2010 (p<0.001), in spite of a statistically insignificant initial increase between 1990 and 1997. When put in broader context, age at menarche mirrored socio-economic changes in the war period. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Age at menarche and its socioeconomic determinants among female students in an urban area in Bangladesh.

PubMed

Islam, Md Serajul; Hussain, Md Altaf; Islam, Saimul; Mahumud, Rashidul Alam; Biswas, Tuhin; Islam, Sheikh Mohammed Shariful

2017-06-01

This cross-sectional study aimed to determine the age at menarche and its socioeconomic determinants among urban female students (n=680) in Bangladesh. The mean age of the respondents was 14±1.43years. Majority of the respondents were unmarried (98.4%). The mean age at menarche was 11.6±3.6years, median 12years. Almost one-third (35.7%) of the participants had menarche at the age of 12years. There was no statistically significant difference between age at menarche before and after 12years with the socio-economic characteristics, except education (p=<0.001). In the multivariate model, only higher education was statistically significant predictor of age at menarche. Copyright © 2017 Elsevier B.V. All rights reserved.

Differential impacts of serum vitamin D levels and age at menarche on metabolic syndrome in premenopausal and postmenopausal women: findings from the Korea national cohort.

PubMed

Jung, Chan-Hee; Mok, Ji-Oh; Chang, Sung Woon; Lee, Bora; Jang, Ji Hyon; Kang, Sukho; Jung, Sang Hee

2018-07-01

It is suggested that vitamin D level and age at menarche are related to each other, and the prevalence of low vitamin D status and early menarche in women is increasing worldwide. Moreover, several studies revealed that both of them are associated with metabolic syndrome (MetS). Therefore, we hypothesized that there are significant associations among vitamin D status, age at menarche, and MetS and that the relationships differ according to menstrual state. We assessed whether the association among MetS, vitamin D, and menarche age is different between premenopausal and postmenopausal women and whether there is a change in risk of MetS according to vitamin D level in different age-at-menarche groups. We used data from the Korea National Health and Nutrition Examination Survey, using 1:1 age-matching for this cross-sectional study. Individuals were stratified into 25-hydroxyvitamin D (25[OH]D) levels (deficient, <10 ng/mL; insufficient, 10-19 ng/mL; and sufficient, ≥20 ng/mL) and categorized as having either early, average, or late menarche (<13, 13-16, and ≥17 years). In premenopausal women, early menarche, not vitamin D level, was associated with risk of MetS (odds ratio [95% confidence interval], 1.65 [1.18-2.33]). In contrast, in postmenopausal women, vitamin D deficiency, not age at menarche, was associated with risk of MetS (1.39 [1.03-1.87]). In a stratified analysis regarding interactions of a change in risk of MetS according to vitamin D level in different ages at menarche, vitamin D deficiency was significantly associated with the risk of MetS (1.36 [1.01-1.86]), but this was only in the average-age-at-menarche group. This study suggests that the time of entry into puberty for women may be an important factor in the development of MetS in adulthood, and vitamin D status in women at average menarche age may contribute to the development of MetS. Copyright © 2018 Elsevier Inc. All rights reserved.

Relationships Between Age at Menarche, Walking Gait Base of Support, and Stance Phase Frontal Plane Knee Biomechanics in Adolescent Girls.

PubMed

Froehle, Andrew W; Grannis, Kimberly A; Sherwood, Richard J; Duren, Dana L

2017-05-01

Age at menarche impacts patterns of pubertal growth and skeletal development. These effects may carry over into variation in biomechanical profiles involved in sports-related traumatic and overuse knee injuries. The present study investigated whether age at menarche is a potential indicator of knee injury risk through its influence on knee biomechanics during normal walking. To test the hypothesis that earlier menarche is related to postpubertal biomechanical risk factors for knee injuries, including a wider, more immature gait base of support, and greater valgus knee angles and moments. Cross-sectional observational study. University research facility. Healthy, postmenarcheal, adolescent girls. Age at menarche was obtained by recall questionnaire. Pubertal growth and anthropometric data were collected by using standard methods. Biomechanical data were taken from tests of walking gait at self-selected speed. Reflective marker position data were collected with a 3-dimensional quantitative motion analysis system, and 3 force plates recorded kinetic data. Age at menarche; growth and anthropometric measurements; base of support; static knee frontal plane angle; and dynamic knee frontal plane angles and moments during stance. Earlier menarche was correlated significantly with abbreviated pubertal growth and postpubertal retention of immature traits, including a wider base of support. Earlier menarche and wider base of support were both correlated with more valgus static knee angles, more valgus knee abduction angles and moments at foot-strike, and a more valgus peak knee abduction angle during stance. Peak knee abduction moment during stance was not correlated with age at menarche or base of support. Earlier menarche and its effects on growth are associated with retention of a relatively immature gait base of support and a tendency for static and dynamic valgus knee alignment. This biomechanical profile may put girls with earlier menarche at greater risk for sports-related knee injuries. Not applicable. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

African-American/white differences in the age of menarche: accounting for the difference.

PubMed

Reagan, Patricia B; Salsberry, Pamela J; Fang, Muriel Z; Gardner, William P; Pajer, Kathleen

2012-10-01

Lifetime health disparity between African-American and white females begins with lower birthweight and higher rates of childhood overweight. In adolescence, African-American girls experience earlier menarche. Understanding the origins of these health disparities is a national priority. There is growing literature suggesting that the life course health development model is a useful framework for studying disparities. The purpose of this study was to quantify the influence of explanatory factors from key developmental stages on the age of menarche and to determine how much of the overall race difference in age of menarche they could explain. The factors were maternal age of menarche, birthweight, poverty during early childhood (age 0 through 5 years), and child BMI z-scores at 6 years. The sample, drawn from the US National Longitudinal Surveys of Youth Child-Mother file, consisted of 2337 girls born between 1978 and 1998. Mean age of menarche in months was 144 for African-American girls and 150 for whites. An instrumental variable approach was used to estimate a causal effect of child BMI z-score on age of menarche. The instrumental variables were pre-pregnancy BMI, high gestational weight gain and smoking during pregnancy. We found strong effects of maternal age of menarche, birthweight, and child BMI z-score (-5.23, 95% CI [-7.35,-3.12]) for both African-Americans and whites. Age of menarche declined with increases in exposure to poverty during early childhood for whites. There was no effect of poverty for African-Americans. We used Oaxaca decomposition techniques to determine how much of the overall race difference in age of menarche was attributable to race differences in observable factors and how much was due to race dependent responses. The African-American/white difference in childhood BMI explained about 18% of the overall difference in age of menarche and birthweight differences explained another 11%. Copyright © 2012 Elsevier Ltd. All rights reserved.

Milk Consumption after Age 9 Years Does Not Predict Age at Menarche123

PubMed Central

Carwile, Jenny L; Willett, Walter C; Wang, Molin; Rich-Edwards, Janet; Frazier, A Lindsay; Michels, Karin B

2015-01-01

Background: Regular milk consumption during childhood and adolescence is recommended for bone health. However, milk consumption increases circulating insulin-like growth factor I concentrations, and may also accelerate puberty. Objective: We prospectively investigated the association between milk consumption and age at menarche in the Growing Up Today Study. Methods: Study participants were 5583 US girls who were premenarcheal and ages 9–14 y in 1996. Girls were followed through 2001, at which time 97% of noncensored participants had reported menarche. Frequency of milk and meat consumption was calculated with the use of annual youth/adolescent food frequency questionnaires from 1996–1998. Intake of related nutrients was also measured. Age at menarche was self-reported annually through 2001. Results: During follow-up, 5227 girls attained menarche over 10,555 accrued person-years. In models adjusted for dietary and sociodemographic predictors of menarche, frequency of milk consumption did not predict age at onset of menarche (for >3 glasses of milk/d vs. 1.1–4 glasses/wk, HR: 0.93; 95% CI: 0.83, 1.04). After additional adjustment for body size, premenarcheal girls consuming >3 glasses of milk daily were 13% less likely (95% CI: −3%, −23%; P-trend: <0.01) to attain menarche in the next month relative to those consuming 1.1–4 glasses/wk. Neither total meat nor red meat consumption was associated with age at menarche. Conclusions: Our findings suggest that regular consumption of milk in girls aged ≥9 y is unlikely to substantially affect age at onset of menarche. Studies assessing associations between diet in early childhood and pubertal timing may be more illuminating. PMID:26136590

Latitude and ultraviolet radiation dose in the birthplace in relation to menarcheal age in a large cohort of French women.

PubMed

Dossus, Laure; Kvaskoff, Marina; Bijon, Anne; Engel, Pierre; Verdebout, Jean; Fervers, Béatrice; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Mesrine, Sylvie

2013-04-01

Age at menarche is an important determinant of hormonal-related neoplasia and other chronic diseases. Spatial and temporal variations in age at menarche have been observed in industrialised countries and several environmental factors were reported to have an influence. We examined geographical variations in self-reported age at menarche and explored the effects of both latitude and ultraviolet radiation (UVR) dose on the onset of menarche in 88,278 women from the French E3N cohort (aged 40-65 years at inclusion). The mean age at menarche was 12.8 years. After adjustment for potential confounders (birth cohort, prematurity, birth weight and length, father's income index, body silhouette in childhood, food deprivation during World War II, population of birthplace, number of siblings, breastfeeding exposure and indoor exposure to passive smoking during childhood), latitude and UVR dose (annual or spring/summer) in county of birth were significantly associated with age at menarche (P(trend) < 0.0001). Women born at lower latitudes or in regions with higher annual or spring/summer UVR dose had a 3- to 4-month earlier menarche than women born at higher latitudes or in regions with lower UVR. On a continuous scale, a 1° increment in latitude resulted in a 0.04-year older age at menarche [95% confidence interval (CI): 0.03, 0.05], whereas a 1-kJ/m(2) increment in annual UVR dose resulted in a 0.42-year younger age at menarche (95% CI: -0.55, -0.29). These data further suggest that light exposure in childhood may influence sexual maturation in women.

Influence of menarche on the relation between diurnal cortisol production and ventral striatum activity during reward anticipation.

PubMed

LeMoult, Joelle; Colich, Natalie L; Sherdell, Lindsey; Hamilton, J Paul; Gotlib, Ian H

2015-09-01

Adolescence is characterized by an increase in risk-taking and reward-seeking behaviors. In other populations, increased risk taking has been associated with tighter coupling between cortisol production and ventral striatum (VS) activation during reward anticipation; this relation has not yet been examined, however, as a function of adolescent development. This study examined the influence of pubertal development on the association between diurnal cortisol production and VS activity during reward anticipation. Pre- and post-menarcheal girls collected diurnal cortisol and completed an functional magnetic resonance imaging-based monetary incentive delay task, from which we extracted estimates of VS activity during the anticipation of reward, anticipation of loss and anticipation of non-incentive neutral trials. Post-menarcheal girls showed greater coupling between the cortisol awakening response and VS activation during anticipation of reward and loss than did their pre-menarcheal counterparts. Post-menarcheal girls did not differ from pre-menarcheal girls in their cortisol-VS coupling during anticipation of neutral trials, suggesting that puberty-related changes in cortisol-VS coupling are specific to affective stimuli. Interestingly, behavioral responses during the task indicate that post-menarcheal girls are faster to engage with affective stimuli than are pre-menarcheal girls. Thus, post-menarcheal girls exhibit neurobiological and behavioral patterns that have been associated with risk taking and that may underlie the dramatic increase in risk-taking behavior documented during adolescence. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Age at menarche, reactions to menarche and attitudes towards menstruation among Mexican adolescent girls.

PubMed

Marván, Ma Luisa; Alcalá-Herrera, Verónica

2014-04-01

To investigate the relationships between menarcheal timing and both menarcheal experience and attitudes toward menstruation in Mexican girls. Cross-sectional survey. Sample of adolescents attending 10 different public schools. Mexican postmenarcheal adolescents, aged 11-16 years. Participants answered 1 questionnaire about menarcheal experience and another about attitudes towards menstruation. Early maturers (menarche before 11 years) were more likely than average (menarche at 11 or 12 years) or late maturers (menarche at 13 or more years) to state they had not known what they should do at the moment they got their first period (P < .01), that they had not felt prepared to start menstruating (P < .05), and that they thought they must keep secret the fact of already having had their first period (P < .05). Concerning their emotional reactions to menarche, early maturers were the most likely to have felt scared (P < .05), worried (P < .05) and sad (P < .05) and were the least likely to have felt calm (P < .05). They were also the most likely to show current secretive attitudes towards menstruation (P < .01). Finally, late maturers showed more positive attitudes toward menstruation than their peers (P < .01). These results could be useful for developing resources to help early maturing girls manage menstruation. Since these girls have limited or in some cases no time for preparation, they need special support. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Mexican adolescents' experience of menarche and attitudes toward menstruation: role of communication between mothers and daughters.

PubMed

Marván, M L; Molina-Abolnik, M

2012-12-01

First, to explore the kind of information that Mexican mothers give their daughters about menstruation before their menarche, and to study the impact of this communication on how prepared the daughters felt when they experienced their menarche. Second, to investigate the influence of the menarcheal experience on attitudes toward menstruation. Cross-sectional survey. Sample of adolescents attending 3 different public schools. 405 Mexican postmenarcheal adolescents, aged 12-15 years. Participants answered a questionnaire that had 3 parts: (a) General data, (b) topics related to menses that participants had discussed with their mothers prior to menarche, and (c) menarcheal experience. They also answered a questionnaire about menstrual attitudes. Although most of the participants knew what they should do when they experienced their menarche, only 39% stated they had felt prepared to start menstruating. Regarding menstrual attitudes, adolescents scored highest on Negative Feelings and Secrecy rather than on Positive Feelings. Participants who had previously discussed the emotional aspects of menses with their mothers were more likely to claim they had felt prepared to start menstruating when they got their first period (OR = 3.45). The fact that adolescents felt prepared to start menstruating predicted positive attitudes toward menstruation (β = .19) Discussing the emotional aspects of menses prior to menarche is crucial to being prepared for menarche, and to holding positive attitudes toward menstruation. Information on biological knowledge and practical aspects of menses needs to be supplemented with emotional issues. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Nutritional status and menarche in a rural community in the Philippines.

PubMed

Osteria, T S

1983-01-01

To examine the relationship between nutritional status and onset of menarche, anthropometric measurements and information on age at menarche were obtained from 1844 females aged 6-17 years in a rural community in the Philippines. The mean age at the initiation of the growth spurt in height was 13.5 years, while the spurt in weight occurred at the age of 11.5 years. 25.2% of respondents had attained menarche by age 11.5 years, 43.6% by age 13.5 years, 88.2% by age 14.5 years, and 96.6% by age 15.5 years. This contrasts with data from Bangladesh, where only 3.5% of girls attain menarche by age 13.5 years and only 35.1% reach this point by age 15.5 years. Further analysis indicated that both age and weight are related to the proportion achieving menarche. The effect of height is not as marked as that of body weight. A minimum level of fatness (about 17% of body weight) is associated with the onset of menstruation and its continued maintenance. Malnutrition results in a shorter reproductive span, later age at menarche, and early menopause. Since improvements in nutritional status in developing countries can be expected to result in a pattern of early menarche, late menopause, short birth intervals, and shorter periods of adolescent subfecundity, increasing attention must be given to family planning counseling of adolescents.

[Age at menarche and indigenous ancestry: a population study in Chile].

PubMed

Ossa, Ximena; Bustos, Patricia; Muñoz, Sergio; Amigo, Hugo

2012-08-01

The age at menarche may influence decisively health and disease in women. It also indicates the beginning of the reproductive period and, as a consequence, the possibility of biological continuity for the human species. Genetic and environmental determinants define the age of menarche and can explain differences found among different populations. To determine the age at menarche among adolescents with different levels of indigenous descent (parental indigenous surnames), considering the effect of socioeconomic and demographic factors. An observational study of historic cohorts of 8.624 girls from the Araucanía Region (central-southern Chile) was carried out. Data were collected by health professionals using a previously validated questionnaire. Occurrence of menarche was estimated through survival analysis and compared between groups (according to indigenous parental surnames) adjusted for parents' income and educational level and provenance (rural/urban). Estimated median age of menarche was 151 months (95% Cl: 150-151). In female with four indigenous surnames, menarche occurred two months later than girls without indigenous surnames and with two indigenous surnames (p < 0,001). In girls whose parents had lowest level of schooling, the difference increased to eight months later (p < 0,005). Age at menarche in the group with higher indigenous descent is later even if socio-economic conditions remain stable. Genetic factors might play an important role, however conditions of vulnerability can influence and further delay the onset of reproductive competency.

Early menarche and childhood adversities in a nationally representative sample.

PubMed

Henrichs, Kimberly L; McCauley, Heather L; Miller, Elizabeth; Styne, Dennis M; Saito, Naomi; Breslau, Joshua

2014-01-01

Epidemiological evidence suggests that early menarche, defined as onset of menses at age 11 or earlier, has increased in prevalence in recent birth cohorts and is associated with multiple poor medical and mental health outcomes in adulthood. There is evidence that childhood adversities occurring prior to menarche contribute to early menarche. Data collected in face-to-face interviews with a nationally representative sample of women age 18 and over (N = 3288), as part of the National Comorbidity Survey-Replication, were analyzed. Associations between pre-menarchal childhood adversities and menarche at age 11 or earlier were estimated in discrete time survival models with statistical adjustment for age at interview, ethnicity, and body mass index. Adversities investigated included physical abuse, sexual abuse, neglect, biological father absence from the home, other parent loss, parent mental illness, parent substance abuse, parent criminality, inter-parental violence, serious physical illness in childhood, and family economic adversity. Mean age at menarche varied across decadal birth cohorts (χ(2)₍₄₎ = 21.41, p < .001) ranging from a high of 12.9 years in the oldest cohort (age 59 or older at the time of interview) to a low of 12.4 in the second youngest cohort (age 28-37). Childhood adversities were also more common in younger than older cohorts. Of the 11 childhood adversities, 5 were associated with menarche at age 11 or earlier, with OR of 1.3 or greater. Each of these five adversities is associated with a 26% increase in the odds of early menarche (OR = 1.26, 95% CI 1.14-1.39). The relationship between childhood sexual abuse and early menarche was sustained after adjustment for co-occurring adversities. (OR = 1.77, 95% CI 1.21-2.6). Evidence from this study is consistent with hypothesized physiological effects of early childhood family environment on endocrine development. Childhood sexual abuse is the adversity most strongly associated with early menarche. However, because of the complex way that childhood adversities cluster within families, the more generalized influence of highly dysfunctional family environments cannot be ruled out.

Sugar-sweetened beverage consumption and age at menarche in a prospective study of US girls.

PubMed

Carwile, J L; Willett, W C; Spiegelman, D; Hertzmark, E; Rich-Edwards, J; Frazier, A L; Michels, K B

2015-03-01

Is sugar-sweetened beverage (SSB) consumption associated with age at menarche? More frequent SSB consumption was associated with earlier menarche in a population of US girls. SSB consumption is associated with metabolic changes that could potentially impact menarcheal timing, but direct associations with age at menarche have yet to be investigated. The Growing up Today Study, a prospective cohort study of 16 875 children of Nurses' Health Study II participants residing in all 50 US states. This analysis followed 5583 girls, aged 9-14 years and premenarcheal at baseline, between 1996 and 2001. During 10 555 person-years of follow-up, 94% (n = 5227) of girls reported their age at menarche, and 3% (n = 159) remained premenarcheal in 2001; 4% (n = 197) of eligible girls were censored, primarily for missing age at menarche. Cumulative updated SSB consumption (composed of non-carbonated fruit drinks, sugar-sweetened soda and iced tea) was calculated using annual Youth/Adolescent Food Frequency Questionnaires from 1996 to 1998. Age at menarche was self-reported annually. The association between SSB consumption and age at menarche was assessed using Cox proportional hazards regression. More frequent SSB consumption predicted earlier menarche. At any given age between 9 and 18.5 years, premenarcheal girls who reported consuming >1.5 servings of SSBs per day were, on average, 24% more likely [95% confidence interval (CI): 13, 36%; P-trend: <0.001] to attain menarche in the next month relative to girls consuming ≤2 servings of SSBs weekly, adjusting for potential confounders including height, but not BMI (considered an intermediate). Correspondingly, girls consuming >1.5 SSBs daily had an estimated 2.7-month earlier menarche (95% CI: -4.1, -1.3 months) relative to those consuming ≤2 SSBs weekly. The frequency of non-carbonated fruit drink (P-trend: 0.03) and sugar-sweetened soda (P-trend: 0.001), but not iced tea (P-trend: 0.49), consumption also predicted earlier menarche. The effect of SSB consumption on age at menarche was observed in every tertile of baseline BMI. Diet soda and fruit juice consumption were not associated with age at menarche. Although we adjusted for a variety of suspected confounders, residual confounding is possible. We did not measure SSB consumption during early childhood, which may be an important window of exposure. More frequent SSB consumption may predict earlier menarche through mechanisms other than increased BMI. Our findings provide further support for public health efforts to reduce SSB consumption. The Growing up Today Study is supported by grant R03 CA 106238. J.L.C. was supported by the Breast Cancer Research Foundation; Training Grant T32ES007069 in Environmental Epidemiology from the National Institute of Environmental Health Sciences, National Institutes of Health; and Training Grant T32HD060454 in Reproductive, Perinatal and Pediatric Epidemiology from the National Institute of Child Health and Human Development, National Institutes of Health. A.L.F. is supported by the American Cancer Society, Research Scholar Grant in Cancer Control. K.B.M. was supported in part by the National Cancer Institute at the National Institutes of Health (Public Health Service grants R01CA158313 and R03CA170952). There are no conflicts of interest to declare. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Experience of Menarche.

ERIC Educational Resources Information Center

Ruble, Diane N.; Brooks-Gunn, Jeanne

1982-01-01

Examines reactions to menarche and the subsequent effects of this experience as a function of preparation for and timing of menarche. A questionnaire including measures of responses about first menstruation, current symptoms, and self-image was completed by 639 girls in fifth through twelfth grades. (Author/MP)

Secular Trends in Menarcheal Age in India-Evidence from the Indian Human Development Survey

PubMed Central

Pathak, Praveen Kumar; Tripathi, Niharika; Subramanian, S. V.

2014-01-01

Background Evidence from a number of countries in Europe and North America point towards the secular declining trend in menarcheal age with considerable spatial variations over the past two centuries. Similar trends were reported in several developing countries from Asia, Africa and Latin America. However, data corroborating any secular trend in the menarcheal age of the Indian population remained sparse and inadequately verified. Methods We examined secular trends, regional heterogeneity and association of socioeconomic, anthropometric and contextual factors with menarcheal age among ever-married women (15–49 years) in India. Using the pseudo cohort data approach, we fit multiple linear regression models to estimate secular trends in menarcheal age of 91394 ever-married women using the Indian Human Development Survey. Results The mean age at menarche among Indian women was 13.76 years (95 % CI: 13.75, 13.77) in 2005. It declined by three months from 13.83 years (95% CI: 13.81, 13.85) among women born prior to 1955–1964, to nearly 13.62 years (95% CI: 13.58, 13.67) among women born during late 1985–1989. However, these aggregate national figures mask extensive spatial heterogeneity as mean age at menarche varied from 15.0 years in Himachal Pradesh during 1955–1964 (95% CI: 14.89–15.11) to about 12.1 years in Assam (95% CI: 11.63–12.56) during 1985–1989. Conclusion The regression analysis established a reduction of nearly one month per decade, suggesting a secular decline in age at menarche among Indian women. Notably, the menarcheal age was significantly associated with the area of residence, geographic region, linguistic groups, educational attainment, wealth status, caste and religious affiliations among Indian women. PMID:25369507

[Pre-and post-pubertal rhythmic gymnastics athletes' physical qualities].

PubMed

Menezes, Luciana de Souza; Novaes, Jefferson; Fernandes-Filho, José

2012-01-01

Identifying and comparinge the physical qualities of Brazilian athletes and practitioners of rhythmic gymnastics. 125 Brazilian athletes and rhythmic gymnasts practitioners of Rhythmic Gymnastics fromaged 7 to 25 years- old were evaluated. They were divided into the following categories: Different competitive levels (international, national and regional) and pre- and post- menarche practitioners. The protocols used were: Burpee (coordination), Sargent jJump test, and gGoniometry (flexibility). This was a cross-sectional, comparative delineation sStudy with a transverse cut and comparative delineation. Descriptive statistics, and inferencialinferential analysianalysiss were estimated. The and ANOVA were usedwas applied. Tukey's Afterwards the post hoc Tuckey test was then applied. The results were: Burpee international level=20.,0±0.,8; national level=18.,3±2.,7; regional level=18.,9±1.,9; pre- menarche=13.,7±3.,2 and post- menarche=16.,2±3.,8; vertical high- international level=40.,1±2.,7 cm; national level= 38.,0±4.,3 cm; regional level=35.,1±3.,5 cm; pre- menarche= 25.,2±7.,4 cm and post- menarche=35.,4±6.,6 cm; leg goniometry: international level =180.,0±00.,0; national level =146.,9±13.,93; regional level=147.,1±10.,75; pre- menarche=135.,80±22.,62 and pPost- menarche=141.,0±23.,09; and back goniometry: international level=33.,3±5.,69; national level=38.,3±13.,82; regional level=36.,5±11.,84; pre- menarche=48.,7±12.,80 and post- menarche=48.,8±12.,30. Significant statistical differences were found between the different categories in regarding the all the variables between the different categories.

[Parity and menarche as risk factors of osteoporosis in postmenopausal Mexican women].

PubMed

Mendoza-Romo, Miguel Angel; Ramírez-Arriola, María Cleofas; Velasco-Chávez, José Fernando; Rivera-Martínez, José Guillermo; Nieva-de Jesús, Rafael Natividad; Valdez-Jiménez, Luis Alvaro

2013-03-01

At the moment the studies lead at world-wide level and even in our country have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. To investigate the relation of osteoporosis in postmenopausal Mexican women with multiparity and age of menarche. A retrospective and analytical cross-sectional study, with a non-probabilistic sampling technique in women rightful claimants of the IMSS, San Luis Potosi. In all of them the bone mineral density was measured with X-ray dual absorptiometry in the distal forearm. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche (< 13 yrs) and late menarche (> or = 13 yrs). 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria of the World Health Organization, 18% of postmenopausal women had osteoporosis, 39% had osteopenia and 43% had bone normality. No association was found between the number of pregnancies and osteoporosis. Additionally we observed that the women who had four or more children were older than the other women, average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. We found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46, p: 0.035). In postmenopausal women a menarche older than 13 years is a risk factor for osteoporosis.

[Parity and menarche as risk factors for osteoporosis in postmenopausal women].

PubMed

Mendoza-Romo, Miguel Angel; Ramírez-Arriola, Mariá Cleofás; Velasco-Chávez, José Fernando; Rivera-Martínez, José Guillermo; de Jesús, Rafael Natividad Nieva; Valdez-Jiménez, Luis Alvaro

2014-02-01

Worldwide studies, even in our country, have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. To investigate the relation of osteoporosis in postmenopausal mexican women with multiparity and age of menarche. Transversal, retrospective and analytical study. Non-probabilistic sampling technique was performing with users women of the IMSS in San Luis Potosí. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche (before the age of 13) and late menarche (at 13 years of age or after). It was measured bone mineral density with dual distal forearm x-ray absorptiometry to all patients. 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria, of the World Health Organization, 18% of posmenopausal women had osteoporosis, 39% had osteopenia and 41% had bone normality. No association was found between the number of deeds and osteoporosis. Additionally we observed that the women who had 4 or more children were older than the other women. average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. In addition we found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46; p = 0.035). In posmenopausal women a menarche at the age of 13 years or after is a risk factor for osteoporosis.

Postmenarche growth: cohort study among indigenous and non-indigenous Chilean adolescents.

PubMed

Amigo, Hugo; Lara, Macarena; Bustos, Patricia; Muñoz, Sergio

2015-01-31

In Chile, indigenous and non-indigenous schoolchildren have the same stature when they begin school but indigenous adults are shorter, indicating the importance of analyzing growth during puberty. The aim of this study was to compare the growth of indigenous and non-indigenous girls during the 36 months after menarche in Chile's Araucanía Region. A concurrent cohort study was conducted to compare growth in the two ethnic groups, which were comprised of 114 indigenous and 126 non-indigenous girls who recently experienced menarche and were randomly selected. Height was measured at menarche and at 6, 12, 18, 24 and 36 months post-menarche. General linear models were used to analyze growth and a generalized estimating equation model was used to compare height at 36 months post-menarche. At menarche, the Z-score of height/age was less for indigenous than non-indigenous girls (-0.01 vs. -0.61, p < 0.001). Indigenous girls grew at a slower rate than non-indigenous girls (6.5 vs. 7.2 cm, p = 0.02), and height at 36-months post-menarche reached -0.82 vs. -0.35 cm (p <0.001). In an adjusted model at 36 months post-menarche, indigenous girls were 1.6 cm shorter than non-indigenous girls (95% confidence interval: -3.13 to -0.04). The height of indigenous girls at menarche was lower than that of non-indigenous girls and they subsequently grew less, maintaining the gap between the two groups. At the end of the follow-up period, the indigenous girls were shorter than their non-indigenous peers.

Effects of early menarche on physical and psychosocial health problems in adolescent girls and adult women

PubMed Central

2016-01-01

The menarcheal age of Korean women has been rapidly decreasing for the last 50 years, and the average menarcheal age of women born in the 1990s is approaching 12.6 years. In addition, interest in early puberty has been increasing recently owing to the rapid increase in precocious puberty. Generally, out of concern for short stature and early menarche, idiopathic central precocious puberty in female adolescents is treated with gonadotropin-releasing hormone analogs. Studies to date have described the association between early menarche and psychosocial problems such as delinquency and risky sexual behavior, as well as physical health problems such as obesity, diabetes, cardiovascular diseases, and breast cancer throughout the lifespan of women. However, the pathophysiological mechanism underlying this association has not been clarified thus far. In this article, we review and discuss the existing literature to describe the current understanding of the effects of early menarche on the physical and psychosocial health of adolescent girls and adult women. PMID:27721839

Nomenclature of primary amenorrhea: A proposal document of the Japan Society of Obstetrics and Gynecology committee for the redefinition of primary amenorrhea.

PubMed

Shozu, Makio; Ishikawa, Hiroshi; Horikawa, Reiko; Sakakibara, Hideya; Izumi, Shun-Ichiro; Ohba, Takashi; Hirota, Yasushi; Ogata, Tsutomu; Osuga, Yutaka; Kugu, Koji

2017-11-01

The aim of this study was to provide medical terms to describe the condition of a girl who should be evaluated for primary amenorrhea in order to facilitate intervention at an appropriate time. We performed a literature and clinical guidelines search for recent practices with regard to menarche and discussed relevant cases that had been experienced by committee members. Additionally, we theoretically reviewed medical terms defined in the Glossary Book of Obstetrics and Gynecology in Japan (Japan Society of Obstetrics and Gynecology, 3rd edition). The committee for the redefinition of primary amenorrhea proposed the introduction of two terms and the deletion of one term that had been defined by the Japan Society of Obstetrics and Gynecology, instead of changing the age definition of primary amenorrhea. 'Delayed menarche' was introduced to describe a condition in which a girl has never experienced cyclic menstruation (menarche) by 15-17 years of age. 'Late menarche' was also introduced to describe a condition in which a girl has experienced menarche at 15 years of age or older. 'Delayed menstruation,' which was defined as a condition in which a girl experiences menarche at 15-18 years of age, was deleted. The new terms 'delayed menarche' and 'late menarche' were introduced, and the term 'delayed menstruation' was deleted. The new system might help in the early detection and appropriate treatment of primary amenorrhea. © 2017 Japan Society of Obstetrics and Gynecology.

Factors related to the occurrence of precocious menarche in female primary school students in Makassar

NASA Astrophysics Data System (ADS)

Renjani, Rizky Swastika; Mappaware, Nasrudin A.; Nontji, Werna; Marniati

2017-09-01

Precocious menarche currently affects 1 in 5000 girls and likely to occur as many as 10 times and possess greater risk to the emergence of cancer in women. The aim of this research is to determine the relationship of nutrition status and lipid profile with precocious menarche occurrence onstudents of primary school in Makassar city. The design of this research was cross sectional design. The samples werethe students of grades IV, V and VI who have already menarche occurrence as many as 20 studentscollected with purposive sampling. The data were analyzed with Mann Whitney U test. The results indicate that there are 17 students (85%) do not undergoprecocious menarche, normal nutrition status is 11 persons (55%), normal cholesterol levelis 12 persons (60%), and level of normal LDL = 19 persons (95%). While the respondents who undergo precocious menarche is 3 persons (15%), fat nutrition status is 9 persons (45%), cautious cholesterol level is 8 persons (40%) and cautious LDL level is 1 person (5%). Based on Mann Whitney U test, there is relationship between nutrition status and precocious menarche occurrence (p = 0.043) and there is correlation of total cholesterol and LDLcholesterollevelswith precocious menarche (p = 0.025) and (p = 0.017). The decrease of knowledge about health of reproduction can be promoted in school by making cooperation with nutritionist to give information to parents and students of primary schools about good and healthy food.

Menarche: Responses of Early Adolescent Females.

ERIC Educational Resources Information Center

McGrory, Arlene

1990-01-01

Investigated responses of menarcheal age females to menarche. Results from 95 girls indicated that premenarcheal girls thought menses was more debilitating than did postmenarcheal girls. Subjects who had been menstruating longer considered menses natural event but denied its effects. Found no significant difference in overall self-esteem and…

Psychosocial and Cultural Factors Influencing Expectations of Menarche: A Study on Chinese Premenarcheal Teenage Girls

ERIC Educational Resources Information Center

Yeung, Dannii Y. L.; Tang, Catherine So-kum; Lee, Antoinette

2005-01-01

This study explored how psychosocial and cultural factors influenced expectations of menarche among 476 Chinese premenarcheal teenage girls. Results showed that participants' expectations of menarche were largely negative and heavily influenced by cultural beliefs about menstruation. Findings of hierarchical regression analyses revealed that…

Menarche: Prior Knowledge and Experience.

ERIC Educational Resources Information Center

Skandhan, K. P.; And Others

1988-01-01

Recorded menstruation information among 305 young women in India, assessing the differences between those who did and did not have knowledge of menstruation prior to menarche. Those with prior knowledge considered menarche to be a normal physiological function and had a higher rate of regularity, lower rate of dysmenorrhea, and earlier onset of…

Cultural practices relating to menarche and menstruation among adolescent girls in Taiwan--qualitative investigation.

PubMed

Liu, H-L; Chen, K-H; Peng, N-H

2012-02-01

The aim of this study was to qualitatively record the cultural attitudes and practices associated with menarche and menstruation in Taiwanese girls, particularly with respect to coping mechanisms. Forty-eight adolescent girls participated. Adolescent girls were individually interviewed to investigate the effects of their cultural practices, coping mechanisms, and physiological symptoms during menarche and menstruation. The qualitative investigation revealed mixed reactions to menstruation, such as eating chocolate, using sanitary napkins, and feeling irritable or embarrassed. Cluster construction suggested that adolescents were prepared for menarche but required emotional support; in addition, the new generation employed the Internet to learn how to cope. A phenomenological approach showed that menarche and menstrual attitudes among Taiwanese adolescents were comprised in 4 dimensions: self-perception, information, and cultural practices with regard to menarche; physiological symptoms and psychological reactions during menstruation; coping mechanisms during menarche and menstruation; and methods for coping and cultural practices for menstruation. Cultural beliefs and the Internet have changed cross-cultural contacts. Educators and health professionals should seek to understand this generation of girls, who perceive the world as more flexible and available and have more creativity and new eating behaviors and hobbies. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Onset of menstrual cycle and menses features among secondary school girls in Italy: A questionnaire study on 3,783 students.

PubMed

De Sanctis, Vincenzo; Bernasconi, Sergio; Bianchin, Luigi; Bona, Gianni; Bozzola, Mauro; Buzi, Fabio; De Sanctis, Carlo; Rigon, Franco; Tatò, Luciano; Tonini, Giorgio; Perissinotto, Egle

2014-11-01

Healthcare professionals need updated information about what is the range of "normal" variation of menstrual cycle features to support young girls and their parents in managing reproductive health, and to detect diseases early. This cross-sectional study aimed to provide an updated picture of age at menarche and main menstrual cycle characteristics and complaints in an Italian population-based sample of 3,783 adolescents attending secondary school. Girls filled in a self-administered anonymous questionnaire including questions about demography, anthropometry, smoking and drinking habits, use of contraceptive, socioeconomic status, age at menarche, menstrual pattern, and physical/psychological menstrual complaints. Mean age at menarche and prevalence of polymenorrhea (cycle length < 21 days), oligomenorrhea (cycle length > 35 days), irregularity, dysmenorrhea, and of physical/psychological complaints were computed. Factors associated with age at menarche and menstrual disturbances were explored by using multiple logistic models. The girls' mean age was 17.1 years (SD 1.4 years) and the mean age at menarche was 12.4 years (SD 1.3 years); menarche occurred with two monthly peaks of frequency in July-September and in December-January (P < 0.0001). Age at menarche was significantly associated with geographic genetics (as expressed by parents' birth area), mother's menarcheal age, BMI, family size, and age at data collection. The prevalence of polymenorrhea was about 2.5%, oligomenorrhea was declared by 3.7%, irregular length by 8.3%, while long bleeding (>6 days) was shown in 19.6% of girls. Gynecological age was significantly associated with cycle length (P < 0.0001) with long cycles becoming more regular within the fourth year after menarche, while frequency of polymenorrhea stabilized after the second gynecological year. Oligomenorrhea and irregularity were both significantly associated with long menstrual bleeding (adjusted OR = 2.36; 95% CI = 1.55-3.60, and adjusted OR = 2.59; 95% CI = 1.95-3.44, respectively). The findings of the study support the levelling-off of secular trend in menarche anticipation in Italy and confirm the timing in menstrual cycle regularization. The study provides updated epidemiological data on frequency of menstrual abnormalities to help reproductive health professionals in managing adolescent gynecology.

Girls' physical activity and sedentary behaviors: Does sexual maturation matter? A cross-sectional study with HBSC 2010 Portuguese survey.

PubMed

Marques, Adilson; Branquinho, Cátia; De Matos, Margarida Gaspar

2016-07-01

The purpose of this study was to examine the relationship between girls' sexual maturation (age of menarche) and physical activity and sedentary behaviors. Data were collected from a national representative sample of girls in 2010 (pre-menarcheal girls n = 583, post-menarcheal girls n = 741). Physical activity (times/week and hours/week) and screen-based sedentary time (minutes/day) including television/video/DVD watching, playing videogames, and computer use were self-reported. Pre-menarcheal girls engaged significantly more times in physical activity in the last 7 days than post-menarcheal girls (3.5 ± 1.9 times/week vs. 3.0 ± 1.7 times/week, P < 0.001). There was no significant difference between pre-menarcheal and post-menarcheal girls in time (hours/week) spent in physical activity. Post-menarcheal girls spent significantly more minutes per day than pre-menarcheal girls watching TV, playing videogames, and using computers on weekdays (TV: 165.2 ± 105.8 vs. 136.0 ± 106.3, P < 0.001; videogames 72.0 ± 84.8 vs. 60.3 ± 78.9, P = 0.015; computer: 123.3 ± 103.9 vs. 82.8 ± 95.8, P < 0.001) and on weekends (TV: 249.0 ± 116.2 vs. 209.3 ± 124.8, P < 0.001; videogames: 123.0 ± 114.0 vs. 104.7 ± 103.5, P = 0.020; computer: 177.0 ± 122.2 vs. 119.7 ± 112.7, P < 0.001). After adjusting analyses for age, BMI, and socioeconomic status, differences were still significant for physical activity and for computer use. Specific interventions should be designed for girls to increase their physical activity participation and decrease time spent on the computer, for post-menarcheal girls in particular. Am. J. Hum. Biol. 28:471-475, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Can the observed association between serum perfluoroalkyl substances and delayed menarche be explained on the basis of puberty-related changes in physiology and pharmacokinetics?

PubMed

Wu, Huali; Yoon, Miyoung; Verner, Marc-André; Xue, Jianping; Luo, Man; Andersen, Melvin E; Longnecker, Matthew P; Clewell, Harvey J

2015-09-01

An association between serum levels of two perfluoroalkyl substances (PFAS) and delayed age at menarche was reported in a cross-sectional study of adolescents. Because perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have half-lives of years, growth dilution and the development of a new route of excretion (menstruation) could account for some or all of the reported association. To assess how much of the epidemiologic association between PFAS and delayed menarche can be explained by the correlation of growth and maturation with PFAS body burden. We developed a Monte Carlo (MC) physiologically-based pharmacokinetic (PBPK) model of PFAS to simulate plasma PFAS levels in a hypothetical female population aged 2 to 20years old. Realistic distributions of physiological parameters as well as timing of growth spurts and menarche were incorporated in the model. The association between PFAS level and delayed menarche in the simulated data was compared with the reported association. The prevalence of menarche, distributions of age-dependent physiological parameters, and quartiles of serum PFAS concentrations in the simulated subjects were comparable to those reported in the epidemiologic study. The delay of menarche in days per natural log increase in PFAS concentrations in the simulated data were about one third as large as the observed values. The reported relationship between PFAS and age at menarche appears to be at least partly explained by pharmacokinetics rather than a toxic effect of these substances. Copyright © 2015 Elsevier Ltd. All rights reserved.

The relationship between age at menarche and infertility among Chinese rural women.

PubMed

Chen, Jianping; Zhong, Chunli; Liang, Hong; Yang, Yuan; Zhang, Ou; Gao, Ersheng; Chen, Aimin; Yuan, Wei; Wang, Jian; Sun, Fei; Miao, Maohua

2015-11-01

To explore the relationship between age at menarche and infertility. The cross-sectional study investigated 6906 couples from the communities in Sandu Shui Autonomous County of Guizhou Province, China. Face to face interviews were conducted to collect information on age at menarche and time to first pregnancy, as well as demographic characteristics and lifestyle factors. Infertility was defined as being unable to become pregnant after attempting for ≥12 months. Poisson regression was used to assess the relationship between age at menarche and infertility of first attempt. The prevalence rate of infertility for the first pregnancy attempt of the study population was 11.87%. There is an obvious monotonic, almost linear, trend of prevalence rate of infertility with increasing age at menarche (P for trend: <0.001). Compared with wives with age at menarche of 13 years, the prevalence ratios of infertility were 0.71 (95%CI: 0.42, 1.20), 1.33 (95%CI: 1.05, 1.68), 1.47 (95%CI: 1.17, 1.85), 1.57 (95%CI: 1.20, 2.04), 1.41 (95%CI: 1.00, 1.99) and 1.73 (95%CI: 1.18, 2.52) for wives with age at menarche of ≤12, 14, 15, 16, 17 and ≥18 years, respectively, after adjusting for wife's year at birth, age at marriage, ethnic group, education and occupation, and husband's smoking and drinking habits before marriage. The present community-based study indicated that increasing age at menarche was associated with an increased risk of infertility in the study population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Menarche Experience in Twenty-Three Foreign Countries.

ERIC Educational Resources Information Center

Logan, Deana Dorman

1980-01-01

Ninety-five women (18-26 years of age) from 23 countries were interviewed regarding (1) their preparation for menarche, (2) messages from others at the time of menarche, and (3) their emotional responses to the first period. Mothers were the source of information for most girls. Others' reactions were primarily hygiene-centered. Comparisons with…

Age of Menarche and Psychosocial Outcomes in a New Zealand Birth Cohort

ERIC Educational Resources Information Center

Boden, Joseph M.; Fergusson, David M.; Horwood, L. John

2011-01-01

Objective: This study examined associations between age of menarche and psychosocial outcomes in early adulthood, including sexual behavior, mental health, criminal behavior, and education/employment, to identify the possible causal role of earlier age of menarche in increasing risks of adverse outcomes. Method: Data were gathered from 497 female…

Sibling composition and household room sharing are associated with menarcheal status among rural Bengalee girls of West Bengal, India.

PubMed

Biswas, Sadaruddin; Koziel, Slawomir; Chakraborty, Raja; Bose, Kaushik

2013-08-01

Menarche, the first menstruation, is one of the most important events in a woman's reproductive life. The timing of menarche varies across populations and depends upon social interaction and family environment. It is also associated with several biological as well as social factors. The objective of this study was to explore the relationship between sibling composition and age at menarche (AAM) and to assess the association between the pattern of room sharing with family members of different sexes and menarcheal occurrence among rural Bengalee girls from West Bengal, India. The total sample comprised 577 Bengalee girls, 6-17 years of age, from various schools and madrasas in two blocks of the Nadia District of West Bengal State in India. The effects of room sharing on the occurrence of menarche, and of sibling composition on the menarcheal age, were assessed by analyses of covariance. The room-sharing pattern had a significant effect on menarcheal status (yes÷no): a significantly higher percentage of girls who shared a room with the mother and÷or sisters were postmenarcheal compared with those who shared a room with male family members. AAM did not differ significantly between girls having brothers or sisters. However, sibling order had a significant impact on AAM. Girls who had a younger sibling only (brother or sister) had a higher mean AAM, and girls who had both younger brothers and younger sisters had significantly higher mean AAM, than did the girls who had no younger sibling (singletons or having only elder siblings). There was no difference in AAM between the girls who had younger sister(s) and those who had younger brother(s). These differences were also independent of body mass index. In conclusion, the room sharing characteristics and the sibling sex composition, particularly their order, had significant effect on menarche in adolescent rural Bengalee girls. Copyright © 2013 Wayne State University Press, Detroit, Michigan 48201-1309.

Early menarche: A systematic review of its effect on sexual and reproductive health in low- and middle-income countries.

PubMed

Ibitoye, Mobolaji; Choi, Cecilia; Tai, Hina; Lee, Grace; Sommer, Marni

2017-01-01

Adolescent girls aged 15-19 bear a disproportionate burden of negative sexual and reproductive health outcomes in low- and middle-income countries. Research from several high-income countries suggests that early age at menarche is an important determinant of sexual and reproductive health. We conducted this systematic review to better understand whether and how early menarche is associated with various negative sexual and reproductive health outcomes in low- and middle-income countries and the implications of such associations. We systematically searched eight health and social sciences databases for peer-reviewed literature on menarche and sexual and reproductive health in low- and middle-income countries. Two reviewers independently assessed all studies for inclusion, overall quality and risk of bias, and performed data extraction on all included studies. Twenty-four articles met all inclusion criteria-nine of moderate quality and fifteen with several methodological weaknesses. Our review of the minimal existing literature showed that early menarche is associated with early sexual initiation, early pregnancy and some sexually transmitted infections in low- and middle-income countries, similar to what has been observed in high-income countries. Early menarche is also associated with early marriage-an association that may have particularly important implications for countries with high child marriage rates. Early age at menarche may be an important factor affecting the sexual and reproductive health of adolescent girls and young women in low- and middle-income countries. More research is needed to confirm the existence of the identified associations across different settings and to better understand the process through which early menarche and other markers of early pubertal development may contribute to the increased vulnerability of girls to negative sexual and reproductive health outcomes in low- and middle-income countries. Given the association of early menarche with early marriage, ongoing efforts to reduce child marriage may benefit from targeting efforts to early maturing girls.

Early menarche: A systematic review of its effect on sexual and reproductive health in low- and middle-income countries

PubMed Central

Choi, Cecilia; Tai, Hina; Lee, Grace; Sommer, Marni

2017-01-01

Background Adolescent girls aged 15–19 bear a disproportionate burden of negative sexual and reproductive health outcomes in low- and middle-income countries. Research from several high-income countries suggests that early age at menarche is an important determinant of sexual and reproductive health. We conducted this systematic review to better understand whether and how early menarche is associated with various negative sexual and reproductive health outcomes in low- and middle-income countries and the implications of such associations. Methods We systematically searched eight health and social sciences databases for peer-reviewed literature on menarche and sexual and reproductive health in low- and middle-income countries. Two reviewers independently assessed all studies for inclusion, overall quality and risk of bias, and performed data extraction on all included studies. Results Twenty-four articles met all inclusion criteria–nine of moderate quality and fifteen with several methodological weaknesses. Our review of the minimal existing literature showed that early menarche is associated with early sexual initiation, early pregnancy and some sexually transmitted infections in low- and middle-income countries, similar to what has been observed in high-income countries. Early menarche is also associated with early marriage–an association that may have particularly important implications for countries with high child marriage rates. Conclusions Early age at menarche may be an important factor affecting the sexual and reproductive health of adolescent girls and young women in low- and middle-income countries. More research is needed to confirm the existence of the identified associations across different settings and to better understand the process through which early menarche and other markers of early pubertal development may contribute to the increased vulnerability of girls to negative sexual and reproductive health outcomes in low- and middle-income countries. Given the association of early menarche with early marriage, ongoing efforts to reduce child marriage may benefit from targeting efforts to early maturing girls. PMID:28591132

Effects of menarcheal age on the anterior cruciate ligament injury risk factors during single-legged drop landing in female artistic elite gymnasts.

PubMed

Kim, Kew-Wan; Lim, Bee-Oh

2014-11-01

Although numerous studies have demonstrated the relationship between maturation and lower extremity biomechanics during landing in team sport athletes, we are presently uninformed of any research that examined the single-legged drop landing biomechanics of gymnasts. The purpose of this study is to investigate the effects of the menarcheal age on the lower extremity biomechanics during a single-legged drop landing in female artistic elite gymnasts. Twenty-two female artistic elite gymnasts, between 9 and 36 years of age, participated in this study. The participants were divided into two groups pre- (n = 11) and post- (n = 11) menarche and asked to perform a single-legged drop landing on top of a 30 cm platform and land on a force plate. The statistical analysis consisted of the multivariate analysis with the level of significance set at p < 0.05. The post-menarche group showed a decrease in their maximum knee flexion angle and increase in their maximum knee abduction angle, maximum internal tibial rotation angle, maximum knee abduction moment, and hamstring-quadriceps muscle activity ratio compared with the pre-menarche group during the single-legged drop landing. The post-menarche group showed an increased noncontact anterior cruciate ligament injury risk, due to their greater knee loads, compared with the pre-menarche group.

Going through the Rites of Passage: Timing and Transition of Menarche, Childhood Sexual Abuse, and Anxiety Symptoms in Girls

ERIC Educational Resources Information Center

Natsuaki, Misaki N.; Leve, Leslie D.; Mendle, Jane

2011-01-01

Menarche is a discrete, transitional event that holds considerable personal, social, biological, and developmental significance. The present longitudinal study examined both the transition and timing of menarche on the trajectory of anxiety in girls with histories of childhood maltreatment (N = 93; 63% European American, 14% multiracial, 10%…

Longitudinal Reliability of Self-Reported Age at Menarche in Adolescent Girls: Variability across Time and Setting

ERIC Educational Resources Information Center

Dorn, Lorah D.; Sontag-Padilla, Lisa M.; Pabst, Stephanie; Tissot, Abbigail; Susman, Elizabeth J.

2013-01-01

Age at menarche is critical in research and clinical settings, yet there is a dearth of studies examining its reliability in adolescents. We examined age at menarche during adolescence, specifically, (a) average method reliability across 3 years, (b) test-retest reliability between time points and methods, (c) intraindividual variability of…

Age at menarche in urban Argentinian girls: association with biological and socioeconomic factors.

PubMed

Orden, Alicia B; Vericat, Agustina; Apezteguía, Maria C

2011-01-01

Age at menarche is regarded as a sensitive indicator of physical, biological, and psychosocial environment. The aim of this study was to determine the age at menarche and its association with biological and socioeconomic factors in girls from Santa Rosa (La Pampa, Argentina). An observational cross-sectional study was carried out on 1,221 schoolgirls aged 9-15 years. Menarche data were obtained by the status-quo method. Height, sitting height, weight, arm circumference, tricipital and subscapular skinfolds were measured. We also calculated body mass index, measures of body composition and proportions, and fat distribution. To assess socioeconomic factors, parents completed a self-administered questionnaire about their occupation and education, family size, household, and other family characteristics. The median age at menarche - estimated by the logit method--was 12.84 years (95% CI: 12.71, 12.97). Compared with their premenarcheal age peers, postmenarcheal girls had greater anthropometric dimensions through age 12. After this age, only height was higher in the latter group. Data were processed by fitting two logistic regressions, both including age. The first model included anthropometric variables and birth weight, while the second model included the socioeconomic variables. The significant variables derived from each model were incorporated into a new regression: height, sitting height ratio (first model), and maternal education (second model). These three variables remained significantly associated with menarche. The results suggest a relationship between linear growth and menarche and agree with those found in other populations where the advancement of menarche is associated with improved living conditions. In relatively uniform urban contexts, maternal education may be a good proxy for the standard of living.

Association Between Early Menarche and School Bullying.

PubMed

Su, Qiru; Chen, Zhengyang; Li, Ruili; Elgar, Frank J; Liu, Zhihao; Lian, Qiguo

2018-04-25

Early pubertal onset may relate to more involvement in bullying in adolescent girls, both as a target and as a perpetrator. However, the few studies of the association between early menarche and school bullying have shown mixed findings. The present study examined whether early menarche is associated with bullying victimization and perpetration. We obtained survey data on adolescent girls from the 2001-2002, 2005-2006, and 2009-2010 cycles of the Health Behaviour in School-aged Children study in 35 European and North American countries. We identified school bullying in the past 2 months using the Revised Olweus Bully/Victim Questionnaire. We defined early menarche as a reported onset of menarche before 11 years and tested the associations between early menarche and bullying victimization and perpetration using three-level logistic regression models. The sample included 227,443 adolescent girls with a mean age of 13.64 (standard deviation [SD] 1.63) years, of which 10,172 (4.47%) were early matured; 62,528 (28.33%) and 56,582 (25.67%) were occasional victims and perpetrators, respectively; and 21,985 (9.96%) and 14,115 (6.40%) were frequent victims and perpetrators, respectively. Early menarche related to occasional victimization (adjusted odds ratio [OR] [95% confidence interval [CI] = 1.21 [1.12-1.31]) and perpetration (aOR [95% CI] = 1.19 [1.11-1.27]) and to frequent victimization (aOR [95% CI] = 1.35 [1.22-1.50]) and perpetration (aOR [95% CI] = 1.46 [1.31-1.63]). Early menarche in European and North American adolescent girls positively relates to bullying victimization and perpetration. Early-maturing girls should not be neglected in antibullying programs. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Important Role of Menarche in Development of Estrogen Receptor-Negative Breast Cancer in African American Women.

PubMed

Ambrosone, Christine B; Zirpoli, Gary; Hong, Chi-Chen; Yao, Song; Troester, Melissa A; Bandera, Elisa V; Schedin, Pepper; Bethea, Traci N; Borges, Virginia; Park, Song-Yi; Chandra, Dhyan; Rosenberg, Lynn; Kolonel, Laurence N; Olshan, Andrew F; Palmer, Julie R

2015-09-01

Menarche is a critical time point for diverging fates of mammary cells of origin. African American women have young age at menarche, which could be associated with their high rates of estrogen receptor-negative (ER-) breast cancer. In the AMBER Consortium, using harmonized data from 4426 African American women with breast cancer and 17 474 controls, we used polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for ages at menarche and first live birth (FLB), and the interval between, in relation to ER+ and ER- breast cancer. All statistical tests were two-sided. Risk of ER- breast cancer was reduced with later age at menarche among both parous and nulliparous women (≥15 vs <11 years OR = 0.62, 95% CI = 0.48 to 0.81 and OR = 0.56, 95% CI = 0.29 to 1.10, respectively), with no effect of age at FLB. For ER+ breast cancer, the inverse association was weaker among nulliparous women. While longer intervals between menarche and FLB were associated with increased risk of ER+ breast cancer in a dose-response fashion (OR for 20 year interval = 1.39, 95% CI = 1.08 to 1.79, P trend = .003), ER- risk was only increased for intervals up to 14 years and not beyond (P trend = .33). While ER- breast cancer risk was markedly reduced in women with a late age at menarche, there was not a clear pattern of increased risk with longer interval between menarche and FLB, as was observed for ER+ breast cancer. These findings indicate that etiologic pathways involving adolescence and pregnancy may differ for ER- and ER+ breast cancer. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Cannabinoid Receptor 2 Q63R Variant Modulates the Relationship between Childhood Obesity and Age at Menarche.

PubMed

Bellini, Giulia; Grandone, Anna; Torella, Marco; Miraglia del Giudice, Emanuele; Nobili, Bruno; Perrone, Laura; Maione, Sabatino; Rossi, Francesca

2015-01-01

The ovary is an important site where gene variants modulate pubertal timing. The cannabinoid receptor 2 (CB2) is expressed in the ovary, plays a role in folliculogenesis and ovulation, and can be modulated by estrogens. Obesity is strictly associated with early menarche and is characterized by sex hormone and endocannabinoid derangement. In this study, we investigated the role of the CB2 receptor in determining the age at menarche in obese girls. We studied a cohort of 240 obese girls (age 11.9±3 years; BMI z-score 2.8±0.8). The age at menarche (if it had already occurred) was recorded at the time of the visit or via phonecall. The CNR2 rs35761398 polymorphism, which leads to the CB2 Q63R variant, was detected by the TaqMan assay. In total, 105 patients were homozygous for the R63-coding allele (RR), 113 were QR and 22 were QQ. Variance analysis revealed a significantly earlier age of menarche in subjects carrying the Q63 allele, which was also found after adjusting for BMI z-score (11±1.2 vs. 11.6±1.2 years, p = 0.0003). Logistic regression analysis demonstrated that patients homozygous for the Q allele had a 2.2-fold higher risk (odds ratio = 2.2; CI1.1-3.4; p = 0.02) of presenting with an early menarche (age at menarche <12 years). We demonstrated for the first time the association between the CB2 Q63R functional variant and the age at menarche in a cohort of Italian obese girls.

Experience of Menarche Among Jordanian Adolescent Girls: An Interpretive Phenomenological Analysis.

PubMed

Al Omari, Omar; Abdel Razeq, Nadin M; Fooladi, Marjaneh M

2016-06-01

Menarche is a significant physical and emotional experience for adolescent girls, especially in certain cultures, where it is viewed as a rite of passage, affecting the meaning of lived experiences. The purpose of the study was to explore the menarche experience among Jordanian adolescent girls when they reach menarche. Interpretive phenomenological analysis. Az-Zarqa City, Jordan. A homogenous sample of 7 Jordanian girls, ages 12-14 years, who had their first menstruation within the past 6 months. Participants were asked to narrate their experiences through journal writing; their reports to be used for interpretive phenomenological analyses by 2 independent researchers, to ensure the findings' trustworthiness. Three major themes emerged as: (1) menstruation as a forbidden topic; (2) keeping the "topic" to oneself; and (3) no more secrets. Each theme was characterized according to distinct sets of emotions and knowledge-seeking patterns because Jordanian culture and Islamic teachings had greatly influenced the girls' experience of menarche. Menarche was considered a social taboo; not to be openly discussed. At the first signs of menarche, participants were shocked, scared, confused, and anxious. They had limited information and support from their family or school system. Therefore, they relied on self-perceptions about menarche, and viewed the experience of menstruation with profound negative emotions. Participants hesitated to share their experiences with their mothers and close friends. They felt alone and experienced their emotional turmoil in isolation and without support. Jordanian adolescent girls need formal health education to understand and manage the reproductive changes that occur in their bodies. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Experiences and Constructions of Menarche and Menstruation Among Migrant and Refugee Women.

PubMed

Hawkey, Alexandra J; Ussher, Jane M; Perz, Janette; Metusela, Christine

2017-08-01

Experiences and constructions of menarche and menstruation are shaped by the sociocultural environment in which women are embedded. We explored experiences and constructions of menarche and menstruation among migrant and refugee women resettled in Sydney, Australia, and Vancouver, Canada. Seventy-eight semistructured individual interviews and 15 focus groups comprised of 82 participants were undertaken with women from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and varying South American countries. We analyzed the data using thematic decomposition, identifying the overall theme "cycles of shame" and two core themes. In "becoming a woman," participants constructed menarche as a marker of womanhood, closely linked to marriage and childbearing. In "the unspeakable," women conveyed negative constructions of menstruation, positioning it as shameful, something to be concealed, and polluting. Identifying migrant and refugee women's experiences and constructions of menarche and menstruation is essential for culturally safe medical practice, health promotion, and health education.

Brief Report: Autistic-Like Traits in Childhood Predict Later Age at Menarche in Girls

ERIC Educational Resources Information Center

Whitehouse, Andrew J. O.; Maybery, Murray T.; Hickey, Martha; Sloboda, Deborah M.

2011-01-01

We investigated the relationship between autistic-like traits in early childhood and age at menarche in typically developing girls. Autistic-like symptoms were measured at age 2 years using the Child Behaviour Checklist, and age at menarche (AAM) was determined prospectively using self-report questionnaires at age 8, 10, 14 and 17 years. Girls…

Does Competence Mediate the Associations between Puberty and Internalizing or Externalizing Problems in Adolescent Girls

PubMed Central

Negriff, Sonya; Hillman, Jennifer, B.; Dorn, Lorah D.

2011-01-01

Purpose To examine separate mediational models linking a) menarcheal status or b) pubertal timing to internalizing and externalizing problems through competence. Method Cross-sectional analyses of 262 adolescent girls (11–17 years; M=14.93, SD=2.17) enrolled in a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health. Measures of menarcheal status (pre/post), pubertal timing (early, on-time, or late), internalizing and externalizing behavior, and perceived competence (parent and adolescent report) were obtained. Structural Equation Modeling was used for analyses. Results Perceived competence was found to fully mediate the association between menarcheal status and parent report of internalizing and externalizing problems. For adolescent report, there was a full mediation effect for internalizing problems but a partial mediation effect for externalizing problems. Being menarcheal was related to lower competence which was related to higher internalizing and externalizing problems. Models including pubertal timing were not significant. Conclusions Perceived competence is important in understanding the associations between menarcheal status and internalizing and externalizing problems. Interventions targeting competence, particularly in post-menarcheal girls, may reduce or prevent problem behaviors. PMID:21939864

Rural–urban variations in age at menarche, adult height, leg-length and abdominal adiposity in black South African women in transitioning South Africa

PubMed Central

2018-01-01

Abstract Background: The pre-pubertal socioeconomic environment may be an important determinant of age at menarche, adult height, body proportions and adiposity: traits closely linked to adolescent and adult health. Aims: This study explored differences in age at menarche, adult height, relative leg-length and waist circumference between rural and urban black South African young adult women, who are at different stages of the nutrition and epidemiologic transitions. Subjects and methods: We compared 18–23 year-old black South African women, 482 urban-dwelling from Soweto and 509 from the rural Mpumalanga province. Age at menarche, obstetric history and household socio-demographic and economic information were recorded using interview-administered questionnaires. Height, sitting-height, hip and waist circumference were measured using standardised techniques. Results: Urban and rural black South African women differed in their age at menarche (at ages 12.7 and 14.5 years, respectively). In urban women, a one-year increase in age at menarche was associated with a 0.65 cm and 0.16% increase in height and relative leg-length ratio, respectively. In both settings, earlier age at menarche and shorter relative leg-length were independently associated with an increase in waist circumference. Conclusions: In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood. PMID:29557678

Serum FSH level below 10 mIU/mL at twelve years old is an index of spontaneous and cyclical menstruation in Turner syndrome.

PubMed

Aso, Keiko; Koto, Shinobu; Higuchi, Asako; Ariyasu, Daisuke; Izawa, Masako; Miyamoto Igaki, Junko; Hasegawa, Yukihiro

2010-01-01

The gonadal function of patients with Turner syndrome (TS) is variable. Individuals with mosaicism characterized by 45,X/46,XX or 45,X/47,XXX are more likely to experience spontaneous menarche compared with other karyotypes. Prepubertal gonadotropins of TS patients with spontaneous menarche are reportedly normal or significantly lower than those of patients with induced menarche. The present study investigated an index of spontaneous and cyclical menstruation at 10-12 years old in TS. Subjects comprised 50 patients with TS, divided into three groups: Group A (n=7), with spontaneous menarche before 16 years old and regular menstruation for at least 1 year and 6 months; Group B (n=6), with irregular menstruation since menarche leading to secondary amenorrhea despite spontaneous menarche before 16 years old; and Group C (n=37), without spontaneous breast budding before 14 years old or without spontaneous menarche before 16 years old. Karyotype, LH and FSH concentrations at 10 and 12 years old were analyzed retrospectively. Spontaneous and cyclical menstruation was more frequently observed in TS with mosaicism characterized by 45,X/46,XX or 45,X/47,XXX than in TS with other karyotypes, as previously described. Spontaneous and cyclical menstruation in TS was observed when serum FSH level was <10 mIU/mL at 12 years old, suggesting this FSH level as an index of spontaneous and cyclical menstruation in TS.

Age at Menarche and Time Spent in Education: A Mendelian Randomization Study.

PubMed

Gill, D; Del Greco M, F; Rawson, T M; Sivakumaran, P; Brown, A; Sheehan, N A; Minelli, C

2017-09-01

Menarche signifies the primary event in female puberty and is associated with changes in self-identity. It is not clear whether earlier puberty causes girls to spend less time in education. Observational studies on this topic are likely to be affected by confounding environmental factors. The Mendelian randomization (MR) approach addresses these issues by using genetic variants (such as single nucleotide polymorphisms, SNPs) as proxies for the risk factor of interest. We use this technique to explore whether there is a causal effect of age at menarche on time spent in education. Instruments and SNP-age at menarche estimates are identified from a Genome Wide Association Study (GWAS) meta-analysis of 182,416 women of European descent. The effects of instruments on time spent in education are estimated using a GWAS meta-analysis of 118,443 women performed by the Social Science Genetic Association Consortium (SSGAC). In our main analysis, we demonstrate a small but statistically significant causal effect of age at menarche on time spent in education: a 1 year increase in age at menarche is associated with 0.14 years (53 days) increase in time spent in education (95% CI 0.10-0.21 years, p = 3.5 × 10 -8 ). The causal effect is confirmed in sensitivity analyses. In identifying this positive causal effect of age at menarche on time spent in education, we offer further insight into the social effects of puberty in girls.

Association Between Age at Menarche and Gestational Diabetes Mellitus: The Australian Longitudinal Study on Women's Health.

PubMed

Schoenaker, Danielle A J M; Mishra, Gita D

2017-04-01

In this study, we aimed to examine the association between age at menarche and gestational diabetes mellitus (GDM). Data were from 4,749 women participating in the Australian Longitudinal Study on Women's Health between 2000 and 2012. Age at menarche was reported at baseline in 2000 when women were aged 22-27 years. During 12 years of follow-up, information on GDM diagnosis was obtained for each live birth. Log-binomial regression analysis was used to estimate relative risks and 95% confidence intervals. Analyses adjusted for mother's highest completed educational qualification, nulliparity, polycystic ovary syndrome, physical activity, and body mass index. Mean age at menarche was 12.9 years (standard deviation, 1.4). A first diagnosis of GDM was reported by 357 women (7.5%). Compared with women with menarche at age 13 years, women who had their first menstruation at age ≤11 years had a 51% higher risk of developing GDM (95% confidence interval: 1.10, 2.07) after adjustment for GDM risk factors. Our findings indicate that a young age at menarche may identify women at higher risk of GDM. Further prospective studies are needed to confirm our findings and to elucidate the role of early-life exposures in age at menarche and subsequent GDM risk. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Age at Menarche Is Associated with Divergent Alcohol Use Patterns in Early Adolescence and Early Adulthood

ERIC Educational Resources Information Center

Richards, Meghan A.; Oinonen, Kirsten A.

2011-01-01

A cross-sectional retrospective design was employed to examine the relationship between age at menarche (AAM) and alcohol use patterns from middle childhood (age 7) to early adulthood in 265 University-aged women. Earlier menarche was associated with: (a) earlier ages at first drink and first intoxication, (b) greater use between ages 9 and 14…

Earlier Mother's Age at Menarche Predicts Rapid Infancy Growth and Childhood Obesity

PubMed Central

Ong, Ken K; Northstone, Kate; Wells, Jonathan CK; Rubin, Carol; Ness, Andy R; Golding, Jean; Dunger, David B

2007-01-01

Background Early menarche tends to be preceded by rapid infancy weight gain and is associated with increased childhood and adult obesity risk. As age at menarche is a heritable trait, we hypothesised that age at menarche in the mother may in turn predict her children's early growth and obesity risk. Methods and Findings We tested associations between mother's age at menarche, mother's adult body size and obesity risk, and her children's growth and obesity risk in 6,009 children from the UK population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort who had growth and fat mass at age 9 y measured by dual-energy X-ray absorptiometry. A subgroup of 914 children also had detailed infancy and childhood growth data. In the mothers, earlier menarche was associated with shorter adult height (by 0.64 cm/y), increased weight (0.92 kg/y), and body mass index (BMI, 0.51 kg/m2/y; all p < 0.001). In contrast, in her children, earlier mother's menarche predicted taller height at 9 y (by 0.41 cm/y) and greater weight (0.80 kg/y), BMI (0.29 kg/m2/y), and fat mass index (0.22 kg/m2/year; all p < 0.001). Children in the earliest mother's menarche quintile (≤11 y) were more obese than the oldest quintile (≥15 y) (OR, 2.15, 95% CI 1.46 to 3.17; p < 0.001, adjusted for mother's education and BMI). In the subgroup, children in the earliest quintile showed faster gains in weight (p < 0.001) and height (p < 0.001) only from birth to 2 y, but not from 2 to 9 y (p = 0.3–0.8). Conclusions Earlier age at menarche may be a transgenerational marker of a faster growth tempo, characterised by rapid weight gain and growth, particularly during infancy, and leading to taller childhood stature, but likely earlier maturation and therefore shorter adult stature. This growth pattern confers increased childhood and adult obesity risks. PMID:17455989

Age at menarche: the influence of environmental conditions

NASA Astrophysics Data System (ADS)

Saar, E.; Shalev, C.; Dalal, I.; Sod-Moriah, U. A.

1988-03-01

Age at menarche was studied by the recollection method in two groups of Causasian Jewish high school girls, inhabitants of two towns in Israel, Safad and Elat. The two towns differ mainly in climatic conditions. The age at menarche was found to be significantly lower ( P<0.02) in the hot town of Elat than in the temperate town of Safad: 13.30±1.21 and 13.58±0.9 years, respectively (mean ±SD). A significant association was found between the age at menarche and the town in which the girls lived. Accordingly, in the hot town of Elat, the percentage of girls who had their first menstrual cycle by the age of 12 years and earlier, was more than double that of the girls in Safad (17.9% and 7.1%, respectively). It is concluded that the environmental temperature, with or without any possible interaction of humidity, is probably responsible for the tendency for an earlier onset of menarche in girls living in the hot town of Elat.

Birth characteristics and female sex hormone concentrations during adolescence: results from the Dietary Intervention Study in Children.

PubMed

Ruder, Elizabeth H; Hartman, Terryl J; Rovine, Michael J; Dorgan, Joanne F

2011-04-01

Birth characteristics and adult hormone concentrations influence breast cancer risk, but little is known about the influence of birth characteristics on hormone concentrations, particularly during adolescence. We evaluated the association of birth characteristics (birth weight, birth length, and gestational age) with serum sex hormone concentrations during late childhood and adolescence in 278 female participants of the Dietary Intervention Study in Children. Repeated measures analysis of variance models were used to assess the relationships of birth characteristics and serum estrogens and androgens at five different time points over a mean period of 7 years. In analyses that did not take into account time from blood draw until menarche, birth weight was inversely associated with pre-menarche concentrations of estradiol, estrone sulfate, androstenedione, testosterone, and dehydroepiandrosterone sulfate (DHEAS). In the post-menarche analyses, birth weight was not significantly associated with concentration of any of the hormones under investigation. Birth length and gestational age were not associated with hormone concentrations before or after menarche. Birth weight is inversely associated with sex hormone concentrations before menarche in the model unadjusted for time from blood draw until menarche. The in utero environment has long-term influences on the hormonal milieu, which could potentially contribute to breast cancer risk.

Heterosexual Romantic Involvement and Depressive Symptoms in Black Adolescent Girls: Effects of Menarche and Perceived Social Support

PubMed Central

Caldwell, Cleopatra Howard; Matusko, Niki; Jackson, James S.

2015-01-01

Research has accumulated to demonstrate that depressive symptoms are associated with heterosexual romantic involvement during adolescence, but relatively little work has linked this body of literature to the existing literature on associations between early pubertal timing and adolescent depressive symptoms. This study extends prior research by examining whether early menarche and heterosexual romantic involvement interact to predict depressive symptoms in a national sample of Black adolescent girls (N = 607; M age = 15 years; 32 % Caribbean Black and 68 % African American). We further examined whether the adverse effects of heterosexual romantic involvement and early menarche would be mediated by perceived social support from mothers, fathers, and peers. Path analysis results indicated that girls who report current involvement in a heterosexual romantic relationship also reported high levels of perceived peer support than girls with no romantic involvement. High levels of perceived peer support, in turn, predicted low levels of depressive symptoms. Romantically involved girls with an early menarche also reported significantly less depressive symptoms than girls not romantically involved with an early menarche. Neither perceived maternal support nor perceived paternal support mediated associations between heterosexual romantic involvement, menarche, and depressive symptoms. The findings suggest that individual and social factors can impede heterosexual romantic involvement effects on depressive symptoms in Black adolescent girls. PMID:25678429

Age at menarche, total mortality and mortality from ischaemic heart disease and stroke: the Adventist Health Study, 1976–88

PubMed Central

Jacobsen, B K; Oda, K; Knutsen, S F; Fraser, G E

2009-01-01

Background Little is known about the relationship between age at menarche and total mortality and mortality from ischaemic heart disease and stroke. Methods A cohort study of 19 462 Californian Seventh-Day Adventist women followed-up from 1976 to 1988. A total of 3313 deaths occurred during follow-up, of which 809 were due to ischaemic heart disease and 378 due to stroke. Results An early menarche was associated with increased total mortality (P-value for linear trend <0.001), ischaemic heart disease (P-value for linear trend = 0.01) and stroke (P-value for linear trend = 0.02) mortality. There were, however, also some indications of an increased ischaemic heart disease mortality in women aged 16–18 at menarche (5% of the women). When assessed as a linear relationship, a 1-year delay in menarche was associated with 4.5% (95% CI 2.3–6.7) lower total mortality. The association was stronger for ischaemic heart disease [6.0% (95% CI 1.2–10.6)] and stroke [8.6% (95% CI 1.6–15.1)] mortality. Conclusions The results suggest that there is a linear, inverse relationship between age at menarche and total mortality as well as with ischaemic heart disease and stroke mortality. PMID:19188208

Age at menarche, total mortality and mortality from ischaemic heart disease and stroke: the Adventist Health Study, 1976-88.

PubMed

Jacobsen, B K; Oda, K; Knutsen, S F; Fraser, G E

2009-02-01

Little is known about the relationship between age at menarche and total mortality and mortality from ischaemic heart disease and stroke. A cohort study of 19 462 Californian Seventh-Day Adventist women followed-up from 1976 to 1988. A total of 3313 deaths occurred during follow-up, of which 809 were due to ischaemic heart disease and 378 due to stroke. An early menarche was associated with increased total mortality (P-value for linear trend <0.001), ischaemic heart disease (P-value for linear trend = 0.01) and stroke (P-value for linear trend = 0.02) mortality. There were, however, also some indications of an increased ischaemic heart disease mortality in women aged 16-18 at menarche (5% of the women). When assessed as a linear relationship, a 1-year delay in menarche was associated with 4.5% (95% CI 2.3-6.7) lower total mortality. The association was stronger for ischaemic heart disease [6.0% (95% CI 1.2-10.6)] and stroke [8.6% (95% CI 1.6-15.1)] mortality. The results suggest that there is a linear, inverse relationship between age at menarche and total mortality as well as with ischaemic heart disease and stroke mortality.

Secular trend in age at menarche in indigenous and nonindigenous women in Chile.

PubMed

Ossa, X M; Munoz, S; Amigo, H; Bangdiwala, S I

2010-01-01

To estimate the secular trend in age at menarche, comparing indigenous and nonindigenous women, and its relationship with socio-demographic, family and nutritional factors. A study (historical cohorts) of 688 indigenous and nonindigenous women, divided into four birth cohorts (1960-69, 1970-79, 1980-89, and 1990-96) in an area in central southern Chile was carried out. Data and measurements were collected by health professionals using a previously validated questionnaire. Age at menarche was self-reported (recall). Adjusted differences among cohorts were estimated using a multivariate regression model. A secular trend (P < 0.001) in age at menarche was found in both ethnic groups, with no significant differences between them (P > 0.05). In an adjusted model, a reduction in age at menarche was estimated at 3.7 months per decade between 1960 and 1990. This trend was moderated by higher socio-economic level, smaller number of siblings, and cohabitation with a single parent during infancy. The trend has occurred in a steady progression over time in indigenous women, whereas in nonindigenous women, it was slow initially but has accelerated in recent years. Nonindigenous women have maintained a slightly lower age of menarche than their indigenous counterparts. (c) 2010 Wiley-Liss, Inc.

Reproductive disturbances among Saudi adolescent girls and young women with type 1 diabetes mellitus

PubMed Central

Braham, Rim; Robert, Asirvatham Alwin; Musallam, Maha Ali; Alanazi, Abdulaziz; Swedan, Nawaf Bin; Al Dawish, Mohamed Abdulaziz

2017-01-01

AIM To identify reproductive disturbances among adolescent girls and young women with type 1 diabetes mellitus (T1DM) in Saudi Arabia. METHODS This cross sectional study was conducted among 102 female with T1DM, (aged 13-29 years) who attended the Diabetes Clinic at Diabetes Treatment Center, Prince Sultan Military Medical City, Saudi Arabia between April 2015 to March 2016. Clinical history, anthropometric characteristics and reproductive disturbance were collected through a questionnaire. RESULTS Of 102 patients included in this analysis, 26.5% (27/102) were reported that they experienced an irregular menses. Of these patients, when compared to whose diabetes was diagnosed before menarche (35.4%, 17/48), patients diagnosed with diabetes after menarche (18.5%, 10/54) showed significantly less irregular menses (difference 16.9%, P = 0.04). Similarly, compared to patients diagnosed with diabetes prior to menarche (mean age 12.9 years; n = 48), patients diagnosed with diabetes after menarche (mean age 12.26 years; n = 54) were found to have 0.64 years delay in the age of menarche (P = 0.04). Among the studied patients, 15.7% (16/102) had polycystic ovary syndrome (PCOS). Of these PCOS patients, 37.5% (6/16) had irregular menses, 6.3% (1/16) had Celiac disease, 37.5% (6/16) had Hashimoto thyroiditis and 18.7% (3/16) had acne. CONCLUSION More than one fourth of the study population with T1DM experiencing an irregular menses. Adolescent girls and young women diagnosed with diabetes prior to menarche showed higher menstrual irregularity and a delay in the age of menarche. PMID:29204256

Reproductive disturbances among Saudi adolescent girls and young women with type 1 diabetes mellitus.

PubMed

Braham, Rim; Robert, Asirvatham Alwin; Musallam, Maha Ali; Alanazi, Abdulaziz; Swedan, Nawaf Bin; Al Dawish, Mohamed Abdulaziz

2017-11-15

To identify reproductive disturbances among adolescent girls and young women with type 1 diabetes mellitus (T1DM) in Saudi Arabia. This cross sectional study was conducted among 102 female with T1DM, (aged 13-29 years) who attended the Diabetes Clinic at Diabetes Treatment Center, Prince Sultan Military Medical City, Saudi Arabia between April 2015 to March 2016. Clinical history, anthropometric characteristics and reproductive disturbance were collected through a questionnaire. Of 102 patients included in this analysis, 26.5% (27/102) were reported that they experienced an irregular menses. Of these patients, when compared to whose diabetes was diagnosed before menarche (35.4%, 17/48), patients diagnosed with diabetes after menarche (18.5%, 10/54) showed significantly less irregular menses (difference 16.9%, P = 0.04). Similarly, compared to patients diagnosed with diabetes prior to menarche (mean age 12.9 years; n = 48), patients diagnosed with diabetes after menarche (mean age 12.26 years; n = 54) were found to have 0.64 years delay in the age of menarche ( P = 0.04). Among the studied patients, 15.7% (16/102) had polycystic ovary syndrome (PCOS). Of these PCOS patients, 37.5% (6/16) had irregular menses, 6.3% (1/16) had Celiac disease, 37.5% (6/16) had Hashimoto thyroiditis and 18.7% (3/16) had acne. More than one fourth of the study population with T1DM experiencing an irregular menses. Adolescent girls and young women diagnosed with diabetes prior to menarche showed higher menstrual irregularity and a delay in the age of menarche.

Genome-wide association studies and epistasis analyses of candidate genes related to age at menarche and age at natural menopause in a Korean population.

PubMed

Pyun, Jung-A; Kim, Sunshin; Cho, Nam H; Koh, InSong; Lee, Jong-Young; Shin, Chol; Kwack, KyuBum

2014-05-01

The aim of this study was to identify polymorphisms and gene-gene interactions that are significantly associated with age at menarche and age at menopause in a Korean population. A total of 3,452 and 1,827 women participated in studies of age at menarche and age at natural menopause, respectively. Linear regression analyses adjusted for residence area were used to perform genome-wide association studies (GWAS), candidate gene association studies, and interactions between the candidate genes for age at menarche and age at natural menopause. In GWAS, four single nucleotide polymorphisms (SNPs; rs7528241, rs1324329, rs11597068, and rs6495785) were strongly associated with age at natural menopause (lowest P = 9.66 × 10). However, GWAS of age at menarche did not reveal any strong associations. In candidate gene association studies, SNPs with P < 0.01 were selected to test their synergistic interactions. For age at natural menopause, there was a significant interaction between intronic SNPs on ADAM metallopeptidase with thrombospondin type I motif 9 (ADAMTS9) and SMAD family member 3 (SMAD3) genes (P = 9.52 × 10). For age at menarche, there were three significant interactions between three intronic SNPs on follicle-stimulating hormone receptor (FSHR) gene and one SNP located at the 3' flanking region of insulin-like growth factor 2 receptor (IGF2R) gene (lowest P = 1.95 × 10). Novel SNPs and synergistic interactions between candidate genes are significantly associated with age at menarche and age at natural menopause in a Korean population.

Evolutionary fitness as a function of pubertal age in 22 subsistence-based traditional societies

PubMed Central

2011-01-01

Context The age of puberty has fallen over the past 130 years in industrialized, western countries, and this fall is widely referred to as the secular trend for earlier puberty. The current study was undertaken to test two evolutionary theories: (a) the reproductive system maximizes the number of offspring in response to positive environmental cues in terms of energy balance, and (b) early puberty is a trade-off response for high mortality rate and reduced resource availability. Methods Using a sample of 22 natural-fertility societies of mostly tropical foragers, horticulturalists, and pastoralists from Africa, South America, Australia, and Southeastern Asia, this study compares indices of adolescence growth and menarche with those of fertility fitness in these non-industrial, traditional societies. Results The average age at menarche correlated with the first reproduction, but did not correlate with the total fertility rate TFR or reproductive fitness. The age at menarche correlated negatively with their average adult body mass, and the average adult body weight positively correlated with reproductive fitness. Survivorship did not correlate with the age at menarche or age indices of the adolescent growth spurt. The population density correlated positively with the age at first reproduction, but not with menarche age, TFR, or reproductive fitness. Conclusions Based on our analyses, we reject the working hypotheses that reproductive fitness is enhanced in societies with early puberty or that early menarche is an adaptive response to greater mortality risk. Whereas body mass is a measure of resources is tightly associated with fitness, the age of menarche is not. PMID:21860629

The Decreasing Age at Menarche in Mexico.

PubMed

Marván, M Luisa; Catillo-López, Rosa Lilia; Alcalá-Herrera, Verónica; Callejo, Diana Del

2016-10-01

To estimate the current age at menarche in 2 urban areas from Mexico and to analyze secular trends in the age at menarche in Mexico City. Cross-sectional survey and secondary data analyses. (1) Samples of female students from Mexico City and from the city of Xalapa; and (2) national health surveys. (1) Pre- and postmenarcheal students, aged 8-17 years; and (2) data for women born between 1904 and 1999 who grew up in Mexico City were obtained from 3 relevant national health surveys. (1) Students were asked if they had had their first period and when it occurred; (2) information on year of birth and age at menarche for the remaining women was obtained from the national surveys; data were divided in groups according to the decade in which the women were born. (1) The estimated mean age at menarche was 11.40 and 11.34 years in Mexico City and Xalapa respectively. (2) There were significant differences in age at menarche among women who were born in the different decades analyzed. Women who were born in the 1990s or later reported an earlier age at menarche than those who were born from the 1940s to 1980s (P < .0001). These results could be helpful to health and education professionals who should take into account that because there is currently a widening gap between the physical and psychosocial maturity of girls, they might need special support. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Effect of family disintegration on age at menarche.

PubMed

Toromanović, Alma; Tahirović, Husref

2015-01-01

The aim of this study was to determine the effect of psychosocial factors on the age at menarche of girls in Federation of Bosnia and Herzegovina (FBH). A cross-sectional study was conducted from September 2002 to May 2003 in all Cantons of the FBH. The random stratified sample included 19.803 girls aged 9.0 to 17.5 years. Data were collected using the status quo method. Probit analysis was used to estimate median age at menarche and 95% confidence intervals. The present study shows that menarche occurred significantly earlier (p<0.05) in girls from dysfunctional families (median: 12.99 years, 95% confidence interval: 12.93-13.05) than in girls who grew up in intact families (median: 13.04 years, 95% confidence interval: 13.01-13.07). Analyzing separately the impact of each of family stressors on age at menarche, we found that menarcheal age was significantly lower in girls from single-mother families, whose parents are divorced, whose one parent is died and where alcoholism in family is present than in girls from intact families. Maturation was found to be earlier in girls from dysfunctional families then in those from intact families after the influence of place of residence and sibship size was eliminated. From our research we can conclude that the girls from dysfunctional families reached earlier age at menarche than their peers who grew up in normal families, and that this effect did not disappear after controlling for socioeconomic variables. Copyright © 2015 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Age at menarche in Polish University students born before, during and after World War II: Economic effects.

PubMed

Liczbińska, Grażyna; Czapla, Zbigniew; Piontek, Janusz; Malina, Robert M

2018-02-01

Although the relationships between economic conditions and biological variables over the past two centuries in Poland are reasonably well-documented, the influence of economic and political disruptions, including nutritional privation, during the years immediately before, during and shortly after World War II (WWII) has received less attention. This paper considers the association between age at menarche and body size of university students born before, during and after WWII and father's level of education, a commonly used indicator of family economic status in Poland. Subjects were 518 university students surveyed between 1955 and 1972, birth years 1931 through 1951. The sample was divided into three birth cohorts: before (n=237), during (n=247) and after (n=34) WWII. Age at menarche was compared among birth cohorts, and by weight status and father's level of education. Age at menarche increased slightly but significantly among women born during WWII (14.4 yrs) compared to those born before (14.2 yrs) and after (13.9 yrs) the war. Controlling for year of birth and age of the student, age at menarche was significantly earlier in overweight (13.42±0.35 yrs) than in normal weight (14.33±0.06 yrs) and thin (14.54±0.21 yrs) women. Adjusted mean ages at menarche in small samples of overweight women did not differ by father's level of education, and were earlier than corresponding ages of thin and normal weight women. Adjusted mean ages at menarche did not differ between thin and normal weight women with fathers having primary or no education, but were slightly later in thin than in normal weight women with fathers having a vocational, secondary or higher education. Although age at menarche was associated with father's level of education, young adult weight status was a somewhat more important correlate. Copyright © 2017 Elsevier B.V. All rights reserved.

Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the Health Behaviour in School-aged Children Study.

PubMed

Currie, Candace; Ahluwalia, Naman; Godeau, Emmanuelle; Nic Gabhainn, Saoirse; Due, Pernille; Currie, Dorothy B

2012-06-01

A unique standardized international data set from adolescent girls in 34 countries in Europe and North America participating in the Health Behaviour in School-aged Children Study (HBSC) is used to investigate the contribution of body mass index (BMI) at individual and country level to cross-national differences in age at menarche. Two independent nationally representative survey data sets from 15-year-olds (n = 27,878, in 34 countries, year = 2005/2006) and 11-year-olds (n = 18,101, in 29 countries, year = 2001/2002) were analyzed. The survey instrument is a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated using Kaplan-Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). "Country-level obesity" was measured by prevalence of overweight/obesity (%) in each country. Country-level median age at menarche ranged between 12 years and 5 months and 13 years and 5 months. Country-level prevalence of overweight among 15-year-old girls ranged from 4% to 28%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = -1.01; 95% CI, -1.09 to -.94) and country-level aggregate overweight at age 11 (unstandardized regression coefficient beta = -.25; 95% CI, -.43 to -.08). Individual- and country-level measures of BMI account for 40% of the country-level variance in age at menarche. The findings add to the evidence that obesity in childhood is a risk factor for early puberty in girls and accounts for much of the cross-national variation in age at menarche. Future HBSC surveys can track this relationship in the wake of the obesity "epidemic." Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

[Nutritional status in telarche and menarche in indigenous and non indigenous Chilean adolescents].

PubMed

Amigo, Hugo; Costa Machado, Thais; Bustos, Patricia

2009-09-01

A compensatory effect of chronic malnutrition that influences excess of weight has been reported. This effect would be more evident in indigenous populations. The aim of this study was to find out the association between ethnic group (mapuche) and body composition in the telarche and menarche of indigenous and non indigenous adolescents. This was a cross sectional design. At the beginning, a screening of 10,121 girls from 168 schools in the Araucania Region, Chile was done. 230 adolescent in telarche (grade II of the development of the mammary gland): 112 indigenous and 118 non indigenous and 239 in menarche (113 indigenous and 126 non indigenous) were identified. Body mass index (BMI), waist circumference (WC), lean mass (LM) and fat mass (FM) were evaluated. BMI, WC and LM were higher in the indigenous adolescent in telarche. For those with menarche, the differences decreased, reaching with higher values for indigenous girls only in BMI and FM (p=0,04 and 0,02, respectively). Belonging to the indigenous group increased the BMI in 0.37 z scores in telarche (95% CI: 0,17-0,58) and 0,44 in menarche (95% CI:0,18-0,70). Being mapuche was also associated to higher WC: 3.33 cm (CI 1,67 - 4,99) in telarche and 3,17 cm (CI 0,73-5,60) in menarche and to higher lean mass only for those adolescents with telarche (1,3 CI: 0,11-2,43) and to fat mass only for those with menarche (2,4 CI: 1,02-3,77). The body composition indicators in indigenous adolescents are of concern and underscores the importance of programs to promote healthy lifestyles that take into account resources from the indigenous communities.

Menstrual and menarche experience among pubescent female students in Taiwan: implications for health education and promotion practice.

PubMed

Chang, Yu-Ting; Chen, Yueh-Chih; Hayter, Mark; Lin, Mei-Ling

2009-07-01

This study aimed to explore the menarche and menstruation experiences of young females aged 10-12 years in elementary education in Taiwan. Menarche is a significant milestone in a woman's life and for female adolescents it is a sharply defined biological event that can be a traumatic and uncomfortable time. If used, school nurses can make a significant contribution in educating young people and help to ameliorate these problems. Understanding how young women feel about menstruation is a central element to sexual health education practice. A qualitative research design was employed using focus groups. Data were collected from 20 female students, aged between 10-12 years. Focus groups were recorded, transcribed and subject to a thematic analysis. Three themes emerged from the data analysis reflecting the menstrual experience of participants. These were: 'Changing bodies: the physical effects of menarche and menstruation', 'Emotional issues: the psychological impact of menarche and menstruation' and 'Social dimensions of the menarche and menstruation'. Our findings show that young females can experience significant physical and emotional difficulties around menstruation - many of which stem from poor information and the reactions of their peer group to menstrual activity. The potential for school nurses to contribute to this education is significant and schools should explore the manner in which nurses can contribute to this area of health education. Nurses involved in health education work with young people and ensure that menstruation education addresses the social and psychological impact of the menarche as well as the physical elements of menstruation. Boys should not be absent from this education and the impact of their attitudes towards menstruation upon their female peers should be addressed in health education work.

The Influence of Organized Physical Activity (including Gymnastics) on Young Adult Skeletal Traits: Is Maturity Phase Important?

PubMed Central

Bernardoni, Brittney; Scerpella, Tamara A.; Rosenbaum, Paula F.; Kanaley, Jill A.; Raab, Lindsay N.; Li, Quefeng; Wang, Sijian; Dowthwaite, Jodi N.

2015-01-01

We prospectively evaluated adolescent organized physical activity (PA) as a factor in adult female bone traits. Annual DXA scans accompanied semi-annual records of anthropometry, maturity and PA for 42 participants in this preliminary analysis (criteria: appropriately timed DXA scans at ~1 year pre-menarche [predictor] and ~5 years post-menarche [dependent variable]). Regression analysis evaluated total adolescent inter-scan PA and PA over 3 maturity sub-phases as predictors of young adult bone outcomes: 1) bone mineral content (BMC), geometry and strength indices at non-dominant distal radius and femoral neck; 2) sub-head BMC; 3) lumbar spine BMC. Analyses accounted for baseline gynecological age (years pre- or post-menarche), baseline bone status, adult body size and inter-scan body size change. Gymnastics training was evaluated as a potentially independent predictor, but did not improve models for any outcomes (p<0.07). Pre-menarcheal bone traits were strong predictors of most adult outcomes (semi-partial r2 = 0.21-0.59, p≤0.001). Adult 1/3 radius and sub-head BMC were predicted by both total PA and PA 1-3 years post-menarche (p<0.03). PA 3-5 years post-menarche predicted femoral narrow neck width, endosteal diameter and buckling ratio (p<0.05). Thus, participation in organized physical activity programs throughout middle and high school may reduce lifetime fracture risk in females. PMID:25386845

Menarcheal age of girls from dysfunctional families.

PubMed

Toromanović, Alma; Tahirović, Husref

2004-07-01

The objective of the present study was to determine median age at menarche and the influence of familial instability on maturation. The sample included 7047 girls between the ages of 9 and 17 years from Tuzla Canton. The girls were divided into two groups. Group A (N=5230) comprised girls who lived in families free of strong traumatic events. Group B (N=1817) included girls whose family dysfunction exposed them to prolonged distress. Probit analysis was performed to estimate mean menarcheal age using the Probit procedure of SAS package. The mean menarcheal age calculated by probit analysis for all the girls studied was 13.07 years. In girls from dysfunctional families a very clear shift toward earlier maturation was observed. The mean age at menarche for group B was 13.0 years, which was significantly lower that that for group A, 13.11 years (t=2.92, P<0.01). The results surveyed here lead to the conclusion that girls from dysfunctional families mature not later but even earlier than girls from normal families. This supports the hypothesis that stressful childhood life events accelerate maturation of girls.

Father absence and timing of menarche in adolescent girls from a UK cohort: the mediating role of maternal depression and major financial problems.

PubMed

Culpin, Iryna; Heron, Jon; Araya, Ricardo; Melotti, Roberto; Lewis, Glyn; Joinson, Carol

2014-04-01

In a prospective birth cohort study of 5295 girls from the UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the association between biological father absence in childhood and age at menarche whilst adjusting for antenatal indicators of socioeconomic disadvantage and maternal characteristics. We also examined whether exposure to maternal depression and financial problems during middle childhood mediate the association between father absence and age at menarche. There was stronger evidence for an association between father absence during the first 5 years of life and early timing of menarche compared with father absence between 5 and 10 years. There was evidence that maternal depression and major financial problems explained some of the association between early childhood father absence and age at menarche. Although father absence cannot be a direct target of prevention, family-based programs to address family processes influenced by maternal depression and socioeconomic disadvantage may be effective. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Relationship of lead, mercury, mirex, dichlorodiphenyldichloroethylene, hexachlorobenzene, and polychlorinated biphenyls to timing of menarche among Akwesasne Mohawk girls.

PubMed

Denham, Melinda; Schell, Lawrence M; Deane, Glenn; Gallo, Mia V; Ravenscroft, Julia; DeCaprio, Anthony P

2005-02-01

Children are commonly exposed at background levels to several ubiquitous environmental pollutants, such as lead and persistent organic pollutants, that have been linked to neurologic and endocrine effects. These effects have prompted concern about alterations in human reproductive development. Few studies have examined the effects of these toxicants on human sexual maturation at levels commonly found in the general population, and none has been able to examine multiple toxicant exposures. The aim of the current investigation was to examine the relationship between attainment of menarche and levels of 6 environmental pollutants to which children are commonly exposed at low levels, ie, dichlorodiphenyldichloroethylene (p,p'-DDE), hexachlorobenzene (HCB), polychlorinated biphenyls (PCBs), mirex, lead, and mercury. This study was conducted with residents of the Akwesasne Mohawk Nation, a sovereign territory that spans the St Lawrence River and the boundaries of New York State and Ontario and Quebec, Canada. Since the 1950s, the St Lawrence River has been a site of substantial industrial development, and the Nation is currently adjacent to a US National Priority Superfund site. PCB, p,p'-DDE, HCB, and mirex levels exceeding the US Food and Drug Administration recommended tolerance limits for human consumption have been found in local animal species. The present analysis included 138 Akwesasne Mohawk Nation girls 10 to 16.9 years of age. Blood samples and sociodemographic data were collected by Akwesasne community members, without prior knowledge of participants' exposure status. Attainment of menses (menarche) was assessed as present or absent at the time of the interview. Congener-specific PCB analysis was available, and all 16 PCB congeners detected in >50% of the sample were included in analyses (International Union of Pure and Applied Chemistry numbers 52, 70, 74, 84, 87, 95, 99, 101 [+90], 105, 110, 118, 138 [+163 and 164], 149 [+123], 153, 180, and 187). Probit analysis was used to determine the median age at menarche for the sample. Binary logistic regression analysis was used to determine predictors of menarcheal status. Six toxicants (p,p'-DDE, HCB, PCBs, mirex, lead, and mercury) were entered into the logistic regression model. Age, socioeconomic status (SES), and BMI were tested as potential cofounders and were included in the model at P < .05. Interactions among toxicants were also evaluated. Toxicant levels were measured in blood for this sample and were consistent with long-term exposure to a variety of toxicants in multiple media. Mercury levels were at or below background levels, all lead levels were well below the Centers for Disease Control and Prevention action limit of 10 microg/dL, and PCB levels were consistent with a cumulative, continuing exposure pattern. The median age at menarche for the total sample was 12.2 years. The predicted age at menarche for girls with lead levels above the median (1.2 microg/dL) was 10.5 months later than that for girls with lead levels below the median. In the logistic regression analysis, age was the strongest predictor of menarcheal status and SES was also a significant predictor but BMI was not. The logistic regression analysis that corrected for age, SES, and other pollutants (p,p'-DDE, HCB, mirex, and mercury) indicated that, at their respective geometric means, lead (geometric mean: 0.49 microg/dL) was associated with a significantly lower probability of having reached menarche (beta = -1.29) and a group of 4 potentially estrogenic PCB congeners (E-PCB) (geometric mean: 0.12 ppb; International Union of Pure and Applied Chemistry numbers 52, 70, 101 [+90], and 187) was associated with a significantly greater probability of having reached menarche (beta = 2.13). Predicted probabilities at different levels of lead and PCBs were calculated on the basis of the logistic regression model. At the respective means of all toxicants and SES, 69% of 12-year-old girls were predicted to have reached menarche. However, at the 75th percentile of lead levels, only 10% of 12-year-old Mohawk girls were predicted to have reached menarche; at the 75th percentile of E-PCB levels, 86% of 12-year-old Mohawk girls were predicted to have reached menarche. No association was observed between mirex, p,p'-DDE, or HCB and menarcheal status. Although BMI was not a significant predictor, we tested BMI in the logistic regression model; it had little effect on the relationships between menarcheal status and either lead or E-PCB. In models testing toxicant interactions, age, SES, lead levels, and PCB levels continued to be significant predictors of menarcheal status. When each toxicant was tested in a logistic regression model correcting only for age and SES, we observed little change in the effects of lead or E-PCB on menarcheal status. The analysis of multichemical exposure among Akwesasne Mohawk Nation adolescent girls suggests that the attainment of menarche may be sensitive to relatively low levels of lead and certain PCB congeners. This study is distinguished by the ability to test many toxicants simultaneously and thus to exclude effects from unmeasured but coexisting exposures. By testing several PCB congener groupings, we were able to determine that specifically a group of potentially estrogenic PCB congeners affected the odds of reaching menarche. The lead and PCB findings are consistent with the literature and are biologically plausible. The sample size, cross-sectional study design, and possible occurrence of confounders beyond those tested suggest that results should be interpreted cautiously. Additional investigation to determine whether such low toxicant levels may affect reproduction and disorders of the reproductive system is warranted.

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

PubMed

Sung, Sooyeon; Simpson, Jeffry A; Griskevicius, Vladas; Kuo, Sally I-Chun; Schlomer, Gabriel L; Belsky, Jay

2016-05-01

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. © The Author(s) 2016.

Age at Menarche: 50-Year Socioeconomic Trends Among US-Born Black and White Women

PubMed Central

Kiang, Mathew V.; Kosheleva, Anna; Waterman, Pamela D.; Chen, Jarvis T.; Beckfield, Jason

2015-01-01

Objectives. We investigated 50-year US trends in age at menarche by socioeconomic position (SEP) and race/ethnicity because data are scant and contradictory. Methods. We analyzed data by income and education for US-born non-Hispanic Black and White women aged 25 to 74 years in the National Health Examination Survey (NHES) I (1959–1962), National Health Examination and Nutrition Surveys (NHANES) I–III (1971–1994), and NHANES 1999–2008. Results. In NHES I, average age at menarche among White women in the 20th (lowest) versus 80th (highest) income percentiles was 0.26 years higher (95% confidence interval [CI] = −0.09, 0.61), but by NHANES 2005–2008 it had reversed and was −0.33 years lower (95% CI = −0.54, −0.11); no socioeconomic gradients occurred among Black women. The proportion with onset at younger than 11 years increased only among women with low SEP, among Blacks and Whites (P for trend < .05), and high rates of change occurred solely among Black women (all SEP strata) and low-income White women who underwent menarche before 1960. Conclusions. Trends in US age at menarche vary by SEP and race/ethnicity in ways that pose challenges to several leading clinical, public health, and social explanations for early age at menarche and that underscore why analyses must jointly include data on race/ethnicity and socioeconomic position. Future research is needed to explain these trends. PMID:25033121

Effects of lifestyle on the onset of puberty as determinant for breast cancer.

PubMed

Vandeloo, Magda J A M; Bruckers, Liesbeth M; Janssens, Jaak Ph

2007-02-01

Breast cancer is more than ever the leading cause of death in women. In this article, we investigate the influence of lifestyle factors, and in particular nutrition (i.e. soft drinks), on physical development, puberty, breast growth and menarche to understand the potential impact of these environmental and lifestyle factors on the induction of breast cancer susceptibility. A questionnaire was obtained from 1146 girls of 10 schools in Belgian Limburg, attending the second year of secondary school. Their mean age was about 13 years. The analyses of the data were performed with 'survival analysis', in particular with the 'Cox regression' model for menarche. This project was conducted in the school year of 1999-2000. In the univariate and multivariate analysis investigating the most important variables of the period from birth to the age of menarche, there was clear evidence that lifestyle factors, including nutrition, have an effect on breast development and menarche. The following variables were significantly related to breast development and menarche: body mass index, drinking high-carbohydrate drinks, i.e. soft drinks, height of the father and the mother, weight of the mother at the start of pregnancy, history of mononucleosis, origin and education of the parents and physical activity. Lifestyle factors, including nutrition (i.e. soft drinks), affect the age at puberty and menarche. The same factors are known to be related to breast cancer risk. Better control of these variables during puberty might reduce breast cancer risk later in life.

Menstruation across time: menarche, menstrual attitudes, experiences, and behaviors.

PubMed

McPherson, Marianne E; Korfine, Lauren

2004-01-01

This study explored the relationship between early and current menstrual experiences. The primary hypothesis was that women who reported positive menarcheal experiences (including menstrual education and menarche) would tend to report positive current menstrual attitudes, experiences, and/or behaviors, and vice versa for women who reported negative menarcheal experiences. In this survey-based study, college-aged women (n = 327) were screened by completing a questionnaire concerning their menarcheal experiences. Women who had extremely negative ("negative group," n = 46) or extremely positive ("positive group," n = 38) early menstrual experiences returned to complete questionnaires concerning current menstrual attitudes, experiences, and behaviors. Early and current menstrual experiences were most strongly associated in the domain of menstrual attitudes. Women in the negative group reported more negative menstrual attitudes than did women in the positive group. There were additional associations between early menstrual experiences and measures of body image and health behaviors. Positive group participants reported more positive body image and better general health behaviors. Results suggest that early menstrual experiences may be related to menstrual experiences later in life. This study invites further investigation of the psychology of menstruation and suggests connecting menstruation with other women's health issues.

Early menarche, nulliparity and the risk for premature and early natural menopause.

PubMed

Mishra, Gita D; Pandeya, Nirmala; Dobson, Annette J; Chung, Hsin-Fang; Anderson, Debra; Kuh, Diana; Sandin, Sven; Giles, Graham G; Bruinsma, Fiona; Hayashi, Kunihiko; Lee, Jung Su; Mizunuma, Hideki; Cade, Janet E; Burley, Victoria; Greenwood, Darren C; Goodman, Alissa; Simonsen, Mette Kildevæld; Adami, Hans-Olov; Demakakos, Panayotes; Weiderpass, Elisabete

2017-03-01

Are parity and the timing of menarche associated with premature and early natural menopause? Early menarche (≤11 years) is a risk factor for both premature menopause (final menstrual period, FMP <40 years) and early menopause (FMP 40-44 years), a risk that is amplified for nulliparous women. Women with either premature or early menopause face an increased risk of chronic conditions in later life and of early death. Findings from some studies suggest that early menarche and nulliparity are associated with early menopause, however overall the evidence is mixed. Much of the evidence for a direct relationship is hampered by a lack of comparability across studies, failure to adjust for confounding factors and inadequate statistical power. This pooled study comprises 51 450 postmenopausal women from nine observational studies in the UK, Scandinavia, Australia and Japan that contribute to the International collaboration for a Life course Approach to reproductive health and Chronic disease Events (InterLACE). Age at menarche (categorized as ≤11, 12, 13, 14 and 15 or more years) and parity (categorized as no children, one child and two or more children) were exposures of interest. Age at FMP was confirmed by at least 12 months of cessation of menses where this was not the result of an intervention (such as surgical menopause due to bilateral oophorectomy or hysterectomy) and categorized as premature menopause (FMP before age 40), early menopause (FMP 40-44 years), 45-49 years, 50-51 years, 52-53 years and 54 or more years. We used multivariate multinomial logistic regression models to estimate relative risk ratio (RRR) and 95% CI for associations between menarche, parity and age at FMP adjusting for within-study correlation. The median age at FMP was 50 years (interquartile range 48-53 years), with 2% of the women experiencing premature menopause and 7.6% early menopause. Women with early menarche (≤11 years, compared with 12-13 years) were at higher risk of premature menopause (RRR 1.80, 95% CI 1.53-2.12) and early menopause (1.31, 1.19-1.44). Nulliparity was associated with increased risk of premature menopause (2.26, 1.84-2.77) and early menopause (1.32, 1.09-1.59). Women having early menarche and nulliparity were at over 5-fold increased risk of premature menopause (5.64, 4.04-7.87) and 2-fold increased risk of early menopause (2.16, 1.48-3.15) compared with women who had menarche at ≥12 years and two or more children. Most of the studies (except the birth cohorts) relied on retrospectively reported age at menarche, which may have led to some degree of recall bias. Our findings support early monitoring of women with early menarche, especially those who have no children, for preventive health interventions aimed at mitigating the risk of adverse health outcomes associated with early menopause. InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). G.D.M. is supported by Australian Research Council Future Fellowship (FT120100812). There are no competing interests. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.

Age at menarche, androgen concentrations, and midlife obesity: findings from the Midlife Women's Health Study.

PubMed

Gallicchio, Lisa; Flaws, Jodi A; Smith, Rebecca L

2016-11-01

Studies have shown that earlier age at menarche is associated with a higher risk of midlife obesity; however, the mechanism underlying this association is not known. The purpose of this study was to examine whether the association between age at menarche and midlife obesity is due to variation in circulating androgen concentrations. Baseline data were analyzed from 748 women aged 45 to 54 years enrolled in the Midlife Women's Health Study, a prospective cohort study conducted in the Baltimore, MD region. Information on age at menarche was collected through a self-administered questionnaire. Body mass index (BMI) was calculated using height and weight measured at a clinic visit. Obesity was defined as a BMI between 30 and 34.9 kg/m; super obesity was defined as a BMI greater than 35 kg/m. Testosterone, estradiol, and sex hormone-binding globulin were measured in blood samples using enzyme-linked immunosorbent assays. The free androgen index (FAI) was calculated using the formula: (testosterone × 3.467)/sex hormone-binding globulin × 100. After adjustment for covariates, for each year increase in age at menarche, the odds of obesity and super obesity decreased by 31% (odds ratio (OR) 0.69; 95% confidence limits (CL) 0.59, 0.81) and 34% (OR 0.66; 95% CL 0.52, 0.83), respectively. Addition of the FAI into the models did not attenuate the observed estimates. The results of this study indicate that age at menarche is associated with midlife obesity independent of free testosterone concentrations measured in adulthood.

Menstrual and hormonal alterations in juvenile dermatomyositis.

PubMed

Aikawa, N E; Sallum, A M E; Leal, M M; Bonfá, E; Pereira, R M R; Silva, C A A

2010-01-01

To evaluate age at menarche, menstrual cycles and hormone profile in juvenile dermatomyositis (JDM) patients and controls. Twelve consecutive JDM patients were compared to 24 age-matched healthy subjects. Age at menarche and age of maternal menarche were recorded. Menstrual cycle was evaluated prospectively for 6 consecutive months and the mean cycle length and flow were calculated. The hormone profile was collected on the last menstrual cycle. Demographic data, clinical features, muscle enzymes, JDM scores and treatment were analysed. The median of current age of JDM patients and controls was similar (18 vs. 17 years, p=0.99). The median age at menarche of the JDM patients was higher than in the control group (13 vs. 11 years, p=0.02) whereas the median age of maternal menarche was alike in both groups (12 vs. 13 years, p=0.67). Menstrual disturbances were not observed, except for one patient who had longer length of menstrual cycle. The median of follicle stimulating hormone (FSH) was significantly higher in JDM patients compared to controls (4.5 vs. 3.0 IU/L, p=0.02) and none of them had premature ovarian failure (POF). The median of progesterone was significantly lower in JDM patients (0.3 vs. 0.7 ng/mL, p=0.01) with a higher frequency of decreased progesterone compared to controls (75% vs. 29%, p=0.01). Our study identifies in JDM patients delayed menarche with normal cycles and low follicular reserve. The decreased progesterone levels may suggest an underlying subclinical corpus luteum dysfunction in this disease.

Timing and secular trend of pubertal development in Beijing girls.

PubMed

Chen, Fang-Fang; Wang, You-Fa; Mi, Jie

2014-02-01

Historical research is limited in changes in pubertal development in Chinese girls. We aimed to identify the timing of pubertal characteristics and the secular trend of menarche age among Beijing girls from the 1980s through the 2000s. Six data sets were analyzed, including the Beijing Child and Adolescent Metabolic Syndrome study in 2004, where 9778 Bejing girls aged 6-18 years were studied. The Fetal Origins of Adult Disease study provided retrospective menarche age from 1940 through 1960. Other four studies were conducted in Beijing to obtain supplementary information to assess secular trend in menarche age. Linear regression method was used to analyze the data. Among Beijing girls in 2004, the median age at menarche was 12.1 years, which was 0.6 years earlier in urban than in rural areas. The median age at Breast Tanner Stage 2 was 9.5 ± 1.2 years, representing 9.4 ± 1.1 years and 9.6 ± 1.2 years for urban and rural girls, respectively. In contrast, the median age at Pubic Hair Tanner Stage 2 was 11.1 ± 1.1 years, representing 10.8 ± 1.1 and 11.4 ± 1.1 years for urban and rural girls, respectively. The menarche age of urban girls decreased by 4.2 months per decade, and that of rural girls by 9.6 months per decade from 1980 to 2004. Urban girls mature earlier than rural girls in Beijing. A secular trend towards earlier menarche was observed between the 1980s and the 2000s.

Menarche and Fatness: Reexamination of the Critical Body Composition Hypothesis

ERIC Educational Resources Information Center

Trussell, James

1978-01-01

Examines the credibility of the theory that, menarche and fecundity require a certain level of fat in the body. Concludes that the evidence does not totally support this hypothesis and that further investigation is warranted. (GA)

Genetic variation at CYP3A is associated with age at menarche and breast cancer risk: a case-control study

PubMed Central

2014-01-01

Introduction We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age ≤50 years. Methods We further investigated the association of rs10235235 with breast cancer risk in a large case control study of 47,346 cases and 47,570 controls from 52 studies participating in the Breast Cancer Association Consortium. Genotyping of rs10235235 was conducted using a custom Illumina Infinium array. Stratified analyses were conducted to determine whether this association was modified by age at diagnosis, ethnicity, age at menarche or tumor characteristics. Results We confirmed the association of rs10235235 with breast cancer risk for women of European ancestry but found no evidence that this association differed with age at diagnosis. Heterozygote and homozygote odds ratios (ORs) were OR = 0.98 (95% CI 0.94, 1.01; P = 0.2) and OR = 0.80 (95% CI 0.69, 0.93; P = 0.004), respectively (Ptrend = 0.02). There was no evidence of effect modification by tumor characteristics. rs10235235 was, however, associated with age at menarche in controls (Ptrend = 0.005) but not cases (Ptrend = 0.97). Consequently the association between rs10235235 and breast cancer risk differed according to age at menarche (Phet = 0.02); the rare allele of rs10235235 was associated with a reduction in breast cancer risk for women who had their menarche age ≥15 years (ORhet = 0.84, 95% CI 0.75, 0.94; ORhom = 0.81, 95% CI 0.51, 1.30; Ptrend = 0.002) but not for those who had their menarche age ≤11 years (ORhet = 1.06, 95% CI 0.95, 1.19, ORhom = 1.07, 95% CI 0.67, 1.72; Ptrend = 0.29). Conclusions To our knowledge rs10235235 is the first single nucleotide polymorphism to be associated with both breast cancer risk and age at menarche consistent with the well-documented association between later age at menarche and a reduction in breast cancer risk. These associations are likely mediated via an effect on circulating hormone levels. PMID:24887515

Genetic variation at CYP3A is associated with age at menarche and breast cancer risk: a case-control study.

PubMed

Johnson, Nichola; Dudbridge, Frank; Orr, Nick; Gibson, Lorna; Jones, Michael E; Schoemaker, Minouk J; Folkerd, Elizabeth J; Haynes, Ben P; Hopper, John L; Southey, Melissa C; Dite, Gillian S; Apicella, Carmel; Schmidt, Marjanka K; Broeks, Annegien; Van't Veer, Laura J; Atsma, Femke; Muir, Kenneth; Lophatananon, Artitaya; Fasching, Peter A; Beckmann, Matthias W; Ekici, Arif B; Renner, Stefan P; Sawyer, Elinor; Tomlinson, Ian; Kerin, Michael; Miller, Nicola; Burwinkel, Barbara; Marme, Frederik; Schneeweiss, Andreas; Sohn, Christof; Guénel, Pascal; Truong, Therese; Cordina, Emilie; Menegaux, Florence; Bojesen, Stig E; Nordestgaard, Børge G; Flyger, Henrik; Milne, Roger; Zamora, M Pilar; Arias Perez, Jose Ignacio; Benitez, Javier; Bernstein, Leslie; Anton-Culver, Hoda; Ziogas, Argyrios; Clarke Dur, Christina; Brenner, Hermann; Müller, Heiko; Arndt, Volker; Dieffenbach, Aida Karina; Meindl, Alfons; Heil, Joerg; Bartram, Claus R; Schmutzler, Rita K; Brauch, Hiltrud; Justenhoven, Christina; Ko, Yon-Dschun; Nevanlinna, Heli; Muranen, Taru A; Aittomäki, Kristiina; Blomqvist, Carl; Matsuo, Keitaro; Dörk, Thilo; Bogdanova, Natalia V; Antonenkova, Natalia N; Lindblom, Annika; Mannermaa, Arto; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M; Chenevix-Trench, Georgia; Beesley, Jonathan; Wu, Anna H; Van den Berg, David; Tseng, Chiu-Chen; Lambrechts, Diether; Smeets, Dominiek; Neven, Patrick; Wildiers, Hans; Chang-Claude, Jenny; Rudolph, Anja; Nickels, Stefan; Flesch-Janys, Dieter; Radice, Paolo; Peterlongo, Paolo; Bonanni, Bernardo; Pensotti, Valeria; Couch, Fergus J; Olson, Janet E; Wang, Xianshu; Fredericksen, Zachary; Pankratz, Vernon S; Giles, Graham G; Severi, Gianluca; Baglietto, Laura; Haiman, Chris; Simard, Jacques; Goldberg, Mark S; Labrèche, France; Dumont, Martine; Soucy, Penny; Teo, Soo; Yip, Cheng Har; Phuah, Sze Yee; Cornes, Belinda K; Kristensen, Vessela N; Grenaker Alnæs, Grethe; Børresen-Dale, Anne-Lise; Zheng, Wei; Winqvist, Robert; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Grip, Mervi; Andrulis, Irene L; Knight, Julia A; Glendon, Gord; Mulligan, Anna Marie; Devillee, Peter; Figueroa, Jonine; Chanock, Stephen J; Lissowska, Jolanta; Sherman, Mark E; Hall, Per; Schoof, Nils; Hooning, Maartje; Hollestelle, Antoinette; Oldenburg, Rogier A; Tilanus-Linthorst, Madeleine; Liu, Jianjun; Cox, Angie; Brock, Ian W; Reed, Malcolm W R; Cross, Simon S; Blot, William; Signorello, Lisa B; Pharoah, Paul D P; Dunning, Alison M; Shah, Mitul; Kang, Daehee; Noh, Dong-Young; Park, Sue K; Choi, Ji-Yeob; Hartman, Mikael; Miao, Hui; Lim, Wei Yen; Tang, Anthony; Hamann, Ute; Försti, Asta; Rüdiger, Thomas; Ulmer, Hans Ulrich; Jakubowska, Anna; Lubinski, Jan; Jaworska-Bieniek, Katarzyna; Durda, Katarzyna; Sangrajrang, Suleeporn; Gaborieau, Valerie; Brennan, Paul; McKay, James; Slager, Susan; Toland, Amanda E; Vachon, Celine; Yannoukakos, Drakoulis; Shen, Chen-Yang; Yu, Jyh-Cherng; Huang, Chiun-Sheng; Hou, Ming-Feng; González-Neira, Anna; Tessier, Daniel C; Vincent, Daniel; Bacot, Francois; Luccarini, Craig; Dennis, Joe; Michailidou, Kyriaki; Bolla, Manjeet K; Wang, Jean; Easton, Douglas F; García-Closas, Montserrat; Dowsett, Mitch; Ashworth, Alan; Swerdlow, Anthony J; Peto, Julian; dos Santos Silva, Isabel; Fletcher, Olivia

2014-05-26

We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age ≤50 years. We further investigated the association of rs10235235 with breast cancer risk in a large case control study of 47,346 cases and 47,570 controls from 52 studies participating in the Breast Cancer Association Consortium. Genotyping of rs10235235 was conducted using a custom Illumina Infinium array. Stratified analyses were conducted to determine whether this association was modified by age at diagnosis, ethnicity, age at menarche or tumor characteristics. We confirmed the association of rs10235235 with breast cancer risk for women of European ancestry but found no evidence that this association differed with age at diagnosis. Heterozygote and homozygote odds ratios (ORs) were OR = 0.98 (95% CI 0.94, 1.01; P = 0.2) and OR = 0.80 (95% CI 0.69, 0.93; P = 0.004), respectively (P(trend) = 0.02). There was no evidence of effect modification by tumor characteristics. rs10235235 was, however, associated with age at menarche in controls (P(trend) = 0.005) but not cases (P(trend) = 0.97). Consequently the association between rs10235235 and breast cancer risk differed according to age at menarche (P(het) = 0.02); the rare allele of rs10235235 was associated with a reduction in breast cancer risk for women who had their menarche age ≥15 years (OR(het) = 0.84, 95% CI 0.75, 0.94; OR(hom) = 0.81, 95% CI 0.51, 1.30; P(trend) = 0.002) but not for those who had their menarche age ≤11 years (OR(het) = 1.06, 95% CI 0.95, 1.19, OR(hom) = 1.07, 95% CI 0.67, 1.72; P(trend) = 0.29). To our knowledge rs10235235 is the first single nucleotide polymorphism to be associated with both breast cancer risk and age at menarche consistent with the well-documented association between later age at menarche and a reduction in breast cancer risk. These associations are likely mediated via an effect on circulating hormone levels.

Growth pattern and age at menarche of obese girls in a transitional society.

PubMed

Jaruratanasirikul, S; Mo-suwan, L; Lebel, L

1997-01-01

Childhood obesity is an increasing problem in a transitional society such as Thailand. To study physical growth and puberty in obese children, a cross-sectional survey of growth and age at menarche was carried out in schoolgirls aged between 8 and 16 years old. The 3,120 girls were divided into two groups based on weight-for-height criteria. Girls with weight-for-height between 80 and 120% were classified as normal stature (2,625; 84.1%) and those more than 120% were obese (495; 15.9%). Using probit analysis, age at menarche in obese girls was 0.9 year earlier than normal stature girls (11.5 years vs 12.4 years). At age 12, obese girls were reaching menarche 2.8 times more when compared with the normal stature girls. In terms of growth pattern, obese girls were taller and grew faster during the prepubertal period, and then reached their final height earlier than the normal stature girls (13 years vs 15 years). The final height in obese girls was significantly shorter (153.0 cm and 155.0 cm, p = 0.01). We conclude that: 1) obese girls grow faster, have earlier menarche and then stop growing earlier, and 2) obese girls tend to be shorter as adults, compared with normal stature girls.

Genetic moderation of effects of maternal sensitivity on girl's age of menarche: Replication of the Manuck et al. study.

PubMed

Hartman, Sarah; Widaman, Keith F; Belsky, Jay

2015-08-01

Manuck, Craig, Flory, Halder, and Ferrell (2011) reported that a theoretically anticipated effect of family rearing on girls' menarcheal age was genetically moderated by two single nucleotide polymorphisms (SNPs) of the estrogen receptor-α gene. We sought to replicate and extend these findings, studying 210 White females followed from birth. The replication was general because a different measure of the rearing environment was used in this inquiry (i.e., maternal sensitivity) than in the prior one (i.e., family cohesion). Extensions of the work included prospective rather than retrospective measurements of the rearing environment, reports of first menstruation within a year of its occurrence rather than decades later, accounting for some heritability of menarcheal age by controlling for maternal age of menarche, and using a new model-fitting approach to competitively compare diathesis-stress versus differential-susceptibility models of Gene × Environment interaction. The replication/extension effort proved successful in the case of both estrogen receptor-α SNPs, with the Gene × Environment interactions principally reflecting diathesis-stress: lower levels of maternal sensitivity predicted earlier age of menarche for girls homozygous for the minor alleles of either SNP but not for girls carrying other genotypes. Results are discussed in light of the new analytic methods adopted.

Does competence mediate the associations between puberty and internalizing or externalizing problems in adolescent girls?

PubMed

Negriff, Sonya; Hillman, Jennifer B; Dorn, Lorah D

2011-10-01

To examine separate mediational models linking (a) menarcheal status or (b) pubertal timing to internalizing and externalizing problems through competence. This study involved cross-sectional analyses of 262 adolescent girls (age: 11-17 years; mean = 14.93, standard deviation = 2.17) enrolled in a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health. Measures of menarcheal status (pre/post), pubertal timing (early, on-time, or late), internalizing and externalizing behavior, and perceived competence (parent and adolescent report) were obtained. Structural equation modeling was used for analyses. Perceived competence was found to fully mediate the association between menarcheal status and parent report of internalizing and externalizing problems. For adolescent report, there was a full mediation effect for internalizing problems but a partial mediation effect for externalizing problems. Being menarcheal was related to lower competence, which was in turn related to higher internalizing and externalizing problems. Models including pubertal timing were not significant. Perceived competence is important in understanding the associations between menarcheal status and internalizing and externalizing problems. Interventions targeting competence, particularly in postmenarcheal girls, may reduce or prevent problem behaviors. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Girls' Understanding and Social Construction of Menarche.

ERIC Educational Resources Information Center

Moore, Susan M.

1995-01-01

Assessed Australian girls' (n=87) beliefs and feelings about menarche and menstruation. Results revealed limited knowledge about menstruation, accompanied by incorrect and negative myths. Attitudes to menstruation were characterized by embarrassment, discomfort, and ambivalence about growing up. Themes in story completion results reflected these…

Hormonal factors and incident asthma and allergic rhinitis during puberty in girls.

PubMed

Wei, Junxiang; Gerlich, Jessica; Genuneit, Jon; Nowak, Dennis; Vogelberg, Christian; von Mutius, Erika; Radon, Katja

2015-07-01

Accumulating evidence is indicating that hormonal factors play a role in new-onset allergic rhinitis and asthma after puberty. To determine whether age at menarche and use of hormonal contraceptives predict new-onset allergic rhinitis and asthma after puberty in young German women. A prospective community-based cohort study followed 1,191 girls 9 to 11 years old to early adulthood (19-24 years old). Self-administrated questionnaires concerning age at menarche, use of hormonal contraceptives, and status and age at onset of physician-diagnosed allergic rhinitis and asthma were collected at 16 to 18 and 19 to 24 years of age. Logistic regression models were used to analyze the incidence of asthma and allergic rhinitis after puberty and pooled estimates were obtained from the final model. Eleven percent of girls developed allergic rhinitis after menarche and 3% reported new-onset asthma. Late menarche (>13 years of age) was statistically significantly inversely related to allergic rhinitis (adjusted odds ratio [OR] 0.32, 95% confidence interval [CI] 0.14-0.74) but did not reach the level of statistical significance for asthma (OR 0.32, 95% CI 0.07-1.42). Use of hormonal contraceptives was inversely associated with new-onset allergic rhinitis (OR 0.14, 95% CI 0.08-0.23) and asthma (OR 0.27, 95% CI 0.12-0.58) after puberty. This study shows that girls with late onset of menarche are less likely to develop allergic rhinitis after puberty compared with those who have menarche at an average age. These findings also suggest that, in addition to endogenous hormones, hormonal contraceptives play a role and might protect young women from allergies and asthma. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Menarche, menstrual problems and suicidal behavior in Chinese adolescents.

PubMed

Chen, Hua; Wang, Xin-Ting; Bo, Qi-Gui; Zhang, Dao-Ming; Qi, Zhen-Biao; Liu, Xianchen; Jia, Cun-Xian

2017-02-01

Menarche is the first menstrual cycle. Menstrual problems, such as dysmenorrheal menorrhagia, oligomenorrhea, and irregular cycle are common in female adolescents. This research aims to examine the associations between age at menarche and menstrual problems and suicidal behavior among Chinese female adolescents. An epidemiological survey of 5831 female adolescents from eight high schools of three counties of Shandong province, China, was conducted. A self-administered paper-and-pencil questionnaire was used to collect information. Logistic regression analyses were used to examine the association between menstruation and suicidality. The mean age of the sample was 15.02 (SD=1.44) years. Of the sample, 5,231 (90.0%) had experienced their first menstrual cycle, and 23.2%, 10.4%, and 4.5% of the sample reported having had suicidal ideation, plan and attempt, respectively. In multivariate models, menarche at ≤11 years was associated with increased risk of suicidal ideation (OR=1.41, 95%CI: 1.10-1.81) and menarche at 12 years was associated with suicide plan (OR=1.23, 95%CI: 1.00-1.51). Irregular menstrual cycle was significantly associated with increased risk of suicidal ideation (OR=1.40, 95%CI: 1.05-1.86) and menstrual period less than or equal to 4 days was significantly associated with increased risk of suicide plan (OR=1.32, 95%CI: 1.06-1.66). This cross-sectional study cannot establish the causal directions between menstrual problems and suicidality in adolescents. Our study suggests that earlier menarche, irregular menstrual cycle and short menstrual period are associated with suicidal behavior in female adolescents. Further research is warranted to examine the causal relationship between menstrual problems and suicidal behavior in adolescents. Copyright © 2016 Elsevier B.V. All rights reserved.

Height, age at menarche and risk of hormone receptor-positive and -negative breast cancer: a cohort study.

PubMed

Ritte, Rebecca; Lukanova, Annekatrin; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Mesrine, Sylvie; Fagherazzi, Guy; Dossus, Laure; Teucher, Birgit; Steindorf, Karen; Boeing, Heiner; Aleksandrova, Krasimira; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Palli, Domenico; Grioni, Sara; Mattiello, Amalia; Tumino, Rosario; Sacerdote, Carlotta; Quirós, José Ramón; Buckland, Genevieve; Molina-Montes, Esther; Chirlaque, María-Dolores; Ardanaz, Eva; Amiano, Pilar; Bueno-de-Mesquita, Bas; van Duijnhoven, Franzel; van Gils, Carla H; Peeters, Petra Hm; Wareham, Nick; Khaw, Kay-Tee; Key, Timothy J; Travis, Ruth C; Krum-Hansen, Sanda; Gram, Inger Torhild; Lund, Eiliv; Sund, Malin; Andersson, Anne; Romieu, Isabelle; Rinaldi, Sabina; McCormack, Valerie; Riboli, Elio; Kaaks, Rudolf

2013-06-01

Associations of breast cancer overall with indicators of exposures during puberty are reasonably well characterized; however, uncertainty remains regarding the associations of height, leg length, sitting height and menarcheal age with hormone receptor-defined malignancies. Within the European Prospective Investigation into Cancer and Nutrition cohort, Cox proportional hazards models were used to describe the relationships of adult height, leg length and sitting height and age at menarche with risk of estrogen and progesterone receptor negative (ER-PR-) (n = 990) and ER+PR+ (n = 3,524) breast tumors. Height as a single risk factor was compared to a model combining leg length and sitting height. The possible interactions of height, leg length and sitting height with menarche were also analyzed. Risk of both ER-PR- and ER+PR+ malignancies was positively associated with standing height, leg length and sitting height and inversely associated with increasing age at menarche. For ER+PR+ disease, sitting height (hazard ratios: 1.14[95% confidence interval: 1.08-1.20]) had a stronger risk association than leg length (1.05[1.00-1.11]). In comparison, for ER-PR- disease, no distinct differences were observed between leg length and sitting height. Women who were tall and had an early menarche (≤13 years) showed an almost twofold increase in risk of ER+PR+ tumors but no such increase in risk was observed for ER-PR- disease. Indicators of exposures during rapid growth periods were associated with risks of both HR-defined breast cancers. Exposures during childhood promoting faster development may establish risk associations for both HR-positive and -negative malignancies. The stronger associations of the components of height with ER+PR+ tumors among older women suggest possible hormonal links that could be specific for postmenopausal women. Copyright © 2012 UICC.

Menstrual characteristics in some adolescent girls in Accra, Ghana.

PubMed

Gumanga, S K; Kwame-Aryee, R A

2012-03-01

Menstruation has a variable pattern within a few years of menarche which may not be well understood by many adolescent girls. Providing accurate information on menstruation is necessary to reduce anxiety, menstrual morbidity and improve reproductive health of these adolescents. To determine the age at menarche, duration of menstruation, length of menstrual cycle, regularity of menstrual cycle, prevalence of dysmenorrhoea and sources of information on menstruation. S(T) Mary's Senior Secondary School, Accra. Cross-sectional descriptive study using self-administered questionnaire. Four hundred and fifty six girls whose ages ranged from 14-19 years with mean and median ages of 16 ± 0.93 years and 16 years respectively were surveyed. Their ages at menarche ranged from 9 years to 16 years and the mean age at menarche was 12.5 ±1.28 years. Their menstrual cycle lengths ranged from 21-35 days with mean menstrual cycle length of 27.9± 0.9 days; the mode and median were both 28 days. The mean duration of menstrual flow was 4.9 days with mode and median of 5 days. Seventy one percent (n=449) had menses lasting 3-5 days while 27.2% had menses lasting over 5 days. Some 24% (n=409) had irregular menses six months after their menarche and 59.6% (n=453) were experiencing menses with clots. The prevalence of dysmenorrhoea was 74.4% (n=453). Some 80.2% (n=378) of the girls got counselling and education on care for their menses from their parents. The age at menarche and other menstrual characteristics observed in this study are similar to adolescent menstrual characteristics described by studies in other populations in the world.

Height Growth and Percentage of Body Fat in Relation to Early Menarche in Girls from Merida, Yucatan, Mexico.

PubMed

Datta Banik, Sudip; Mendez, Nina; Dickinson, Federico

2015-01-01

Early menarche (EM) (i.e., age at menarche [AAM] <12 years of age) is related to short height and higher body fatness. In a mixed-longitudinal study done in Merida, Yucatan, height, body mass index (BMI), and percentage of body fat (BF%) were recorded at a one-year interval among 258 postmenarcheal (EM = 94) girls. Anthropometric measurements were recorded of the age cohorts in 2008-09 when participants were 13-17 years of age (baseline), and in the one-year follow-up study (± 6 days) the girls were 14-18 years of age. The BF% was estimated through bioelectrical impedance analysis. Mean AAM was 10.59 years in EM girls and 12.54 years in not early menarche (NEM) girls. Height growth (cm/year) was greater in NEM girls. Mean values of BMI, BF%, and frequencies of stunting (low height-for-age) and excess weight (overweight + obesity) were higher in EM girls than in their NEM age peers.

Thirty new loci for age at menarche identified by a meta-analysis of genome-wide association studies

PubMed Central

Elks, Cathy E.; Perry, John R.B.; Sulem, Patrick; Chasman, Daniel I.; Franceschini, Nora; He, Chunyan; Lunetta, Kathryn L.; Visser, Jenny A.; Byrne, Enda M.; Cousminer, Diana L.; Gudbjartsson, Daniel F.; Esko, Tõnu; Feenstra, Bjarke; Hottenga, Jouke-Jan; Koller, Daniel L.; Kutalik, Zoltán; Lin, Peng; Mangino, Massimo; Marongiu, Mara; McArdle, Patrick F.; Smith, Albert V.; Stolk, Lisette; van Wingerden, Sophie W.; Zhao, Jing Hua; Albrecht, Eva; Corre, Tanguy; Ingelsson, Erik; Hayward, Caroline; Magnusson, Patrik K.E.; Smith, Erin N.; Ulivi, Shelia; Warrington, Nicole M.; Zgaga, Lina; Alavere, Helen; Amin, Najaf; Aspelund, Thor; Bandinelli, Stefania; Barroso, Ines; Berenson, Gerald S.; Bergmann, Sven; Blackburn, Hannah; Boerwinkle, Eric; Buring, Julie E.; Busonero, Fabio; Campbell, Harry; Chanock, Stephen J.; Chen, Wei; Cornelis, Marilyn C.; Couper, David; Coviello, Andrea D.; d’Adamo, Pio; de Faire, Ulf; de Geus, Eco J.C.; Deloukas, Panos; Döring, Angela; Smith, George Davey; Easton, Douglas F.; Eiriksdottir, Gudny; Emilsson, Valur; Eriksson, Johan; Ferrucci, Luigi; Folsom, Aaron R.; Foroud, Tatiana; Garcia, Melissa; Gasparini, Paolo; Geller, Frank; Gieger, Christian; Gudnason, Vilmundur; Hall, Per; Hankinson, Susan E.; Ferreli, Liana; Heath, Andrew C.; Hernandez, Dena G.; Hofman, Albert; Hu, Frank B.; Illig, Thomas; Järvelin, Marjo-Riitta; Johnson, Andrew D.; Karasik, David; Khaw, Kay-Tee; Kiel, Douglas P.; Kilpeläinen, Tuomas O.; Kolcic, Ivana; Kraft, Peter; Launer, Lenore J.; Laven, Joop S.E.; Li, Shengxu; Liu, Jianjun; Levy, Daniel; Martin, Nicholas G.; McArdle, Wendy L.; Melbye, Mads; Mooser, Vincent; Murray, Jeffrey C.; Murray, Sarah S.; Nalls, Michael A.; Navarro, Pau; Nelis, Mari; Ness, Andrew R.; Northstone, Kate; Oostra, Ben A.; Peacock, Munro; Palmer, Lyle J.; Palotie, Aarno; Paré, Guillaume; Parker, Alex N.; Pedersen, Nancy L.; Peltonen, Leena; Pennell, Craig E.; Pharoah, Paul; Polasek, Ozren; Plump, Andrew S.; Pouta, Anneli; Porcu, Eleonora; Rafnar, Thorunn; Rice, John P.; Ring, Susan M.; Rivadeneira, Fernando; Rudan, Igor; Sala, Cinzia; Salomaa, Veikko; Sanna, Serena; Schlessinger, David; Schork, Nicholas J.; Scuteri, Angelo; Segrè, Ayellet V.; Shuldiner, Alan R.; Soranzo, Nicole; Sovio, Ulla; Srinivasan, Sathanur R.; Strachan, David P.; Tammesoo, Mar-Liis; Tikkanen, Emmi; Toniolo, Daniela; Tsui, Kim; Tryggvadottir, Laufey; Tyrer, Jonathon; Uda, Manuela; van Dam, Rob M.; van Meurs, Joyve B.J.; Vollenweider, Peter; Waeber, Gerard; Wareham, Nicholas J.; Waterworth, Dawn M.; Weedon, Michael N.; Wichmann, H. Erich; Willemsen, Gonneke; Wilson, James F.; Wright, Alan F.; Young, Lauren; Zhai, Guangju; Zhuang, Wei Vivian; Bierut, Laura J.; Boomsma, Dorret I.; Boyd, Heather A.; Crisponi, Laura; Demerath, Ellen W.; van Duijn, Cornelia M.; Econs, Michael J.; Harris, Tamara B.; Hunter, David J.; Loos, Ruth J.F.; Metspalu, Andres; Montgomery, Grant W.; Ridker, Paul M.; Spector, Tim D.; Streeten, Elizabeth A.; Stefansson, Kari; Thorsteinsdottir, Unnur; Uitterlinden, André G.; Widen, Elisabeth; Murabito, Joanne M.; Ong, Ken K.; Murray, Anna

2011-01-01

To identify loci for age at menarche, we performed a meta-analysis of 32 genome-wide association studies in 87,802 women of European descent, with replication in up to 14,731 women. In addition to the known loci at LIN28B (P=5.4×10−60) and 9q31.2 (P=2.2×10−33), we identified 30 novel menarche loci (all P<5×10−8) and found suggestive evidence for a further 10 loci (P<1.9×10−6). New loci included four previously associated with BMI (in/near FTO, SEC16B, TRA2B and TMEM18), three in/near other genes implicated in energy homeostasis (BSX, CRTC1, and MCHR2), and three in/near genes implicated in hormonal regulation (INHBA, PCSK2 and RXRG). Ingenuity and MAGENTA pathway analyses identified coenzyme A and fatty acid biosynthesis as biological processes related to menarche timing. PMID:21102462

Menstruation in schoolgirls--1: The normal menarche.

PubMed

Gilbert, P

2000-01-01

The mean age for onset of menstruation (menarche) is 12.8 years. Many schools teach girls about puberty and menstruation and prepare them for the menarche. The school nurse has a valuable part to play in all aspects of menstruation in schoolgirls, psychological as well as physical. The early periods may be irregular and vary markedly in the amount of blood loss. It can take up a year or more for a steady pattern to develop. Dysmenhorrhoea may occur, which may be mild or of the severe spasmodic type. Premenstrual tension syndrome is less common in schoolgirls. Girls should be taught about the importance of hygiene, especially if tampons are used.

Dairy intake in relation to breast and pubertal development in Chilean girls.

PubMed

Gaskins, Audrey J; Pereira, Ana; Quintiliano, Daiana; Shepherd, John A; Uauy, Ricardo; Corvalán, Camila; Michels, Karin B

2017-05-01

Background: Frequent dairy consumption in childhood has been related to higher growth-hormone concentrations that may affect mammary gland and pubertal development. Objective: We evaluated the relation of dairy intake to breast composition at Tanner stage 4 and age at menarche. Design: A total of 515 Chilean girls are included in the Growth and Obesity Cohort Study. The subjects have been followed longitudinally since they were 3-4 y old (from 2006 to the present). Starting in 2013, diet was assessed every 6 mo via a 24-h recall. The breast fibroglandular volume (FGV) was measured with the use of dual-energy X-ray absorptiometry at Tanner stage 4. The date of menarche was reported every 6 mo. Our analysis included 290 girls with data on prospective diet and breast composition and 324 girls with data on prospective diet and age at menarche. Results: The mean ± SD breast FGV and percentage of fibroglandular volume (%FGV) (i.e., FGV divided by total breast volume times 100) at Tanner stage 4 was 81.7 ± 32.2 cm 3 and 42.0% ± 16.7%, respectively. Only sweetened, artificially flavored milk-based drinks were associated with the %FGV with girls who consumed >125 g/d having a %FGV that was 4.5% (95% CI: 0.9%, 8.1%) higher than that of girls who consumed none ( P -trend = 0.007). Yogurt intake was associated with a lower FGV. Specifically, girls who consumed >125 g yogurt/d had -10.2 cm 3 (95% CI: -20.2, -0.3 cm 3 ) less FGV than did girls who consumed no yogurt ( P -trend = 0.03). The majority (90.7%) of girls in our cohort attained menarche before the data analyses with a mean ± SD age at menarche of 11.9 ± 0.7 y. In multivariable models, low-fat dairy, low-fat milk, and yogurt intakes were associated with a later age at menarche. In particular, girls who consumed >125 g yogurt/d had menarche, on average, 4.6 mo (95% CI: 1.9, 7.4 mo) later than girls who consumed no yogurt ( P -trend = 0.01). Conclusion: More-frequent consumption of sweetened, artificially-flavored milk-based drinks is associated with a higher %FGV, whereas higher yogurt intake is associated with a lower FGV and delayed age at menarche in Chilean girls. © 2017 American Society for Nutrition.

Age at menarche, age at menopause and duration of fertility as risk factors for osteoporosis.

PubMed

Sioka, C; Fotopoulos, A; Georgiou, A; Xourgia, X; Papadopoulos, A; Kalef-Ezra, J A

2010-02-01

To investigate the relationship of osteopenia and osteoporosis in apparently healthy postmenopausal patients with age at menarche, age at menopause and duration of fertility. One hundred and twenty-four apparently healthy Greek postmenopausal women underwent spinal and hip X-ray absorptiometry scans. Among them, 47 were classified as normal (control group), 52 as osteopenic, and 25 as having osteoporosis. These groups were compared according to their age at menarche (three subgroups of 10-12, 13 and 14-16 years old), at menopause (three subgroups of 40-45, 46-50 and > or = 51 years old) and duration of fertility (four subgroups of < or = 30, 31-35, 36-40 and 41-45 years). The groups were not found to differ statistically according to age and age at menarche. However, decreased bone mineral density was found in patients with duration of fertility not exceeding 30 years (p = 0.034) and age at menopause less than 45 years (p = 0.034). No association was found between bone mineral density in Greek postmenopausal women and either number of live births or lactation. In postmenopausal females, the cumulative exposure to endogenous estrogens, measured as years of menstruation, seems to be a significant protective factor against the development of postmenopausal osteoporosis. Age at menopause between 40 and 45 years, but not age at menarche, correlated with low bone mineral density in postmenopausal females.

Relationship between menarche and psychosis onset in women with first episode of psychosis.

PubMed

Rubio-Abadal, Elena; Usall, Judith; Barajas, Anna; Carlson, Janina; Iniesta, Raquel; Huerta-Ramos, Elena; Baños, Iris; Dolz, Montserrat; Sánchez, Bernardo; Ochoa, Susana

2016-10-01

The aim of this study was to explore the relationship between age at menarche and age at first episode of psychosis, as well as clinical severity and outcome, in a population of women with first-episode psychosis. Clinical and socio-demographical data, age at menarche and at first-episode psychosis, parental history of psychosis and cannabis-use habits were obtained from 42 subjects with a first episode of psychosis. Positive and Negative Syndrome Scale, Clinical Global Impression, Global Assessment Function, Disability Assessment Schedule, Wechsler Adult Intelligence Scale and Wechsler Intelligence Scale for Children, European Quality of Life, and Lewis and Murray Obstetric Complication Scales were administered. Statistical analysis was performed by means of zero-order correlations and Mann-Whitney U and Kruskal-Wallis tests using SPSS version 17.0. We found no significant correlation between age at menarche and age at first-episode psychosis, or with the clinical scores performed. We observed that subjects with earlier age at menarche had more parental history of psychosis. Our negative results do not support the theory of a possible protective role of oestrogen, which seems to be more complex than previously thought. We would suggest that further research is needed to investigate developmental influences of sex steroids on the onset of psychosis and potentially therapeutic benefits based upon oestrogen. © 2014 Wiley Publishing Asia Pty Ltd.

Depressive Symptomatology among Very Early Maturing Girls.

ERIC Educational Resources Information Center

Rierdan, Jill; Koff, Elissa

1991-01-01

The relationship between very early menarche and depression was studied in a sample of 488 girls (336 sixth graders and 152 seventh graders), less than 10 percent of whom were very early maturers. Very early menarche was associated with higher levels of depression than was more normative development. (SLD)

Preparing Girls for Menstruation: Recommendations from Adolescent Girls.

ERIC Educational Resources Information Center

Koff, Elissa; Rierdan, Jill

1995-01-01

Ninth-grade girls (n=157) rated their own experience of menarche and answered 4 open-ended questions. Responses suggested several ways that early preparation could be revised, and supported a conceptualization of menstrual education as a long-term, continuous process, beginning well before menarche and continuing long after. (JPS)

An Exploration of Mothers' Attitudes towards Their Daughters' Menarche

ERIC Educational Resources Information Center

Bennett, Clare; Harden, Jane

2014-01-01

Menarche is a significant milestone for young women, representing an important juncture between girlhood and maturation. The limited literature that exists suggests that a mother's reaction to her daughter's first periods can shape her experiences and perceptions of menstruation which, in turn, may impact on her self-image and, consequently,…

Study of menstrual patterns in adolescent girls with disabilities in a residential institution.

PubMed

Joshi, Ganesh Arun; Joshi, Prajakta Ganesh

2015-02-01

The gynecological health needs of girls with disabilities is an issue related to their rights as individuals. The objective of this study is to describe the menstrual pattern of girls with disabilities. A descriptive study was undertaken on thirty girls with different types of disabilities in a residential institution. The diagnosis, type of disability, secondary sexual characters, age at menarche, menstrual pattern and practice of menstrual hygiene was noted. The girls with intellectual disabilities had later age of menarche, irregular cycles and more behaviour problems. The girls with hearing impairment and locomotor disabilities had normal menstrual pattern. The girl with low vision had earlier menarche and regularized cycles. Girls with normal intelligence and mild intellectual disabilities were independent in maintaining menstrual hygiene. The menstrual disorders are managed conservatively in accordance with latest guidelines. Onset of menarche is towards the extremes of normal age range in girls with intellectual disabilities or visual impairment but not in girls with hearing impairments or locomotor disabilities. Girls with disabilities have potential for independent menstrual care. Menstrual disorders were managed conservatively.

Post-migration adaptation and age at menarche in the second generation of migrants.

PubMed

Gomula, Aleksandra; Koziel, Slawomir

2015-01-01

Age at menarche is one of the most important measures of sexual maturation in girls. Since it has a high level of ecosensitivity, early environmental stress may trigger early puberty. One of these stress factors may be parental stress caused by the change of living conditions related to migration and adaptation to the new environment. Therefore, the aim of this study was to investigate the relationship between parental migration status and the timing of sexual maturity in second generation, i.e. migrants' daughters. Data were collected during the 2(nd) Polish Anthropological Survey carried out in 1966 - 1969. The information on age at menarche as well as demographic and social characteristics were collected by the use of a questionnaire. The results show that the age at menarche has been accelerated in girls from low socioeconomic status (low-SES) migrant families in comparison to low-SES non-migrant families. This study provides new biosocial evidence on the impact of the parental long-lasting post-migration adaptation on the timing of maturation in the second generation of migrants.

Life-course origins of the ages at menarche and menopause

PubMed Central

Forman, Michele R; Mangini, Lauren D; Thelus-Jean, Rosenie; Hayward, Mark D

2013-01-01

A woman’s age at menarche (first menstrual period) and her age at menopause are the alpha and omega of her reproductive years. The timing of these milestones is critical for a woman’s health trajectory over her lifespan, as they are indicators of ovarian function and aging. Both early and late timing of either event are associated with risk for adverse health and psychosocial outcomes. Thus, the search for a relationship between age at menarche and menopause has consequences for chronic disease prevention and implications for public health. This article is a review of evidence from the fields of developmental biology, epidemiology, nutrition, demography, sociology, and psychology that examine the menarche–menopause connection. Trends in ages at menarche and menopause worldwide and in subpopulations are presented; however, challenges exist in constructing trends. Among 36 studies that examine the association between the two sentinel events, ten reported a significant direct association, two an inverse association, and the remainder had null findings. Multiple factors, including hormonal and environmental exposures, socioeconomic status, and stress throughout the life course are hypothesized to influence the tempo of growth, including body size and height, development, menarche, menopause, and the aging process in women. The complexity of these factors and the pathways related to their effects on each sentinel event complicate evaluation of the relationship between menarche and menopause. Limitations of past investigations are discussed, including lack of comparability of socioeconomic status indicators and biomarker use across studies, while minority group differences have received scant attention. Suggestions for future directions are proposed. As research across endocrinology, epidemiology, and the social sciences becomes more integrated, the confluence of perspectives will yield a richer understanding of the influences on the tempo of a woman’s reproductive life cycle as well as accelerate progress toward more sophisticated preventive strategies for chronic disease. PMID:24600293

Menstrual Hygiene Practices in Context of Schooling: A Community Study Among Rural Adolescent Girls in Varanasi

PubMed Central

Kansal, Sangeeta; Singh, Sweta; Kumar, Alok

2016-01-01

Introduction: Up until now, poor menstrual hygiene in developing countries has been an insufficiently acknowledged problem. The lack of attention to this issue is striking as we cannot achieve several Millennium Development Goals (MDGs), that is, 2, 3 4,5, and 5B. This study aimed to assess the level of awareness about menarche and hygienic practices during menstruation in context of schooling. Materials and Methods: Community-based cross-sectional study using a mix method approach (qualitative and quantitative). It was conducted among 650 adolescent girls in the field practice area of Rural Health and Training Centre, Chiraigaon block of district Varanasi between January and June2011. Pretested, semistructured interview schedule was used. Data were analyzed statistically by using Statistical Package for Social Sciences (SPSS) software. Results: Out of the total 650 respondents, 590 (90.78%) had attained menarche at the time of interview and only one-third of the respondents (29.4%) were aware of menstruation before menarche and sisters (55%) played the key role in providing information to them. Only 31% respondents were using sanitary pads during menstruation. Self-reported reproductive tract infection (RTI) was observed more in respondents not maintaining hygienic practices (6.6%) as compared to those maintaining hygiene (2.6%). Conclusion and Recommendations: From the Focus Group Discussions (FGDs) as well as quantitative survey it was observed that the awareness about menarche before its onset was still poor in rural areas. Significant association (P < 0.05) was observed between respondent education and their awareness about menarche before its onset. Therefore, it is recommended that teachers can play an influential role in informing them about changes during adolescence, especially about menarche and other issues related to menstruation. As per the present study, sisters and mothers were the major source of information. Therefore, there is a need for the provision of comprehensive family life education for the parents also. PMID:26917872

Interactive Effects of Menarcheal Status and Dating on Dieting and Disordered Eating among Adolescent Girls.

ERIC Educational Resources Information Center

Cauffman, Elizabeth; Steinberg, Laurence

1996-01-01

Examined effects of three different aspects of heterosocial activity--mixed-sex activities, dating, and physical involvement with boys--on the diet patterns of adolescent girls. Found interaction between dating and menarcheal status in the prediction of dieting and disordered eating, with dating more strongly linked to dieting and disordered…

"A Kotex and a Smile": Mothers and Daughters at Menarche

ERIC Educational Resources Information Center

Lee, Janet

2008-01-01

This article explores the menarche or first-period narratives of 155 young women, focusing on their relationships with their mothers at this time. It finds that maternal scripts are changing as young women of this cohort, most of whom started their periods around the new millennium, recalled supportive mothers who were emotionally engaged with…

Menstrual Patterns and Treatment of Heavy Menstrual Bleeding in Adolescents with Bleeding Disorders.

PubMed

Dowlut-McElroy, Tazim; Williams, Karen B; Carpenter, Shannon L; Strickland, Julie L

2015-12-01

To characterize menstrual bleeding patterns and treatment of heavy menstrual bleeding in adolescents with bleeding disorders. We conducted a retrospective review of female patients aged nine to 21 years with known bleeding disorders who attended a pediatric gynecology, hematology, and comprehensive hematology/gynecology clinic at a children's hospital in a metropolitan area. Prevalence of heavy menstrual bleeding at menarche, prolonged menses, and irregular menses among girls with bleeding disorders and patterns of initial and subsequent treatment for heavy menstrual bleeding in girls with bleeding disorders. Of 115 participants aged nine to 21 years with known bleeding disorders, 102 were included in the final analysis. Of the 69 postmenarcheal girls, almost half (32/69, 46.4%) noted heavy menstrual bleeding at menarche. Girls with von Willebrand disease were more likely to have menses lasting longer than seven days. Only 28% of girls had discussed a treatment plan for heavy menstrual bleeding before menarche. Hormonal therapy was most commonly used as initial treatment of heavy menstrual bleeding. Half (53%) of the girls failed initial treatment. Combination (hormonal and non-hormonal therapy) was more frequently used for subsequent treatment. Adolescents with bleeding disorders are at risk of heavy bleeding at and after menarche. Consultation with a pediatric gynecologist and/or hematologist prior to menarche may be helpful to outline abnormal patterns of menstrual bleeding and to discuss options of treatment in the event of heavy menstrual bleeding. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

The influence of strenuous muscle stimulation on the menarche.

PubMed

Yabuuchi, F; Ichikawa, Y; Arakawa, M; Chiba, G

1984-03-01

Nowadays, the average age at which menarche begins is lowering by three to four years every century, that is, four months every decade, according to both Japanese, and European and American annual changes of the average age. It emerged that the menarche shows a tendency to occur later in female gymnasts, because of the influence of strenuous muscle stimulation, and the fact that a higher level of technic is required in gymnastic games each year. These conclusions have been drawn from replies submitted to a questionnaire distributed among a relatively small number of gymnasts who participated in the competitions including the Inter High School Championship and the World Cup Championship. For example, at the age of 14, the percentage of women who had menstruated is almost 100% among women in general, but only 24% among World Cup Championship gymnasts, the average age at menarche of the latter being later than that of the former by as many as 3 years. At the age of 16, the percentage of women who had menstruated is 100% among women in general, but on the other hand, it is only 60% among World Cup Championship gymnasts, in other words, only a low percentage of women, of the latter group, had menstruated. Finally in our study, we established that the age at menarche of gymnasts is three or five years later than that of women in general. From our study, we concluded that the excessive burden imposed on muscles might cause an abnormal menstrual cycle, and the influence on menstruation would be considerable.

Hair product use, age at menarche and mammographic breast density in multiethnic urban women.

PubMed

McDonald, Jasmine A; Tehranifar, Parisa; Flom, Julie D; Terry, Mary Beth; James-Todd, Tamarra

2018-01-04

Select hair products contain endocrine disrupting chemicals (EDCs) that may affect breast cancer risk. We hypothesize that, if EDCs are related to breast cancer risk, then they may also affect two important breast cancer risk factors: age at menarche and mammographic breast density. In two urban female cohorts (N = 248): 1) the New York site of the National Collaborative Perinatal Project and 2) the New York City Multiethnic Breast Cancer Project, we measured childhood and adult use of hair oils, lotions, leave-in conditioners, root stimulators, perms/relaxers, and hair dyes using the same validated questionnaire. We used multivariable relative risk regression models to examine the association between childhood hair product use and early age at menarche (defined as <11 years of age) and multivariable linear regression models to examine the association between childhood and adult hair product use and adult mammographic breast density. Early menarche was associated with ever use of childhood hair products (RR 2.3, 95% CI 1.1, 4.8) and hair oil use (RR 2.5, 95% CI 1.2, 5.2); however, additional adjustment for race/ethnicity, attenuated associations (hair products RR 1.8, 95% CI 0.8, 4.1; hair oil use RR 2.3, 95% CI 1.0, 5.5). Breast density was not associated with adult or childhood hair product or hair oil use. If confirmed in larger prospective studies, these data suggest that exposure to EDCs through hair products in early life may affect breast cancer risk by altering timing of menarche, and may operate through a mechanism distinct from breast density.

Secular trends are associated with the demographic and epidemiologic transitions in an indigenous community in Oaxaca, Southern Mexico.

PubMed

Malina, Robert M; Little, Bertis B; Peña Reyes, Maria Eugenia

2018-01-01

To test the hypothesis that secular changes in body size and age at menarche are related to the demographic and epidemiologic transitions in an indigenous community in Oaxaca, southern Mexico. Data were derived from surveys of a Zapotec-speaking community conducted between 1968 and 2000. Segmented linear regressions of height, weight, BMI and recalled age at menarche on year of birth in cohorts of adults born before and after the demographic transition were used to evaluate secular changes. Corresponding comparisons of body size (MANCOVA controlling for age) and age at menarche (status quo, probit analysis) were done for samples of children and adolescents born before and after the epidemiological transition. Height and weight increased in adults born after the demographic transition (mid-1950s), and especially in children and adolescents born after the epidemiological transition (mid-1980s). Age at menarche also decreased significantly in women born after the demographic transition, but at a more rapid estimated rate in adolescents born after the epidemiological transition. Secular gains in body weight were proportional to those for height among children and adolescents, but adults, males more so than females, gained proportionally more weight. The secular trend in height in adults of both sexes was associated with the decade of the demographic transition in the mid-1950s. Significant secular gains in size attained and age at menarche occurred in children and youth born after the epidemiologic transition which likely reflected improved health and nutritional conditions since the mid-1980s. © 2017 Wiley Periodicals, Inc.

Age at Menarche and Premenstrual Syndrome in Adolescent Girls with Intellectual Disability in Bosnia and Herzegovina

ERIC Educational Resources Information Center

Ibralic, Inga; Sinanovic, Osman; Memisevic, Haris

2010-01-01

The issues involving menstruation are the topic of many scientific inquires in the fields of medicine, psychology, sociology and anthropology. The aim of this study was to determine the age at menarche and the most common symptoms of premenstrual syndrome (PMS) in adolescent girls with intellectual disability. The main method of data collection…

Outcome of Isolated Premature Menarche: A Retrospective and Follow-Up Study.

PubMed

Ejaz, Sehar; Lane, Andrew; Wilson, Thomas

2015-01-01

Isolated premature menarche is isolated or recurrent vaginal bleeding in a female in the absence of appropriate secondary sexual characters. Retrospective chart review of patients with premature menarche, followed by a telephone questionnaire. Charts of patients evaluated in the Pediatric Endocrine Clinic for premature vaginal bleeding from 1982-2013 were reviewed. Of 21 patients identified, 17 could be contacted. Five newly diagnosed patients were recruited during the course of the study. The median age at initial presentation was 7 years. Most patients presented with Tanner I sexual development. Some had more advanced breast staging, which regressed later. All had prepubertal baseline and stimulated gonadotropins. Most of the patients reported a single or few episodes of menses. Two reported continuation of irregular bleeding into adulthood. All reported an adult height within the midparental target height. Premature menarche in the absence of other appropriate secondary sexual characteristics is a benign entity. Most patients have a few isolated episodes of menses that stop spontaneously; some may continue to have periods into adulthood. Unlike true puberty, these patients do not demonstrate advanced skeletal maturation, and the adult height is normal. Fertility appears to be normal. © 2015 S. Karger AG, Basel.

Association between reproductive variables and metabolic syndrome in chinese community elderly women.

PubMed

Liu, Miao; He, Yao; Jiang, Bin; Wu, Lei; Wang, Jianhua; Yang, Shanshan; Wang, Yiyan; Li, Xiaoying

2016-01-01

This study aimed to evaluate the association between reproductive variables and metabolic syndrome (MetS) among Chinese community elderly women. We conducted a cross-sectional study in a Beijing urban district. A two-stage stratified clustering sampling method was used and 1251 elderly women were included. The prevalence of MetS was 65.1% in this population. Women with MetS had younger menarche age, a greater number of years after menopause, higher gravidity and parity. The prevalence of MetS showed an increasing trend for tertiles of years after menopause (p=0.002) and number of children (p<0.001), while decreasing trend for menarche age (p=0.021). Logistic regression showed ORs of age at menarche, years after menopause and number of children for MetS were 0.94, 1.40, and 1.36 for second and 0.63, 1.58, and 1.75 for last tertiles. There is strong association between reproductive variables and higher risk of MetS. Simple information on timing of menarche and menopause could help identify women who may have higher risk of getting MetS and take early action to prevent related chronic diseases. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Knowledge and practices regarding menstruation among adolescent girls in an urban slum, Bijapur.

PubMed

Udgiri, Rekha; Angadi, M M; Patil, Shailaja; Sorganvi, Vijaya

2010-08-01

Adolescence is a crucial period in woman's life. The adolescent girls of today are the mothers of tomorrow in whose hand lie the future of her family, community and the nation. Because of the scarcity of information regarding the problems of adolescent girls, particularly in urban areas, the present study was undertaken to elicit information about the knowledge and practices regarding menstruation among adolescent girls. With this objective, a community-based cross-sectional study was done in an urban field practice area of BLDEA's Shri BM Patil Medical College, Bijapur. The study subjects included all adolescent girls who had attained menarche. Data was collected by questionnaire method and analysed. Out of 342 adolescent girls 324 (94.74%) were literate. Only 63 (18.42%) had knowledge about menstruation prior to attainment of menarche and this association was found to be statistically significant. The main source of information about menstruation was mother ie, 195 (57.01%). Nearly 81.58% adolescent girls were lacking knowledge about menstruation prior to menarche, this reflects upon the standard of awareness in the society to such important event and it also leads to negative reaction to menarche.

Body composition and concentrations of leptin, neuropeptide Y, beta-endorphin, growth hormone, insulin-like growth factor-I and insulin at menarche in girls with constitutional delay of puberty.

PubMed

Błogowska, Anna; Krzyzanowska-Swiniarska, Barbara; Zielińska, Dorota; Rzepka-Górska, Izabella

2006-05-01

Constitutional delay of puberty (CDP), a rare condition among girls, manifests as retarded sexual maturity past the 13th year of life. The clinical and endocrinological aspects of this interesting problem appear to have escaped attention in the literature. The purpose of the present study was to compare body composition and concentrations of leptin, neuropeptide Y (NPY), beta-endorphin, growth hormone (GH), insulin growth factor-I (IGF-I) and insulin at menarche in CDP girls and girls with normal pubertal development (NP). We enrolled 11 girls with CDP and 40 girls with NP. All participants were studied at or within 3 months of menarche. Age, height and weight were recorded. Body composition was established with a body composition analyzer. Radioimmunoassays were performed to measure concentrations of NPY, beta-endorphin, leptin, GH, IGF-I and insulin. The mean age at menarche in the CDP and NP groups was 16.1 and 12.5 years, respectively (p = 0.0001). CDP girls at menarche were taller (1.64 vs. 1.57 m; p = 0.012). The difference between groups in body weight (57.5 vs. 50.4 kg; p = 0.1), body mass index (BMI), fat mass, fat percentage (BF%) and lean mass was not significant, and nor was the difference in leptin, GH and insulin levels. However, CDP girls demonstrated significantly higher NPY concentrations (199.4+/-105.1 vs. 56.9+/-26.3 pg/ml; p = 0.001). NPY correlated with BF% (r = 0.60) in this group. IGF-I concentrations were significantly lower in CDP girls (524.8+/-50.6 ng/ml) than in NP girls (744.5+/-56.1 ng/ml; p = 0.024). Girls with CDP differed from NP girls only in age at menarche and height; they did not differ significantly with respect to BMI and body composition parameters. Higher concentrations of NPY in CDP girls may be responsible for CDP and reduced levels of IGF-I. Correlation of NPY with BF% suggests an involvement of this neuropeptide in the process of fat accumulation associated with CDP.

Sustained skeletal benefit from childhood mechanical loading

PubMed Central

Scerpella, T. A.; Dowthwaite, J. N.; Rosenbaum, P. F.

2011-01-01

Summary Preliminary prospective, longitudinal results suggest that pre-menarcheal exposure to artistic gymnastics is associated with greater radius BMC, aBMD, and projected area throughout growth and into early adulthood, more than 4 years after activity cessation. Any loss of benefit associated with de-training appears to be temporary. Introduction Mechanical loading may enhance bone accrual during growth, but prospective evidence of benefit retention is limited. This prospective, longitudinal cohort study tests whether gymnastics is linked to distal radius advantages during growth and four or more years post-training cessation. Methods Semi-annually, female ex/gymnasts and non-gymnasts underwent height and weight measurements; questionnaires assessed calcium intake, physical activity, and maturation. Annual dual energy X-ray absorptiometry scans (Hologic QDR 4500W) measured total body fat-free mass, skull areal density (aBMD), and bone mineral content (BMC); forearm scans measured ultradistal and 1/3 radius area, BMC, and aBMD. Analysis inclusion criteria were: (1) achievement of gynecological age >4 years and (2) for gymnasts, >2 years of pre-menarcheal training (>6 h/week), ceasing between 0.5 year pre-menarche and 1 year post-menarche. Hierarchical linear modeling (HLM v6.0) evaluated outcomes for ex/gymnasts versus non-gymnasts; a slope/intercept discontinuity evaluated de-training effects. Results Data from 14 non-gymnasts and six ex/gymnasts represented outcomes from 4 years pre-menarche to 9 years post-menarche. All adjusted distal radius parameters were higher in ex/gymnasts than non-gymnasts (p<0.02). Ultradistal BMC, ultradistal aBMD, and 1/3 aBMD temporarily decreased with gymnastic cessation (p<0.04); ultradistal area, 1/3 area, and 1/3 BMC did not change significantly. Skull outcomes did not differ between groups or change with activity cessation. Conclusion Gymnastic exposure during childhood and early puberty is associated with greater radius bone mass, size, and aBMD. Despite brief de-training losses in density and mass, significant skeletal benefits are manifested throughout growth and at least 4 years beyond activity cessation into early adulthood. PMID:20838772

Biological maturity at birth, the course of the subsequent ontogenetic stages and age at menarche.

PubMed

Szwed, A; Kosińska, M

2012-08-01

The main aim of the study was to assess the influence of biological maturity at birth on growth processes in the subsequent years and during puberty in girls. The material of this study comes from the outpatient clinic cards and cross-sectional research on girls from the province of Wielkopolska in Poland. It includes data of 527 girls. The influence of perinatal maturity on body weight in the later stages of ontogeny was determined with the use of the Kruskal-Wallis test and the Mann-Whitney U test. In order to determine the relationship between perinatal maturity and age at menarche, the survival analysis module was used. The results show a diverse influence of perinatal maturity on the values of body weight achieved in later years of life. The indicated predictive factors included both birth weight and gestational age. In the examined girls menarche occurred between the 10th year and the 17th year of life (X¯=12.87, s=1.26; Me=13 years). The comparison showed a significant variation in age at menarche depending on the length of pregnancy (log-rank χ(2)(2)=27.068, p<0.0001) and birth weight (log-rank χ(2)(2)=23.241, p<0.0001). There was no variation in maturation of the examined girls conditioned by the occurrence of intra-uterine growth retardation (log-rank χ(2)(2)=2.046, p>0.05). Remote prognoses as to the postnatal development of preterm-born children and/or children with low birth weight indicate adverse influence of these variables on age at menarche. Perinatal biological maturity of a newborn conditions the course of postnatal development. Copyright © 2012 Elsevier GmbH. All rights reserved.

Is soy intake related to age at onset of menarche? A cross-sectional study among adolescents with a wide range of soy food consumption

PubMed Central

2014-01-01

Background Early onset of menarche may negatively influence the future health of adolescent girls. Several factors affect the timing of menarche but it is not clear if soy foods consumption around pubertal years plays a role; thus, we examined its relation to age at onset of menarche (AOM) in a high soy-consuming population. Methods We conducted a cross-sectional study on 339 girls ages 12–18 years attending middle and high schools near two Seventh-day Adventist universities in California and Michigan using a web-based dietary questionnaire and physical development tool. Soy consumption (categorized as total soy, meat alternatives, tofu/traditional soy, and soy beverages) was estimated from the questionnaire, while AOM was self-reported. Data analyses included descriptive statistics, Cox proportional hazards ratios, Kaplan-Meier curves and Poisson regression with adjustment for relevant confounders. Results Mean (SD) intakes were: total soy,12.9 (14.4) servings/week; meat alternatives, 7.0 (8.9) servings/week; tofu/traditional soy foods, 2.1 (3.8) servings/week; soy beverages, 3.8 (6.3) servings/week. Mean AOM was 12.5 (1.4) y for those who reached menarche. Consumption of total soy and the 3 types of soy foods was not significantly associated with AOM and with the odds for early- or late-AOM. Adjustment for demographic and dietary factors did not change the results. Conclusion Soy intake is not associated with AOM in a population of adolescent girls who have a wide range of, and relatively higher, soy intake than the general US population. Our finding suggests that the increasing popularity of soy in the US may not be associated with AOM. PMID:24889551

Is soy intake related to age at onset of menarche? A cross-sectional study among adolescents with a wide range of soy food consumption.

PubMed

Segovia-Siapco, Gina; Pribis, Peter; Messina, Mark; Oda, Keiji; Sabaté, Joan

2014-06-03

Early onset of menarche may negatively influence the future health of adolescent girls. Several factors affect the timing of menarche but it is not clear if soy foods consumption around pubertal years plays a role; thus, we examined its relation to age at onset of menarche (AOM) in a high soy-consuming population. We conducted a cross-sectional study on 339 girls ages 12-18 years attending middle and high schools near two Seventh-day Adventist universities in California and Michigan using a web-based dietary questionnaire and physical development tool. Soy consumption (categorized as total soy, meat alternatives, tofu/traditional soy, and soy beverages) was estimated from the questionnaire, while AOM was self-reported. Data analyses included descriptive statistics, Cox proportional hazards ratios, Kaplan-Meier curves and Poisson regression with adjustment for relevant confounders. Mean (SD) intakes were: total soy,12.9 (14.4) servings/week; meat alternatives, 7.0 (8.9) servings/week; tofu/traditional soy foods, 2.1 (3.8) servings/week; soy beverages, 3.8 (6.3) servings/week. Mean AOM was 12.5 (1.4) y for those who reached menarche. Consumption of total soy and the 3 types of soy foods was not significantly associated with AOM and with the odds for early- or late-AOM. Adjustment for demographic and dietary factors did not change the results. Soy intake is not associated with AOM in a population of adolescent girls who have a wide range of, and relatively higher, soy intake than the general US population. Our finding suggests that the increasing popularity of soy in the US may not be associated with AOM.

Childhood psychosocial adversity and female reproductive timing: a cohort study of the ALSPAC mothers

PubMed Central

Magnus, Maria C; Anderson, Emma L; Howe, Laura D; Joinson, Carol J; Penton-Voak, Ian S; Fraser, Abigail

2018-01-01

Background Previous studies of childhood psychosocial adversity and age at menarche mostly evaluated single or a few measures of adversity, and therefore could not quantify total psychosocial adversity. Limited knowledge is currently available regarding childhood psychosocial adversity in relation to age at menopause and reproductive lifespan. Methods We examined the associations of total and specific components of childhood psychosocial adversity with age at menarche (n=8984), age at menopause (n=945), and length of reproductive lifespan (n=841), in mothers participating in the Avon Longitudinal Study of Parents and Children. We used confirmatory factor analysis to characterise lack of care, maladaptive family functioning, non-sexual abuse, overprotective parenting, parental mental illness and sexual abuse. These specific components of childhood psychosocial adversity were combined into a total psychosocial adversity score using a second-order factor analysis. We used structural equation models to simultaneously conduct the factor analysis and estimate the association with the continuous outcomes of interest. Results Total childhood psychosocial adversity was not associated with age at menarche, age at menopause or length of reproductive lifespan. When we examined the separate psychosocial adversity constructs, sexual abuse was inversely associated with age at menarche, with a mean difference of −0.17 (95% CI −0.23 to −0.12) years per SD higher factor score, and with age at menopause, with a mean difference of −0.17 (95% CI −0.52 to 0.18) per SD higher factor score. Conclusion Childhood sexual abuse was associated with lower age at menarche and menopause, but the latter needs to be confirmed in larger samples. PMID:29122994

Childhood psychosocial adversity and female reproductive timing: a cohort study of the ALSPAC mothers.

PubMed

Magnus, Maria C; Anderson, Emma L; Howe, Laura D; Joinson, Carol J; Penton-Voak, Ian S; Fraser, Abigail

2018-01-01

Previous studies of childhood psychosocial adversity and age at menarche mostly evaluated single or a few measures of adversity, and therefore could not quantify total psychosocial adversity. Limited knowledge is currently available regarding childhood psychosocial adversity in relation to age at menopause and reproductive lifespan. We examined the associations of total and specific components of childhood psychosocial adversity with age at menarche (n=8984), age at menopause (n=945), and length of reproductive lifespan (n=841), in mothers participating in the Avon Longitudinal Study of Parents and Children. We used confirmatory factor analysis to characterise lack of care, maladaptive family functioning, non-sexual abuse, overprotective parenting, parental mental illness and sexual abuse. These specific components of childhood psychosocial adversity were combined into a total psychosocial adversity score using a second-order factor analysis. We used structural equation models to simultaneously conduct the factor analysis and estimate the association with the continuous outcomes of interest. Total childhood psychosocial adversity was not associated with age at menarche, age at menopause or length of reproductive lifespan. When we examined the separate psychosocial adversity constructs, sexual abuse was inversely associated with age at menarche, with a mean difference of -0.17 (95% CI -0.23 to -0.12) years per SD higher factor score, and with age at menopause, with a mean difference of -0.17 (95% CI -0.52 to 0.18) per SD higher factor score. Childhood sexual abuse was associated with lower age at menarche and menopause, but the latter needs to be confirmed in larger samples. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Maternal investment, life-history strategy of the offspring and adult chronic disease risk in South Asian women in the UK.

PubMed

Wells, Jonathan C K; Yao, Pallas; Williams, Jane E; Gayner, Rebecca

2016-01-01

Patterns of development predict cardiovascular disease (CVD) risk, and ethnic differences therein, but it remains unclear why apparently 'adaptive plasticity' in early life should generate health costs in later life. We hypothesized that offspring receiving low maternal investment during fetal life, the primary period of organogenesis, should predict a shorter reproductive career and develop a fast life-history strategy, prioritizing reproduction over growth and homeostatic maintenance. We studied 58 young adult South Asian women living in the UK, a group with high susceptibility to CVD. We obtained gestational age, birth weight (BW) and menarcheal age by recall and measured anthropometry, body composition, resting metabolic rate (RMR) and blood pressure (BP). BW and gestational age were inversely associated with menarcheal age, indicating that lower maternal investment is associated with faster maturation. Menarcheal age was positively associated with height but inversely with adiposity, indicating that rapid maturation prioritizes lipid stores over somatic growth. BW was inversely associated with BP, whereas adiposity was positively associated, indicating that lower maternal investment reduces BP homeostasis. BW was positively associated with RMR, whereas menarche was inversely associated, indicating that maternal investment influences adult metabolism. Supporting our hypothesis, low maternal investment promoted faster life histories, demonstrated by earlier menarche, reduced growth and elevated adiposity. These traits were associated with poorer BP regulation. This is the first study demonstrating strategic adjustment of the balance between reproduction and metabolic health in response to the level of maternal investment during fetal life. © The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

Menarche and menstruation: a review of the literature.

PubMed

Swenson, I; Havens, B

1987-01-01

Puberty initiation rites heralding menarche are common across cultures. Paige (1973) reflected that societies with the highest levels of social rigidity and male solidarity also have the strongest codification of menstrual taboos. This may reflect a need to maintain clear sex roles, often by controlling women and their fertility. Social and cultural factors impact on adjustment to menses and have an effect on the early menarcheal experience. Certain common features, however, were observed in that most girls reported their mothers as a principal source of information and received some limited education about menses in school with frequent emphasis on hygienic aspects of menstruation. A more positive attitude toward menses can be achieved if girls are physically and emotionally prepared. The most current evaluation of educational materials on menses dates back to 1975 and reveals a preponderance of emphasis on hygiene to the exclusion of issues of emotional and psychological development. Women perceive themselves as being very knowledgeable but cannot accurately answer physiological questions. A content analysis of advertisements for sanitary products and medications for the relief of menstrual symptoms in a popular teen magazine indicated that advertisements conveyed the image that hygienic aspects of migration could be dealt with effectively. There were no significant relationships between reported incidence of menstrual symptoms and adequacy of preparation for menarche. Nurses involved in the planning or implementing of educational programs for girls regarding the menarche should be sensitive to the adolescent's desire for control of the learning environment and a need for selective sharing of the event. Strategies for coping with the "inconvenience" may be usefully developed with the girls as a part of the learning situation.

Predictors of stunting and thinness in post-menarcheal adolescent girls in rural Bangladesh.

PubMed

Rah, Jee H; Christian, Parul; Shamim, Abu Ahmed; Arju, Ummeh T; Labrique, Alain B; Rashid, Mahbubur

2009-12-01

To assess the nutritional status and risk factors of undernutrition in post-menarcheal girls in rural northern Bangladesh. Cross-sectional data on anthropometric measurements, dietary intake, work activity, morbidity and socio-economic status were collected from 12- to 19-year-old primigravidae (n 209) and never-pregnant adolescents (n 456) matched on age and time since menarche. Multiple regression analyses were conducted to determine predictors of stunting, thinness, upper-arm muscle (UAMZ) and fat area Z-scores (UAFZ) among the adolescent girls. A large proportion of adolescents (49 %) were stunted (height-for-age Z-score <-2) and underweight (40 %; weight-for-age Z-score <-2), but not thin (BMI-for-age <5th percentile; approximately 10 %). The mean (sd) UAMZ and UAFZ of the adolescent girls was -0.3 (0.64) and -0.9 (0.40), respectively. Lean mass increased whereas fat mass declined with age. Both stunting and thinness were positively associated with age and time since menarche (P < 0.05). Young age (12-14 years) and literacy were protective against stunting among pregnant adolescents (OR = 0.29, 95 % CI 0.09, 0.88 and OR = 0.50, 95 % CI 0.26, 0.96, respectively). Having symptoms of diarrhoea or dysentery (OR = 7.40, 95 % CI 1.43, 38.29) predicted thinness and was associated with lower UAMZ and UAFZ among never-pregnant girls (both P < 0.05). Performing light-to-moderate activities was protective against thinness among never-pregnant girls (OR = 0.43, 95 % CI 0.22, 0.82), whereas pregnant adolescents who performed high levels of strenuous activities had greater UAMZ (P < 0.05). Undernutrition was widespread among this post-menarcheal adolescent population. Younger and literate adolescents were less likely to be stunted, whereas thinness and body composition were associated with morbidity and work activity.

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

PubMed

Pandeya, Nirmala; Huxley, Rachel R; Chung, Hsin-Fang; Dobson, Annette J; Kuh, Diana; Hardy, Rebecca; Cade, Janet E; Greenwood, Darren C; Giles, Graham G; Bruinsma, Fiona; Demakakos, Panayotes; Simonsen, Mette Kildevaeld; Adami, Hans-Olov; Weiderpass, Elisabete; Mishra, Gita D

2018-04-25

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/m 2 . 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. © 2018 John Wiley & Sons Ltd.

Early Puberty, School Context, and Delinquency Among South Korean Girls.

PubMed

Park, Hye-Sook; Yun, Ilhong; Walsh, Anthony

2017-05-01

Compared with chronological age, criminologists have paid less attention to the biological sense of age typically expressed by pubertal development. Studies that have examined pubertal timing's effects on delinquency have almost exclusively been conducted in Western countries using mostly White samples. To our knowledge, no study has ever examined this issue in the Asian context. The current study is the first attempt to bridge this research gap by examining the association among menarcheal timing, the sex composition of schools, and delinquency in a representative sample of 1,108 ninth-grade girls in South Korea. The results show that significant association between early menarche and delinquency exists only in mixed-sex schools but not in all-girls schools. In addition, the significant linkage between early menarche and delinquency in mixed-sex schools is mediated by delinquent peer associations.

Menstruation during and after caloric restriction: the 1944-1945 Dutch famine.

PubMed

Elias, Sjoerd G; van Noord, Paulus A H; Peeters, Petra H M; den Tonkelaar, Isolde; Kaaks, Rudolf; Grobbee, Diederick E

2007-10-01

To investigate the relation between exposure to the 1944-45 Dutch famine and concurrent and subsequent menstrual disturbances. Cohort study. Doorlopend Onderzoek Mammacarcinoom breast cancer screening project, Utrecht, the Netherlands. Between 1983 and 1986, approximately 12,500 women (born 1911-41) reported their individual famine experiences. Irregular menstruation during the famine; time to regular menses after menarche, and menstrual patterns in adulthood after childhood famine. The famine had a direct impact on menstruation. The odds ratio (OR) of concurrent irregular menses in severely versus unexposed women was 8.85 (95% confidence interval [CI], 7.31-10.70). Women exposed to severe famine before menarche were 1.51 (95% CI, 1.15-1.98) times more likely to experience irregular menses for a prolonged time after menarche compared with the unexposed. This association was stronger in women with an early menarche. When the menstrual pattern was assessed in adulthood by menstrual diaries, a nonsignificant tendency of increased irregularity (OR, 1.13; 95% CI, 0.82-1.54) and regular but long menstrual cycles (OR, 1.41; 95% CI, 0.89-2.23) was observed in women exposed to severe famine. Famine relates to concurrent menstrual irregularity, and exposure in childhood seems to affect the subsequent menstrual pattern.

Childhood growth and breast cancer.

PubMed

De Stavola, B L; dos Santos Silva, I; McCormack, V; Hardy, R J; Kuh, D J; Wadsworth, M E J

2004-04-01

Adult height is known to be positively associated with breast cancer risk. The mechanism underlying this association is complex, since adult height is positively correlated with age at menarche, which in turn is negatively associated with breast cancer risk. The authors used prospective data from a British cohort of 2,547 girls followed from birth in 1946 to the end of 1999 to examine breast cancer risk in relation to childhood growth. As expected, adult height was positively associated with age at menarche and breast cancer. In childhood, cases were taller and leaner, on average, than noncases. Significant predictors of breast cancer risk in models containing all components of growth were height velocity at age 4-7 years (for a one-standard-deviation increase, odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.13, 2.09) and age 11-15 years (OR = 1.29, 95% CI: 0.97, 1.71) and body mass index velocity (weight (kg)/height (m)(2)/year) at age 2-4 years (OR = 0.63, 95% CI: 0.48, 0.83). The effects of these variables were particularly marked in women with early menarche (age <12.5 years). These findings suggest that women who grow faster in childhood and reach an adult height above the average for their menarche category are at particularly increased risk of breast cancer.

Neonatal amygdala lesions advance pubertal timing in female rhesus macaques

PubMed Central

Stephens, Shannon B.Z.; Raper, Jessica; Bachevalier, Jocelyne; Wallen, Kim

2014-01-01

Summary Social context influences the timing of puberty in both humans and nonhuman primates, such as delayed first ovulation in low-ranking rhesus macaques, but the brain region(s) mediating the effects of social context on pubertal timing are unknown. The amygdala is important for responding to social information and thus, is a potential brain region mediating the effects of social context on pubertal timing. In this study, female rhesus macaques living in large, species-typical, social groups received bilateral neurotoxic amygdala lesions at one month of age and pubertal timing was examined beginning at 14 months of age. Pubertal timing was affected in neonatal amygdala-lesioned females (Neo-A), such that they experienced significantly earlier menarche and first ovulation than did control females (Neo-C). Duration between menarche and first ovulation did not differ between Neo-A and Neo-C females, indicating earlier first ovulation in Neo-A females was likely a consequence of earlier menarche. Social rank of Neo-A females was related to age at menarche, but not first ovulation, and social rank was not related to either event in Neo-C females. It is more likely that amygdalectomy affects pubertal timing through its modulation of GABA-ergic mechanisms rather than as a result of the removal of a social-contextual inhibition on pubertal timing. PMID:25462903

Vaginal Microbiota of Adolescent Girls Prior to the Onset of Menarche Resemble Those of Reproductive-Age Women

PubMed Central

Hickey, Roxana J.; Zhou, Xia; Settles, Matthew L.; Erb, Julie; Malone, Kristin; Hansmann, Melanie A.; Shew, Marcia L.; Van Der Pol, Barbara

2015-01-01

ABSTRACT Puberty is an important developmental stage wherein hormonal shifts mediate the physical and physiological changes that lead to menarche, but until now, the bacterial composition of vaginal microbiota during this period has been poorly characterized. We performed a prospective longitudinal study of perimenarcheal girls to gain insight into the timing and sequence of changes that occur in the vaginal and vulvar microbiota during puberty. The study enrolled 31 healthy, premenarcheal girls between the ages of 10 and 12 years and collected vaginal and vulvar swabs quarterly for up to 3 years. Bacterial composition was characterized by Roche 454 pyrosequencing and classification of regions V1 to V3 of 16S rRNA genes. Contrary to expectations, lactic acid bacteria, primarily Lactobacillus spp., were dominant in the microbiota of most girls well before the onset of menarche in the early to middle stages of puberty. Gardnerella vaginalis was detected at appreciable levels in approximately one-third of subjects, a notable finding considering that this organism is commonly associated with bacterial vaginosis in adults. Vulvar microbiota closely resembled vaginal microbiota but often exhibited additional taxa typically associated with skin microbiota. Our findings suggest that the vaginal microbiota of girls begin to resemble those of adults well before the onset of menarche. PMID:25805726

Does serum 25-hydroxyvitamin D influence muscle development during puberty in girls? A 7-year longitudinal study.

PubMed

Wang, Ru; Alen, Markku; Yu, Zhusheng; Wiklund, Petri; Cheng, Shu Mei; Törmäkangas, Timo; Chen, Peijie; Cheng, Sulin

2013-01-01

Vitamin D is well known for its regulatory role in calcium and phosphate homeostasis, but its role in muscle mass and strength during growth remains inconclusive. We explored the association of serum 25-hydroxyvitamin D (25(OH)D) with muscle development in girls from 11 to 18-years old. Whole body lean tissue mass (LMWB), appendicular lean mass (aLM), muscle cross-sectional area at the lower leg (mCSA), maximal voluntary contraction of elbow flexors (MVC elbow) and knee extensors (MVC knee) were assessed in 217 girls aged 10-13 years (at baseline), 215 in 2-year and 226 in 7.5-year follow-up. Serum concentration of 25(OH)D and intact parathyroid hormone (PTH) were analyzed retrospectively and girls were categorized according to their 25(OH)D levels (consistently insufficient 25(OH)D GLL <50 nmol/l and consistently sufficient GHH >50 nmol/l from baseline to 7-year follow-up). We found that 25(OH)D level declined until menarche (p<0.05) while LMWB, aLM, mCSA, MVC elbow and MVC knee continued to increase (p<0.001 for all) post menarche. At pre-menarche, the GLL (n = 34) had higher LMWB and aLM than the GHH (n = 21, p<0.05), while post-menarche the GHH (n = 15) had a greater catch-up gain in LMWB (p = 0.004), aLM (p = 0.001) and mCSA (p = 0.027) compared to the GLL (n = 65) over the first 2-year period. At the age of 18, no differences in muscle mass/strength between the low (n = 151) and high (n = 77) levels of 25(OH)D groups were found. This finding was independent of vitamin D receptor genotype and other confounders. In conclusion, our results showed that levels of 25(OH)D have no significant negative influence on the development of muscle mass and strength during pubertal growth both with longitudinal and cross-sectional comparison. On the contrary, our results suggest that the temporary negative association between 25(OH)D and muscle mass arises as a consequence of fast growth prior to menarche, and this negative association is diminished through catch-up growth after menarche.

Vaginal microbiota of adolescent girls prior to the onset of menarche resemble those of reproductive-age women.

PubMed

Hickey, Roxana J; Zhou, Xia; Settles, Matthew L; Erb, Julie; Malone, Kristin; Hansmann, Melanie A; Shew, Marcia L; Van Der Pol, Barbara; Fortenberry, J Dennis; Forney, Larry J

2015-03-24

Puberty is an important developmental stage wherein hormonal shifts mediate the physical and physiological changes that lead to menarche, but until now, the bacterial composition of vaginal microbiota during this period has been poorly characterized. We performed a prospective longitudinal study of perimenarcheal girls to gain insight into the timing and sequence of changes that occur in the vaginal and vulvar microbiota during puberty. The study enrolled 31 healthy, premenarcheal girls between the ages of 10 and 12 years and collected vaginal and vulvar swabs quarterly for up to 3 years. Bacterial composition was characterized by Roche 454 pyrosequencing and classification of regions V1 to V3 of 16S rRNA genes. Contrary to expectations, lactic acid bacteria, primarily Lactobacillus spp., were dominant in the microbiota of most girls well before the onset of menarche in the early to middle stages of puberty. Gardnerella vaginalis was detected at appreciable levels in approximately one-third of subjects, a notable finding considering that this organism is commonly associated with bacterial vaginosis in adults. Vulvar microbiota closely resembled vaginal microbiota but often exhibited additional taxa typically associated with skin microbiota. Our findings suggest that the vaginal microbiota of girls begin to resemble those of adults well before the onset of menarche. This study addresses longitudinal changes in vaginal and vulvar microbial communities prior to and immediately following menarche. The research is significant because microbial ecology of the vagina is an integral aspect of health, including resistance to infections. The physiologic changes of puberty and initiation of cyclic menstruation are likely to have profound effects on vaginal microbiota, but almost nothing is known about changes that normally occur during this time. Our understanding has been especially hampered by the lack of thorough characterization of microbial communities using techniques that do not rely on the cultivation of fastidious bacteria, as well as a dearth of studies on girls in the early to middle stages of puberty. This study improves our understanding of the normal development of vaginal microbiota during puberty and onset of menarche and may better inform clinical approaches to vulvovaginal care of adolescent girls. Copyright © 2015 Hickey et al.

Eating attitudes and body image in ethnic Japanese and Caucasian adolescent girls in the city of São Paulo, Brazil.

PubMed

Sampei, Míriam A; Sigulem, Dirce M; Novo, Neil F; Juliano, Yara; Colugnati, Fernando A B

2009-01-01

Despite investigations into the rapid increase in eating disorders across diverse ethnic groups, conclusions concerning ethnicity and eating disorders are contradictory. The objective of the present study was to investigate eating attitudes in ethnic Japanese and Caucasian adolescents in Brazil. The influence of body mass index (BMI), menarche and social-affective relationships on the development of eating disorders was also assessed. Questionnaires evaluating the incidence of eating disorders and the influence of social-affective relationships were applied to 544 Japanese-Brazilian and Caucasian adolescent girls: 10 to 11-year-old Japanese-Brazilian (n = 122) and Caucasian (n = 176) pre-menarcheal adolescents, and 16 to 17-year-old Japanese-Brazilian (n = 71) and Caucasian (n = 175) post-menarcheal adolescents. Caucasian girls obtained higher scores on the Eating Attitudes Test (EAT-26), showed greater body image dissatisfaction, dieted more often and had more diet models introduced by their mothers and peers than the Japanese-Brazilian girls. CONCLUSION The Caucasian adolescents overall appeared to be more sensitive to aesthetic and social pressures regarding body image than the Japanese adolescents. The high incidence of EAT-26 scores above 20 in the Caucasian pre-menarcheal group indicates that individual body image concerns are developing at an earlier age. Multiple logistic regression revealed several associations between mother-teen interactions and the development of abnormal eating attitudes.

Pubertal development in children diagnosed with diabetes mellitus type 1 before puberty.

PubMed

Pereira, K C X; Pugliese, B S; Guimarães, M M; Gama, M P

2015-02-01

To investigate an association between pubertal development and timing of menarche with glycemic control, disease duration, and body mass index (BMI) in patients diagnosed with diabetes mellitus type 1 (DM1) before puberty. Retrospective study. The study was performed at the diabetes outpatient clinic of Instituto de Puericultura e Pediatria Martagão Gesteira--IPPMG of the Federal University of Rio de Janeiro--UFRJ. A total of 131 children, 61 girls and 70 boys, diagnosed with DM1 before puberty participated in the study. The study investigated how age at puberty onset relates to mean glycated hemoglobin (HbA1c) before puberty, BMI percentile, and disease duration; how puberty duration relates to mean HbA1c before and during puberty and to disease duration; and how timing of menarche relates to mean HbA1c before puberty, BMI percentile, and disease duration. Age at puberty onset was positively correlated with mean HbA1c before puberty (r = 0.204, R(2) = 0.042; P = .019) and disease duration (r = 0.451, R(2) = 0.203; P < .0001), and negatively correlated with BMI percentile (r = -0.289, R(2) = 0.084; P = .001). Timing of menarche was negatively correlated with BMI percentile (r = -0.556, R(2) = 0.310; P < .001). Children with longer disease duration began puberty later than those diagnosed more recently. Girls in higher BMI percentiles reached menarche sooner.

Parent-of-origin specific allelic associations among 106 genomic loci for age at menarche

PubMed Central

Thompson, Deborah J; Ferreira, Teresa; He, Chunyan; Chasman, Daniel I; Esko, Tõnu; Thorleifsson, Gudmar; Albrecht, Eva; Ang, Wei Q; Corre, Tanguy; Cousminer, Diana L; Feenstra, Bjarke; Franceschini, Nora; Ganna, Andrea; Johnson, Andrew D; Kjellqvist, Sanela; Lunetta, Kathryn L; McMahon, George; Nolte, Ilja M; Paternoster, Lavinia; Porcu, Eleonora; Smith, Albert V; Stolk, Lisette; Teumer, Alexander; Tšernikova, Natalia; Tikkanen, Emmi; Ulivi, Sheila; Wagner, Erin K; Amin, Najaf; Bierut, Laura J; Byrne, Enda M; Hottenga, Jouke-Jan; Koller, Daniel L; Mangino, Massimo; Pers, Tune H; Yerges-Armstrong, Laura M; Zhao, Jing Hua; Andrulis, Irene L; Anton-Culver, Hoda; Atsma, Femke; Bandinelli, Stefania; Beckmann, Matthias W; Benitez, Javier; Blomqvist, Carl; Bojesen, Stig E; Bolla, Manjeet K; Bonanni, Bernardo; Brauch, Hiltrud; Brenner, Hermann; Buring, Julie E; Chang-Claude, Jenny; Chanock, Stephen; Chen, Jinhui; Chenevix-Trench, Georgia; Collée, J. Margriet; Couch, Fergus J; Couper, David; Coveillo, Andrea D; Cox, Angela; Czene, Kamila; D’adamo, Adamo Pio; Smith, George Davey; De Vivo, Immaculata; Demerath, Ellen W; Dennis, Joe; Devilee, Peter; Dieffenbach, Aida K; Dunning, Alison M; Eiriksdottir, Gudny; Eriksson, Johan G; Fasching, Peter A; Ferrucci, Luigi; Flesch-Janys, Dieter; Flyger, Henrik; Foroud, Tatiana; Franke, Lude; Garcia, Melissa E; García-Closas, Montserrat; Geller, Frank; de Geus, Eco EJ; Giles, Graham G; Gudbjartsson, Daniel F; Gudnason, Vilmundur; Guénel, Pascal; Guo, Suiqun; Hall, Per; Hamann, Ute; Haring, Robin; Hartman, Catharina A; Heath, Andrew C; Hofman, Albert; Hooning, Maartje J; Hopper, John L; Hu, Frank B; Hunter, David J; Karasik, David; Kiel, Douglas P; Knight, Julia A; Kosma, Veli-Matti; Kutalik, Zoltan; Lai, Sandra; Lambrechts, Diether; Lindblom, Annika; Mägi, Reedik; Magnusson, Patrik K; Mannermaa, Arto; Martin, Nicholas G; Masson, Gisli; McArdle, Patrick F; McArdle, Wendy L; Melbye, Mads; Michailidou, Kyriaki; Mihailov, Evelin; Milani, Lili; Milne, Roger L; Nevanlinna, Heli; Neven, Patrick; Nohr, Ellen A; Oldehinkel, Albertine J; Oostra, Ben A; Palotie, Aarno; Peacock, Munro; Pedersen, Nancy L; Peterlongo, Paolo; Peto, Julian; Pharoah, Paul DP; Postma, Dirkje S; Pouta, Anneli; Pylkäs, Katri; Radice, Paolo; Ring, Susan; Rivadeneira, Fernando; Robino, Antonietta; Rose, Lynda M; Rudolph, Anja; Salomaa, Veikko; Sanna, Serena; Schlessinger, David; Schmidt, Marjanka K; Southey, Mellissa C; Sovio, Ulla; Stampfer, Meir J; Stöckl, Doris; Storniolo, Anna M; Timpson, Nicholas J; Tyrer, Jonathan; Visser, Jenny A; Vollenweider, Peter; Völzke, Henry; Waeber, Gerard; Waldenberger, Melanie; Wallaschofski, Henri; Wang, Qin; Willemsen, Gonneke; Winqvist, Robert; Wolffenbuttel, Bruce HR; Wright, Margaret J; Boomsma, Dorret I; Econs, Michael J; Khaw, Kay-Tee; Loos, Ruth JF; McCarthy, Mark I; Montgomery, Grant W; Rice, John P; Streeten, Elizabeth A; Thorsteinsdottir, Unnur; van Duijn, Cornelia M; Alizadeh, Behrooz Z; Bergmann, Sven; Boerwinkle, Eric; Boyd, Heather A; Crisponi, Laura; Gasparini, Paolo; Gieger, Christian; Harris, Tamara B; Ingelsson, Erik; Järvelin, Marjo-Riitta; Kraft, Peter; Lawlor, Debbie; Metspalu, Andres; Pennell, Craig E; Ridker, Paul M; Snieder, Harold; Sørensen, Thorkild IA; Spector, Tim D; Strachan, David P; Uitterlinden, André G; Wareham, Nicholas J; Widen, Elisabeth; Zygmunt, Marek; Murray, Anna; Easton, Douglas F

2014-01-01

Age at menarche is a marker of timing of puberty in females. It varies widely between individuals, is a heritable trait and is associated with risks for obesity, type 2 diabetes, cardiovascular disease, breast cancer and all-cause mortality1. Studies of rare human disorders of puberty and animal models point to a complex hypothalamic-pituitary-hormonal regulation2,3, but the mechanisms that determine pubertal timing and underlie its links to disease risk remain unclear. Here, using genome-wide and custom-genotyping arrays in up to 182,416 women of European descent from 57 studies, we found robust evidence (P<5×10−8) for 123 signals at 106 genomic loci associated with age at menarche. Many loci were associated with other pubertal traits in both sexes, and there was substantial overlap with genes implicated in body mass index and various diseases, including rare disorders of puberty. Menarche signals were enriched in imprinted regions, with three loci (DLK1/WDR25, MKRN3/MAGEL2 and KCNK9) demonstrating parent-of-origin specific associations concordant with known parental expression patterns. Pathway analyses implicated nuclear hormone receptors, particularly retinoic acid and gamma-aminobutyric acid-B2 receptor signaling, among novel mechanisms that regulate pubertal timing in humans. Our findings suggest a genetic architecture involving at least hundreds of common variants in the coordinated timing of the pubertal transition. PMID:25231870

Risk factors for adolescent primigravida in Kaohsiung county, Taiwan.

PubMed

Wang, C S; Chou, P

1999-07-01

To study the risk factors for adolescent primigravida in Kaohsiung county, Taiwan. This is a population survey on primigravida based on household registry to study risk factors affecting pregnancy of 215 women aged < 18; 341 women aged 18-19; and 590 women aged 20-34. The mean age of menarche, first intercourse, and first pregnancy, as well as the duration of menarche to the first intercourse increased significantly with the increased age of primigravida (P < 0.001). Adolescent primigravida, when compared to adult primigravida, were less likely to communicate well with their parents or be in a dual parent family (P < 0.05). They were also more likely to have alcoholic fathers, have drinking alcohol and smoking health behavior problems, exhibit poor school performance, have relatives or friends who became pregnant as adolescents, have been raped, and exhibit poorer knowledge of contraception before pregnancy (P < 0.05). Dose-response relationship in the odds ratio was found. Non-dual family, adolescent pregnancy in relatives or friends, smoking before pregnancy, and age of menarche were independent factors in multiple logistic regression on adolescent primigravida. The main risk factors for adolescent primigravida in Kaohsiung county. Taiwan, were family influence, health behavior problems, adolescent pregnancy in relatives or friends, and earlier onset of menarche. The age at which intercourse and smoking start appear to be two crucial factors that can be addressed through education as a means of intervention before pregnancy occurs.

Parent-of-origin-specific allelic associations among 106 genomic loci for age at menarche.

PubMed

Perry, John Rb; Day, Felix; Elks, Cathy E; Sulem, Patrick; Thompson, Deborah J; Ferreira, Teresa; He, Chunyan; Chasman, Daniel I; Esko, Tõnu; Thorleifsson, Gudmar; Albrecht, Eva; Ang, Wei Q; Corre, Tanguy; Cousminer, Diana L; Feenstra, Bjarke; Franceschini, Nora; Ganna, Andrea; Johnson, Andrew D; Kjellqvist, Sanela; Lunetta, Kathryn L; McMahon, George; Nolte, Ilja M; Paternoster, Lavinia; Porcu, Eleonora; Smith, Albert V; Stolk, Lisette; Teumer, Alexander; Tšernikova, Natalia; Tikkanen, Emmi; Ulivi, Sheila; Wagner, Erin K; Amin, Najaf; Bierut, Laura J; Byrne, Enda M; Hottenga, Jouke-Jan; Koller, Daniel L; Mangino, Massimo; Pers, Tune H; Yerges-Armstrong, Laura M; Zhao, Jing Hua; Andrulis, Irene L; Anton-Culver, Hoda; Atsma, Femke; Bandinelli, Stefania; Beckmann, Matthias W; Benitez, Javier; Blomqvist, Carl; Bojesen, Stig E; Bolla, Manjeet K; Bonanni, Bernardo; Brauch, Hiltrud; Brenner, Hermann; Buring, Julie E; Chang-Claude, Jenny; Chanock, Stephen; Chen, Jinhui; Chenevix-Trench, Georgia; Collée, J Margriet; Couch, Fergus J; Couper, David; Coveillo, Andrea D; Cox, Angela; Czene, Kamila; D'adamo, Adamo Pio; Smith, George Davey; De Vivo, Immaculata; Demerath, Ellen W; Dennis, Joe; Devilee, Peter; Dieffenbach, Aida K; Dunning, Alison M; Eiriksdottir, Gudny; Eriksson, Johan G; Fasching, Peter A; Ferrucci, Luigi; Flesch-Janys, Dieter; Flyger, Henrik; Foroud, Tatiana; Franke, Lude; Garcia, Melissa E; García-Closas, Montserrat; Geller, Frank; de Geus, Eco Ej; Giles, Graham G; Gudbjartsson, Daniel F; Gudnason, Vilmundur; Guénel, Pascal; Guo, Suiqun; Hall, Per; Hamann, Ute; Haring, Robin; Hartman, Catharina A; Heath, Andrew C; Hofman, Albert; Hooning, Maartje J; Hopper, John L; Hu, Frank B; Hunter, David J; Karasik, David; Kiel, Douglas P; Knight, Julia A; Kosma, Veli-Matti; Kutalik, Zoltan; Lai, Sandra; Lambrechts, Diether; Lindblom, Annika; Mägi, Reedik; Magnusson, Patrik K; Mannermaa, Arto; Martin, Nicholas G; Masson, Gisli; McArdle, Patrick F; McArdle, Wendy L; Melbye, Mads; Michailidou, Kyriaki; Mihailov, Evelin; Milani, Lili; Milne, Roger L; Nevanlinna, Heli; Neven, Patrick; Nohr, Ellen A; Oldehinkel, Albertine J; Oostra, Ben A; Palotie, Aarno; Peacock, Munro; Pedersen, Nancy L; Peterlongo, Paolo; Peto, Julian; Pharoah, Paul Dp; Postma, Dirkje S; Pouta, Anneli; Pylkäs, Katri; Radice, Paolo; Ring, Susan; Rivadeneira, Fernando; Robino, Antonietta; Rose, Lynda M; Rudolph, Anja; Salomaa, Veikko; Sanna, Serena; Schlessinger, David; Schmidt, Marjanka K; Southey, Mellissa C; Sovio, Ulla; Stampfer, Meir J; Stöckl, Doris; Storniolo, Anna M; Timpson, Nicholas J; Tyrer, Jonathan; Visser, Jenny A; Vollenweider, Peter; Völzke, Henry; Waeber, Gerard; Waldenberger, Melanie; Wallaschofski, Henri; Wang, Qin; Willemsen, Gonneke; Winqvist, Robert; Wolffenbuttel, Bruce Hr; Wright, Margaret J; Boomsma, Dorret I; Econs, Michael J; Khaw, Kay-Tee; Loos, Ruth Jf; McCarthy, Mark I; Montgomery, Grant W; Rice, John P; Streeten, Elizabeth A; Thorsteinsdottir, Unnur; van Duijn, Cornelia M; Alizadeh, Behrooz Z; Bergmann, Sven; Boerwinkle, Eric; Boyd, Heather A; Crisponi, Laura; Gasparini, Paolo; Gieger, Christian; Harris, Tamara B; Ingelsson, Erik; Järvelin, Marjo-Riitta; Kraft, Peter; Lawlor, Debbie; Metspalu, Andres; Pennell, Craig E; Ridker, Paul M; Snieder, Harold; Sørensen, Thorkild Ia; Spector, Tim D; Strachan, David P; Uitterlinden, André G; Wareham, Nicholas J; Widen, Elisabeth; Zygmunt, Marek; Murray, Anna; Easton, Douglas F; Stefansson, Kari; Murabito, Joanne M; Ong, Ken K

2014-10-02

Age at menarche is a marker of timing of puberty in females. It varies widely between individuals, is a heritable trait and is associated with risks for obesity, type 2 diabetes, cardiovascular disease, breast cancer and all-cause mortality. Studies of rare human disorders of puberty and animal models point to a complex hypothalamic-pituitary-hormonal regulation, but the mechanisms that determine pubertal timing and underlie its links to disease risk remain unclear. Here, using genome-wide and custom-genotyping arrays in up to 182,416 women of European descent from 57 studies, we found robust evidence (P < 5 × 10(-8)) for 123 signals at 106 genomic loci associated with age at menarche. Many loci were associated with other pubertal traits in both sexes, and there was substantial overlap with genes implicated in body mass index and various diseases, including rare disorders of puberty. Menarche signals were enriched in imprinted regions, with three loci (DLK1-WDR25, MKRN3-MAGEL2 and KCNK9) demonstrating parent-of-origin-specific associations concordant with known parental expression patterns. Pathway analyses implicated nuclear hormone receptors, particularly retinoic acid and γ-aminobutyric acid-B2 receptor signalling, among novel mechanisms that regulate pubertal timing in humans. Our findings suggest a genetic architecture involving at least hundreds of common variants in the coordinated timing of the pubertal transition.

Early Menarche and Menstrual Problems Are Associated with Sleep Disturbance in a Large Sample of Chinese Adolescent Girls.

PubMed

Liu, Xianchen; Chen, Hua; Liu, Zhen-Zhen; Fan, Fang; Jia, Cun-Xian

2017-09-01

Little is known about the association between menstruation and sleep disturbance in adolescent girls. This study examined sleep duration, insomnia symptoms, and sleep quality in relation to age at menarche and menstrual problems in a large sample of Chinese adolescent girls. This report represents the baseline data of an ongoing longitudinal study of the Shandong Adolescent Behavior & Health Cohort in Shandong, China. A total of 5800 girls aged 12-18 years (mean age = 15.0, standard deviation = 1.4) participated in the baseline survey. A structured questionnaire was used to assess participants' age at menarche, menstrual cycle interval, menstrual flow length, period irregularity, period pain, body weight and height, and demographics. Internalizing and externalizing problems were measured by the Youth-Self Report of Child Behavioral Checklist. Sleep duration, insomnia symptoms, and sleep quality were assessed by the items adapted from the Pittsburgh Sleep Quality Index. After adjusting for age, school, body mass index, internalizing and externalizing problems, and family covariates, irregular periods (odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.06-2.02), period pain (OR = 1.99, 95% CI = 1.44-2.76), and menstrual flow length ≥7 days (OR = 1.21, 95% CI = 1.00-1.48) were significantly associated with insomnia symptoms. Irregular periods (OR = 1.72, 95% CI = 1.30-2.27) and period pain (OR = 1.78, 95% CI = 1.34-2.37) were significantly associated with poor sleep quality. Age at menarche ≤11 years (OR = 1.62, 95% CI = 1.05-2.50) was significantly associated with insomnia symptoms in 12- to 14-year-old girls. Our results suggest that irregular periods and period pain appear to be associated with sleep disturbance and that early menarche may have short-term impact on sleep in adolescent girls. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

[A survey of pubertal development in children born with assisted reproductive technology].

PubMed

Liu, Zi-Yuan; Wang, Xin-Li; Han, Tong-Yan; Cui, Yun-Pu; Wang, Xue-Mei; Tong, Xiao-Mei; Song, Yi; Wang, Hai-Jun; Li, Song

2017-06-01

To investigate the status of pubertal development in children born with assisted reproductive technology (ART). A retrospective analysis was performed on the pubertal development data of children born with ART in Peking University Third Hospital from 1994 to 2003 (ART group). The data in the cross-sectional study "Reports on the Physical Fitness and Health Research of Chinese School Students in 2010" were used as a control. The age at menarche and the age at spermarche were compared between the two groups. The status of pubertal development in the overweight and obese children in the ART group was evaluated to investigate the correlation between pubertal development and body mass index (BMI). A total of 200 children born with ART were enrolled in this study, and 72 of them (41 males and 31 females) completed the survey (response rate=36.0%). In the ART group, the mean age at spermarche and the mean age at menarche were 13.9 years (95%CI: 13.7-14.3 years) and 12.2 years (95%CI: 11.8-12.6 years), respectively. There were no significant differences in the age at spermarche and the age at menarche between the ART and control groups (P>0.05). In the ART group, there were no significant differences in the age at spermarche and the age at menarche between the overweight and obese children and the normal weight children (P>0.05). There were also no significant differences in overweight rate and obesity rate between the children in the ART group and the adolescents in Beijing (P>0.05). In the ART group, there was no significant correlation between the age at spermarche or menarche and BMI (P>0.05). No delayed or precocious puberty is observed in children born with ART. This is consistent with the normal control data. And there is no significant correlation between pubertal development and BMI in children born with ART.

Age at menarche and age at natural menopause in East Asian women: a genome-wide association study.

PubMed

Shi, Jiajun; Zhang, Ben; Choi, Ji-Yeob; Gao, Yu-Tang; Li, Huaixing; Lu, Wei; Long, Jirong; Kang, Daehee; Xiang, Yong-Bing; Wen, Wanqing; Park, Sue K; Ye, Xingwang; Noh, Dong-Young; Zheng, Ying; Wang, Yiqin; Chung, Seokang; Lin, Xu; Cai, Qiuyin; Shu, Xiao-Ou

2016-12-01

Age at menarche (AM) and age at natural menopause (ANM) are complex traits with a high heritability. Abnormal timing of menarche or menopause is associated with a reduced span of fertility and risk for several age-related diseases including breast, endometrial and ovarian cancer, cardiovascular disease, and osteoporosis. To identify novel genetic loci for AM or ANM in East Asian women and to replicate previously identified loci primarily in women of European ancestry by genome-wide association studies (GWASs), we conducted a two-stage GWAS. Stage I aimed to discover promising novel AM and ANM loci using GWAS data of 8073 women from Shanghai, China. The Stage II replication study used the data from another Chinese GWAS (n = 1230 for AM and n = 1458 for ANM), a Korean GWAS (n = 4215 for AM and n = 1739 for ANM), and de novo genotyping of 2877 additional Chinese women. Previous GWAS-identified loci for AM and ANM were also evaluated. We identified two suggestive menarcheal age loci tagged by rs79195475 at 10q21.3 (beta = -0.118 years, P = 3.4 × 10 -6 ) and rs1023935 at 4p15.1 (beta = -0.145 years, P = 4.9 × 10 -6 ) and one menopausal age locus tagged by rs3818134 at 22q12.2 (beta = -0.276 years, P = 8.8 × 10 -6 ). These suggestive loci warrant a further validation in independent populations. Although limited by low statistical power, we replicated 19 of the 98 menarche loci and 5 of the 20 menopause loci previously identified in women of European ancestry in East Asian women, suggesting a shared genetic architecture for these two traits across populations.

Insulin resistance, obesity, hypofibrinolysis, hyperandrogenism, and coronary heart disease risk factors in 25 pre-perimenarchal girls age < or =14 years, 13 with precocious puberty, 23 with a first-degree relative with polycystic ovary syndrome.

PubMed

Glueck, Charles J; Morrison, John A; Wang, Ping

2008-10-01

Pre-peri-menarchal diagnosis of polycystic ovary syndrome (PCOS) is important, because intervention with metformin-diet may prevent progression to full blown PCOS. In 25 girls age < or =14 years with probable familial PCOS, 10 pre-, 15 post-menarchal, 13 with precocious puberty, 23 with a first-degree relative with PCOS, we hypothesized that reversible coronary heart disease (CHD) risk factors, insulin resistance, clinical and biochemical hyperandrogenism, and hypofibrinolysis were already established. Fasting measures: insulin, glucose, total, LDL- (LDL-C), and HDL-cholesterol (HDL-C), triglycerides (TG), systolic and diastolic blood pressure (SBP, DBP), plasminogen activator inhibitor activity (PAI-Fx), total (T) and free testosterone (FT), androstenedione, and DHEAS. Clinical and/or biochemical hyperandrogenism was present in all 25 girls, with elevations of T or FT, or androstenedione in seven of ten pre-menarchal girls and in all 15 post-menarche. PAI-Fx was high in 28% of the 25 girls vs 6.5% in age-gender-race matched controls (p = 0.013). Categorized by race-age-specific distributions in 870 schoolgirls, the 25 girls with probable familial PCOS were more likely to have top decile body mass index (BMI), insulin, HOMA-insulin resistance (HOMA-IR), SBP, DBP, and TG, and bottom decile HDL-C. By analysis of variance, adjusting for race, age and BMI, PCOS girls had higher FT and waist circumference than controls, but did not differ for SBP, DBP, HDL-C, or TG (p>0.05). Pre-peri-menarchal acquisition of centripetal obesity amplifies CHD risk factors and hypofibrinolysis in hyperandrogenemic girls with probable familial PCOS and precocious puberty. When schoolgirls become as obese as girls with probable familial PCOS, they acquire the same CHD risk factors, and differ only by lower free T and less centripetal obesity.

Prenatal smoking and age at menarche: influence of the prenatal environment on the timing of puberty.

PubMed

Behie, A M; O'Donnell, M H

2015-04-01

Do prenatal exposure to cigarette smoking and birthweight influence age at menarche (AAM) in a cohort of Australian girls? We find that prenatal smoke exposure and lower birthweight increase the chance of earlier menarche in accordance with theoretical predictions as do confounding factors of maternal AAM and higher BMI of the girls. Much prior research focuses on the role of the early childhood environment in determining AAM but fewer studies consider the role of the prenatal environment. Those studies that examine the prenatal period find an acceleration of maturation associated with maternal smoking and low birthweight. Life history theory predicts that early life exposure to stressful environments should promote more rapid maturation and that this timing can be established before birth, making the prenatal environment particularly important. Statistical analysis of longitudinal survey data collected from a large cohort (n = 2446) of Australian children using data from birth to 12-13 years of age. Owing to missing data, 1493 girls were included in the final analysis. Using cox regression, we examine how (i) maternal cigarette smoking during gestation and (ii) birthweight influence girls' AAM. Cox regression was used because not all girls had reached menarche. We find that older maternal AAM (hazards ratio (HR): 0.75, confidence interval (CI) (95%): 0.71-0.79) and higher birthweight (HR: 0.86, CI (95%): 0.75-0.97) lower the chance of earlier menarche; while higher girls' BMI at 8-9 years (HR: 1.12, CI (95%): 1.10-1.15), and maternal cigarette smoking on 'most days' during gestation (HR: 1.40, CI (95%): 1.10-1.79 with 'no smoking' as the reference level) increased the chance of earlier menarche. All factors were statistically significant at P = 0.05. Not all girls had reached menarche, necessitating the use of cox regression. As with other longitudinal studies, there was study sample attrition and some missing data, particularly in reports of maternal smoking. In addition, as the degree of bias in the missing data is unknown, possible inaccurate reporting of maternal smoking may influence the results of birthweight on AAM. Because of the association between younger AAM and higher risk of uterine, endometrial and breast cancer development, our finding adds to the need to consider the stress caused by prenatal smoke exposure as an important health risk. In addition, this study needs to be extended, when the same girls are 14-15 years of age, and on a larger dataset from a younger cohort within the same Australian Government project. No funding was received for this study and there are no competing interests to declare. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cultural and social practices regarding menstruation among adolescent girls.

PubMed

Kumar, Anant; Srivastava, Kamiya

2011-01-01

The study attempts to find out the existing social and cultural practices regarding menstruation, awareness levels, and the behavioral changes that come about in adolescent girls during menstruation, their perception about menarche, how do they treat it, and the various taboos, norms, and cultural practices associated with menarche. The study was conducted on 117 adolescent girls (age 11-20 years) and 41 mothers from various communities and classes in Ranchi comprising residential colonies and urban slums. The findings unfolds many practices: cultural and social restrictions associated with menstruation, myth, and misconception; the adaptability of the adolescent girls toward it; their reaction, reaction of the family; realization of the importance of menstruation; and the changes that have come in their life after menarche and their resistance to such changes. The article also suggests the strategies to improve menstrual health and hygiene among adolescent girls. The study concludes that cultural and social practices regarding menstruation depend on girls' education, attitude, family environment, culture, and belief.

Other-Sex Relationship Stress and Sex Differences in the Contribution of Puberty to Depression

PubMed Central

Llewellyn, Nicole; Rudolph, Karen D.; Roisman, Glenn I.

2015-01-01

Research suggests that the pubertal transition, particularly when experienced earlier than age-matched peers, is associated with heightened depression in girls but less depression in boys. This study examined whether stress within other-sex relationships serves as one process through which puberty differentially contributes to depression for girls and boys. Youth (51 girls, 34 boys; M age = 12.68) and their caregivers reported on pubertal status and age of menarche. Semistructured interviews were conducted to assess youths’ depression and exposure to chronic other-sex stress. As anticipated, more advanced status and earlier timing were associated with more depression in girls and less depression in boys. More advanced status and earlier timing were associated with less other-sex stress in boys; earlier age of menarche was associated with more other-sex stress in girls. Other-sex stress partially mediated the early menarche-depression association in girls, suggesting one process through which puberty promotes risk for depression in girls. PMID:26778876

Genome-Wide Copy Number Variation Association Analyses for Age at Menarche

PubMed Central

Li, Jian; Pan, Rong; Shen, Hui; Tian, Qing; Zhou, Yu; Liu, Yong-Jun

2012-01-01

Context: Menarche is a significant physiological event for women. Age at menarche (AAM) is a heritable trait associated with many common female diseases. The genetic basis and the mechanism for AAM are largely unknown. Copy number variation (CNV) is a common type of genetic variation underlying human complex traits. The importance of CNV to AAM variation is unclear. Objective: The objective of the study was to identify CNV important to AAM variation. Design: We performed the first genome-wide CNV study of AAM in 1654 Caucasian females using Affymetrix human single-nucleotide polymorphism 6.0 array. We also replicated our findings in another Chinese cohort containing 752 women. Results: We identified a CNV, variation_38399, in the 2q14.2 region, for association with AAM (P = 1.03 × 10−3). The CNV has two variants (one copy and two copy), with a mean AAM of 14.00 yr and 12.90 yr, respectively. Interestingly, in a Chinese sample containing 752 women, this CNV has been replicated both with a marginally significant P = 0.090 and with a same direction of effect (a lower copy number for a later AAM). The CNV is located approximately 75 kb upstream of the diazepam binding inhibitor (DBI), a gene known to regulate estrogen levels, a key factor for menarche. Conclusion: Our findings for the first time identified a novel CNV and suggested the DBI-mediated endocrinological pathway as a potential mechanism for AAM regulation. PMID:22904172

Socioeconomic development and secular trend in height in China.

PubMed

Zong, Xin-Nan; Li, Hui; Wu, Hua-Hong; Zhang, Ya-Qin

2015-12-01

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. Copyright © 2015 Elsevier B.V. All rights reserved.

Bone mass and lifestyle related factors: a comparative study between Japanese and Inner Mongolian young premenopausal women.

PubMed

Zhang, M; Shimmura, T; Bi, L F; Nagase, H; Nishino, H; Kajita, E; Eto, M; Wang, H B; Su, X L; Chang, H; Aratani, T; Kagamimori, S

2004-07-01

The purpose of this study was to evaluate the ethnic difference in bone mass between Japanese and Inner Mongolian young premenopausal women and to assess the contribution of lifestyle related and anthropometric factors to bone mass. We studied 33 Japanese and 44 Inner Mongolian healthy young women, aged 20-34 years, in urban area. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI) were measured at the calcaneus using quantitative ultrasound (QUS) analysis. Age at menarche, regularity of menstruation and lifestyle related factors were estimated by a self-reported questionnaire. There were no differences between the two groups in age, height, weight, BMI, regularity of menstruation, frequency of meat intake, frequency of yellow-green vegetable intake and exercise habit. Japanese women had significantly lower age at menarche and higher proportion of milk consumption habit at junior high school, senior school and present. Before adjustment, Japanese women had significantly higher SOS and SI than Inner Mongolian women. However, after adjustment for age at menarche and milk consumption habit at junior high school, both of which were significantly different between groups, no group-differences remained in either SOS or SI. These results suggest that the differences in age at menarche and milk consumption habit at junior high school, which relate to hormonal and nutritional status during puberty, may account for the differences in bone mass between Japanese and Inner Mongolian young women.

[Survey on menopausal age and menstruation span in women in Pudong district of Shanghai].

PubMed

Chen, Hua; Feng, You-ji; Shu, Hui-min; Lu, Tian-mei; Zhu, Hong-mei; Yang, Bin-lie; Xiong, Miao

2010-06-01

To investigate natural spontaneous menopausal age, menstruation span and their relationship with menarche age and parity in Pudong district of Shanghai. From Jan 2007 to Jul 2008, 15 083 spontaneous menopause women undergoing cervical cancer screening were enrolled in this study. The questionnaire included menarche age, parity, spontaneous menopausal age and menstruation span. Those women were divided into four groups based on age, which were group of 56 - 60, 61 - 65, 66 - 70 and more than 70.Analysis of variance (ANOVA) was used for comparing difference between menopausal age and menstruation span. Multiple factor regressions was used to analyze the relationship between menarche age, parity and menopausal age and menstruation span. (1) Spontaneous menopausal age: the minimum was 29 years old, the maximum was 61 years old, and the mean age was (50.6 ± 3.7) years old. The mean spontaneous menopause age were (50.9 ± 3.4), (50.7 ± 3.7), (50.0 ± 4.1), (49.6 ± 4.0) years in groups of 56 - 60, 61 - 65, 66 - 70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menopausal age were observed, which the difference of 1.36 year was shown between groups of 56 - 60 and more than 70 years. (2) Menstruation span: the mean of menstruation span was (34.3 ± 4.1) years, which the minimal age of 12 years and maximal age of 48 years were recorded. (34.6 ± 3.8), (34.3 ± 4.1), (33.9 ± 4.6), (33.2 ± 4.5) were observed in groups of 56 - 60, 61 - 65, 66 - 70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menstruation span were observed, which the difference of 1.41 year was shown between groups of 56 - 60 and more than 70 years. (3) The impact of menarche age on menopausal age and menstruation span: there was no correlation between menarche age and menopausal age (r = 0.02); however, menstruation span was found to be negatively correlated with the menarche age (r = -0.43). (4) The impact of parity on menopausal age and menstruation span: the mean menopausal age of women who had 1 - 2 deliveries was significantly higher than those had no delivery or more than 3 deliveries (P < 0.05). However, there was no difference in menopausal age between women with 1 and 2 deliveries or between women without delivery and more than 3 deliveries (P > 0.05). Menstruation span of women with 1 delivery was significantly longer that those with more than 1 delivery (P < 0.05), similarly, women with 2 deliveries had longer menstruation span than women without delivery or more than 3 deliveries (P < 0.05). There were no difference in menstruation span between women with more than 3 deliveries and without delivery (P > 0.05). (5) Multifactor regression analysis for menstruation span: menarche age was correlated with menstruation span negatively (r = -0.97, P < 0.001). There was significantly different menstruation span between group of 61 - 65, 66 - 70 or more than 70 years and group of 56 - 60 (r = -0.18, P = 0.020; r = -0.78, P < 0.001 and r = -1.23, P < 0.001). Menstruation span in women with 1 - 2 deliveries was significantly longer than that of women without delivery or more than 3 deliveries. (6) Multifactor logistic analysis of menopausal age: there was no association between menarche age and menopausal age, however, significant differences were found in mean menopausal age between different groups, which show that menopausal age of group 56 - 60 years was significant higher than the other groups, including age-group 61 - 65 years, 66 - 70 years and over 70 years (r = -0.18, P = 0.020; r = -0.78, P < 0.001; r = -1.23, P < 0.001). Menopausal age in women with 1 - 2 deliveries was significantly higher than those of women without delivery or with more than 3 deliveries, however, no difference between women with 1 and 2 deliveries or between women without deliveries and more than 3 deliveries was observed. (1) Menopausal age and menstruation span exhibited increasing trends in Pudong district of Shanghai. (2) Menarche age and parity were the important factors influencing menopausal age and menstruation span. (3) With younger age of menarche, the menstruation span become longer.(4) Deliveries of 1 - 2 times can significantly delay the menopause and prolong menstruation span, however, the multiple deliveries (≥ 3 times) had no significant impact on menopausal age and menstruation span.

Site-specific, adult bone benefits attributed to loading during youth: A preliminary longitudinal analysis.

PubMed

Scerpella, Tamara A; Bernardoni, Brittney; Wang, Sijian; Rathouz, Paul J; Li, Quefeng; Dowthwaite, Jodi N

2016-04-01

We examined site-specific bone development in relation to childhood and adolescent artistic gymnastics exposure, comparing up to 10years of prospectively acquired longitudinal data in 44 subjects, including 31 non-gymnasts (NON) and 13 gymnasts (GYM) who participated in gymnastics from pre-menarche to ≥1.9years post-menarche. Subjects underwent annual regional and whole-body DXA scans; indices of bone geometry and strength were calculated. Anthropometrics, physical activity, and maturity were assessed annually, coincident with DXA scans. Non-linear mixed effect models centered growth in bone outcomes at menarche and adjusted for menarcheal age, height, and non-bone fat-free mass to evaluate GYM-NON differences. A POST-QUIT variable assessed the withdrawal effect of quitting gymnastics. Curves for bone area, mass (BMC), and strength indices were higher in GYM than NON at both distal radius metaphysis and diaphysis (p<0.0001). At the femoral neck, greater GYM BMC (p<0.01), narrower GYM endosteal diameter (p<0.02), and similar periosteal width (p=0.09) yielded GYM advantages in narrow neck cortical thickness and buckling ratio (both p<0.001; lower BR indicates lower fracture risk). Lumbar spine and sub-head BMC were greater in GYM than NON (p<0.036). Following gymnastics cessation, GYM slopes increased for distal radius diaphysis parameters (p≤0.01) and for narrow neck BR (p=0.02). At the distal radius metaphysis, GYM BMC and compressive strength slopes decreased, as did slopes for lumbar spine BMC, femoral neck BMC, and narrow neck cortical thickness (p<0.02). In conclusion, advantages in bone mass, geometry, and strength at multiple skeletal sites were noted across growth and into young adulthood in girls who participated in gymnastics loading to at least 1.9years post-menarche. Following gymnastics cessation, advantages at cortical bone sites improved or stabilized, while advantages at corticocancellous sites stabilized or diminished. Additional longitudinal observation is necessary to determine whether residual loading benefits enhance lifelong skeletal strength. Copyright © 2016 Elsevier Inc. All rights reserved.

Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies

PubMed Central

2012-01-01

Summary Background Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected women. Methods Individual data from 117 epidemiological studies, including 118 964 women with invasive breast cancer and 306 091 without the disease, none of whom had used menopausal hormone therapy, were included in the analyses. We calculated adjusted relative risks (RRs) associated with menarche and menopause for breast cancer overall, and by tumour histology and by oestrogen receptor expression. Findings Breast cancer risk increased by a factor of 1·050 (95% CI 1·044–1·057; p<0·0001) for every year younger at menarche, and independently by a smaller amount (1·029, 1·025–1·032; p<0·0001), for every year older at menopause. Premenopausal women had a greater risk of breast cancer than postmenopausal women of an identical age (RR at age 45–54 years 1·43, 1·33–1·52, p<0·001). All three of these associations were attenuated by increasing adiposity among postmenopausal women, but did not vary materially by women's year of birth, ethnic origin, childbearing history, smoking, alcohol consumption, or hormonal contraceptive use. All three associations were stronger for lobular than for ductal tumours (p<0·006 for each comparison). The effect of menopause in women of an identical age and trends by age at menopause were stronger for oestrogen receptor-positive disease than for oestrogen receptor-negative disease (p<0·01 for both comparisons). Interpretation The effects of menarche and menopause on breast cancer risk might not be acting merely by lengthening women's total number of reproductive years. Endogenous ovarian hormones are more relevant for oestrogen receptor-positive disease than for oestrogen receptor-negative disease and for lobular than for ductal tumours. Funding Cancer Research UK. PMID:23084519

Pubertal timing and adult obesity and cardiometabolic risk in women and men: a systematic review and meta-analysis.

PubMed

Prentice, P; Viner, R M

2013-08-01

Obesity has complex multifactorial aetiology. It has been suggested by many, but not all, reports that earlier pubertal maturation may increase adult obesity risk. We conducted a systemic review and meta-analysis in both women and men, and hypothesised that any association between pubertal timing and adult obesity is likely to be confounded by childhood adiposity. In addition, we investigated whether pubertal timing is related to other cardiometabolic risk and long-term cardiovascular morbidity/mortality. Literature search was undertaken using MEDLINE, EMBASE, Web of Knowledge and TRIP databases, with a hand search of references. Both authors independently reviewed and extracted pre-defined data from all selected papers. Meta-analyses were conducted using Review Manager (RevMan) 5.0.24. A total of 48 papers were identified. Out of 34 studies, 30 reported an inverse relationship between pubertal timing and adult body mass index (BMI), the main adiposity measure used. Meta-analysis of 10 cohorts showed association between early menarche (menarche <12 vs ≥12 years) and increased adult BMI, with a standardised mean difference of 0.34 kg m(-2) (95% confidence interval: 0.33-0.34). Heterogeneity was large (I(2)=92%) but reduced significantly when grouped by outcome age. Late menarche (menarche ≥15 vs <15 years) was associated with decreased adult BMI, with a standardised mean difference of -0.26 kg m(-2) (95% confidence interval: -0.36, -0.21) (seven cohorts). Only eight papers included data on childhood BMI; the majority reported that childhood BMI only partially attenuated association between early menarche and later obesity. Although not suitable for meta-analysis, data on cardiometabolic risk factors and puberty suggested negative association between earlier pubertal timing and cardiovascular mortality, hypertension, metabolic syndrome (MetS) and abnormal glycaemia. Earlier pubertal timing is predictive of higher adult BMI and greater risk of obesity. This effect appears to be partially independent of childhood BMI. Earlier pubertal development appears to also be inversely correlated with risk of other cardiometabolic risk factors and cardiovascular mortality. Further work is needed to examine potential mechanisms and the level at which interventions may be targeted.

Menarche, menopause, years of menstruation, and the incidence of osteoporosis: the influence of prenatal exposure to diethylstilbestrol.

PubMed

Parker, Samantha E; Troisi, Rebecca; Wise, Lauren A; Palmer, Julie R; Titus-Ernstoff, Linda; Strohsnitter, William C; Hatch, Elizabeth E

2014-02-01

Estrogen is critical for bone formation and growth in women. Estrogen exposures occur throughout life, including prenatally, and change with reproductive events, such as menarche and menopause. The objective of this study was to investigate the association between age at menarche, age at menopause, and years of menstruation with incidence of osteoporosis and assess the impact of prenatal exposure to diethylstilbestrol (DES), a synthetic estrogen, on such associations. Participants were 5573 women in the National Cancer Institute Combined Cohort Study of DES (1994-2006). Data on reproductive history and medical conditions were collected through questionnaires at baseline in 1994 and subsequently in 1997, 2001, and 2006. Age-stratified Cox regression models were used to calculate multivariable incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Effect measure modification by prenatal DES exposure was assessed using cubic restricted spline regression models. Osteoporosis was the main outcome measure. The IRRs for osteoporosis incidence with age at menarche less than 11 years and age at menopause of 50 years or younger were 0.82 (CI 0.59, 1.14) and 0.61 (CI 0.40, 0.92), respectively. Fewer than 25 years of menstruation was associated with an increased incidence of osteoporosis (IRR 1.80; CI 1.14, 2.86) compared with 35 years or more of menstruation. Associations were stronger among women who had not been prenatally exposed to DES. Our data support the hypothesis that lifetime cumulative exposure to estrogens is protective against osteoporosis. Furthermore, prenatal exposure to estrogen appears to modify these associations, although the mechanism by which this occurs is unknown.

[Analysis of characteristics and influence factors of diagnostic delay of endometriosis].

PubMed

Han, X T; Guo, H Y; Kong, D L; Han, J S; Zhang, L F

2018-02-25

Objective: To access the influence factors of diagnostic delay of endometriosis. Methods: We designed a questionnaire of diagnostic delay of endometriosis. From February 2014 to February 2016, 400 patients who had dysmenorrhea and diagnosed with endometriosis by surgery in Peking University Third Hospital were surveyed retrospectively. Time and risk factors of diagnostic delay were analyzed. Results: The diagnostic delay of 400 patients was 13.0 years (0.2-43.0 years), 78.5%(314/400) patients thought pain was a normal phenomenon and didn't see the doctor. Patients who suffered dysmenorrhea at menarche experienced longer diagnostic delay than those who had dysmenorrhea after menarche (18.0 vs 4.5 years; Z= 191.800, P< 0.01) . Patients who suffered aggravating dysmenorrhea experienced shorter delay time than those who suffered stable or relieving dysmenorrhea (11.0 vs 12.5 vs 18.0 years; Z= 8.270, P< 0.05) , with the difference statistically significant, single factor analysis shows. Severe dysmenorrhea, deep infiltration endometriosis (DIE) , family history of dysmenorrhea or endometriosis, previous surgical history of endometriosis, high stage, with infertility, adenomyoma or other symptoms, could help to shorten diagnostic delay with no significant difference ( P> 0.05) . By multiple logistic regression analysis, the results shown that whether have dysmenorrhea at menarche and clinical diagnosis time were the independent factors affecting delayed diagnosis ( P< 0.01) . Conclusions: Diagnostic delay of endometriosis is common and the mean delay time is 13.0 years mainly due to the unawareness of dysmenorrhea. Dysmenorrhea at menarche, clinical diagnosis time and dysmenorrhea intensity are the factors affecting time of diagnostic delay.

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

PubMed

Nwokocha, Ada R C; Chinawa, Josephat M; Ubesie, Agozie C; Onukwuli, Vivian I; Manyike, Pius C

2016-03-01

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.

Genomic analyses identify hundreds of variants associated with age at menarche and support a role for puberty timing in cancer risk.

PubMed

Day, Felix R; Thompson, Deborah J; Helgason, Hannes; Chasman, Daniel I; Finucane, Hilary; Sulem, Patrick; Ruth, Katherine S; Whalen, Sean; Sarkar, Abhishek K; Albrecht, Eva; Altmaier, Elisabeth; Amini, Marzyeh; Barbieri, Caterina M; Boutin, Thibaud; Campbell, Archie; Demerath, Ellen; Giri, Ayush; He, Chunyan; Hottenga, Jouke J; Karlsson, Robert; Kolcic, Ivana; Loh, Po-Ru; Lunetta, Kathryn L; Mangino, Massimo; Marco, Brumat; McMahon, George; Medland, Sarah E; Nolte, Ilja M; Noordam, Raymond; Nutile, Teresa; Paternoster, Lavinia; Perjakova, Natalia; Porcu, Eleonora; Rose, Lynda M; Schraut, Katharina E; Segrè, Ayellet V; Smith, Albert V; Stolk, Lisette; Teumer, Alexander; Andrulis, Irene L; Bandinelli, Stefania; Beckmann, Matthias W; Benitez, Javier; Bergmann, Sven; Bochud, Murielle; Boerwinkle, Eric; Bojesen, Stig E; Bolla, Manjeet K; Brand, Judith S; Brauch, Hiltrud; Brenner, Hermann; Broer, Linda; Brüning, Thomas; Buring, Julie E; Campbell, Harry; Catamo, Eulalia; Chanock, Stephen; Chenevix-Trench, Georgia; Corre, Tanguy; Couch, Fergus J; Cousminer, Diana L; Cox, Angela; Crisponi, Laura; Czene, Kamila; Davey Smith, George; de Geus, Eco J C N; de Mutsert, Renée; De Vivo, Immaculata; Dennis, Joe; Devilee, Peter; Dos-Santos-Silva, Isabel; Dunning, Alison M; Eriksson, Johan G; Fasching, Peter A; Fernández-Rhodes, Lindsay; Ferrucci, Luigi; Flesch-Janys, Dieter; Franke, Lude; Gabrielson, Marike; Gandin, Ilaria; Giles, Graham G; Grallert, Harald; Gudbjartsson, Daniel F; Guénel, Pascal; Hall, Per; Hallberg, Emily; Hamann, Ute; Harris, Tamara B; Hartman, Catharina A; Heiss, Gerardo; Hooning, Maartje J; Hopper, John L; Hu, Frank; Hunter, David J; Ikram, M Arfan; Im, Hae Kyung; Järvelin, Marjo-Riitta; Joshi, Peter K; Karasik, David; Kellis, Manolis; Kutalik, Zoltan; LaChance, Genevieve; Lambrechts, Diether; Langenberg, Claudia; Launer, Lenore J; Laven, Joop S E; Lenarduzzi, Stefania; Li, Jingmei; Lind, Penelope A; Lindstrom, Sara; Liu, YongMei; Luan, Jian'an; Mägi, Reedik; Mannermaa, Arto; Mbarek, Hamdi; McCarthy, Mark I; Meisinger, Christa; Meitinger, Thomas; Menni, Cristina; Metspalu, Andres; Michailidou, Kyriaki; Milani, Lili; Milne, Roger L; Montgomery, Grant W; Mulligan, Anna M; Nalls, Mike A; Navarro, Pau; Nevanlinna, Heli; Nyholt, Dale R; Oldehinkel, Albertine J; O'Mara, Tracy A; Padmanabhan, Sandosh; Palotie, Aarno; Pedersen, Nancy; Peters, Annette; Peto, Julian; Pharoah, Paul D P; Pouta, Anneli; Radice, Paolo; Rahman, Iffat; Ring, Susan M; Robino, Antonietta; Rosendaal, Frits R; Rudan, Igor; Rueedi, Rico; Ruggiero, Daniela; Sala, Cinzia F; Schmidt, Marjanka K; Scott, Robert A; Shah, Mitul; Sorice, Rossella; Southey, Melissa C; Sovio, Ulla; Stampfer, Meir; Steri, Maristella; Strauch, Konstantin; Tanaka, Toshiko; Tikkanen, Emmi; Timpson, Nicholas J; Traglia, Michela; Truong, Thérèse; Tyrer, Jonathan P; Uitterlinden, André G; Edwards, Digna R Velez; Vitart, Veronique; Völker, Uwe; Vollenweider, Peter; Wang, Qin; Widen, Elisabeth; van Dijk, Ko Willems; Willemsen, Gonneke; Winqvist, Robert; Wolffenbuttel, Bruce H R; Zhao, Jing Hua; Zoledziewska, Magdalena; Zygmunt, Marek; Alizadeh, Behrooz Z; Boomsma, Dorret I; Ciullo, Marina; Cucca, Francesco; Esko, Tõnu; Franceschini, Nora; Gieger, Christian; Gudnason, Vilmundur; Hayward, Caroline; Kraft, Peter; Lawlor, Debbie A; Magnusson, Patrik K E; Martin, Nicholas G; Mook-Kanamori, Dennis O; Nohr, Ellen A; Polasek, Ozren; Porteous, David; Price, Alkes L; Ridker, Paul M; Snieder, Harold; Spector, Tim D; Stöckl, Doris; Toniolo, Daniela; Ulivi, Sheila; Visser, Jenny A; Völzke, Henry; Wareham, Nicholas J; Wilson, James F; Spurdle, Amanda B; Thorsteindottir, Unnur; Pollard, Katherine S; Easton, Douglas F; Tung, Joyce Y; Chang-Claude, Jenny; Hinds, David; Murray, Anna; Murabito, Joanne M; Stefansson, Kari; Ong, Ken K; Perry, John R B

2017-06-01

The timing of puberty is a highly polygenic childhood trait that is epidemiologically associated with various adult diseases. Using 1000 Genomes Project-imputed genotype data in up to ∼370,000 women, we identify 389 independent signals (P < 5 × 10 -8 ) for age at menarche, a milestone in female pubertal development. In Icelandic data, these signals explain ∼7.4% of the population variance in age at menarche, corresponding to ∼25% of the estimated heritability. We implicate ∼250 genes via coding variation or associated expression, demonstrating significant enrichment in neural tissues. Rare variants near the imprinted genes MKRN3 and DLK1 were identified, exhibiting large effects when paternally inherited. Mendelian randomization analyses suggest causal inverse associations, independent of body mass index (BMI), between puberty timing and risks for breast and endometrial cancers in women and prostate cancer in men. In aggregate, our findings highlight the complexity of the genetic regulation of puberty timing and support causal links with cancer susceptibility.

Genomic analyses identify hundreds of variants associated with age at menarche and support a role for puberty timing in cancer risk

PubMed Central

Day, Felix R; Thompson, Deborah J; Helgason, Hannes; Chasman, Daniel I; Finucane, Hilary; Sulem, Patrick; Ruth, Katherine S; Whalen, Sean; Sarkar, Abhishek K; Albrecht, Eva; Altmaier, Elisabeth; Amini, Marzyeh; Barbieri, Caterina M; Boutin, Thibaud; Campbell, Archie; Demerath, Ellen; Giri, Ayush; He, Chunyan; Hottenga, Jouke J; Karlsson, Robert; Kolcic, Ivana; Loh, Po-Ru; Lunetta, Kathryn L; Mangino, Massimo; Marco, Brumat; McMahon, George; Medland, Sarah E; Nolte, Ilja M; Noordam, Raymond; Nutile, Teresa; Paternoster, Lavinia; Perjakova, Natalia; Porcu, Eleonora; Rose, Lynda M; Schraut, Katharina E; Segrè, Ayellet V; Smith, Albert V; Stolk, Lisette; Teumer, Alexander; Andrulis, Irene L; Bandinelli, Stefania; Beckmann, Matthias W; Benitez, Javier; Bergmann, Sven; Bochud, Murielle; Boerwinkle, Eric; Bojesen, Stig E; Bolla, Manjeet K; Brand, Judith S; Brauch, Hiltrud; Brenner, Hermann; Broer, Linda; Brüning, Thomas; Buring, Julie E; Campbell, Harry; Catamo, Eulalia; Chanock, Stephen; Chenevix-Trench, Georgia; Corre, Tanguy; Couch, Fergus J; Cousminer, Diana L; Cox, Angela; Crisponi, Laura; Czene, Kamila; Smith, George Davey; de Geus, Eco JCN; de Mutsert, Renée; De Vivo, Immaculata; Dennis, Joe; Devilee, Peter; dos-Santos-Silva, Isabel; Dunning, Alison M; Eriksson, Johan G; Fasching, Peter A; Fernández-Rhodes, Lindsay; Ferrucci, Luigi; Flesch-Janys, Dieter; Franke, Lude; Gabrielson, Marike; Gandin, Ilaria; Giles, Graham G; Grallert, Harald; Gudbjartsson, Daniel F; Guénel, Pascal; Hall, Per; Hallberg, Emily; Hamann, Ute; Harris, Tamara B; Hartman, Catharina A; Heiss, Gerardo; Hooning, Maartje J; Hopper, John L; Hu, Frank; Hunter, David J; Ikram, M Arfan; Im, Hae Kyung; Järvelin, Marjo-Riitta; Joshi, Peter K; Karasik, David; Kellis, Manolis; Kutalik, Zoltan; LaChance, Genevieve; Lambrechts, Diether; Langenberg, Claudia; Launer, Lenore J; Laven, Joop S E; Lenarduzzi, Stefania; Li, Jingmei; Lind, Penelope A; Lindstrom, Sara; Liu, YongMei; Luan, Jian’an; Mägi, Reedik; Mannermaa, Arto; Mbarek, Hamdi; McCarthy, Mark I; Meisinger, Christa; Meitinger, Thomas; Menni, Cristina; Metspalu, Andres; Michailidou, Kyriaki; Milani, Lili; Milne, Roger L; Montgomery, Grant W; Mulligan, Anna M; Nalls, Mike A; Navarro, Pau; Nevanlinna, Heli; Nyholt, Dale R; Oldehinkel, Albertine J; O’Mara, Tracy A; Padmanabhan, Sandosh; Palotie, Aarno; Pedersen, Nancy; Peters, Annette; Peto, Julian; Pharoah, Paul D P; Pouta, Anneli; Radice, Paolo; Rahman, Iffat; Ring, Susan M; Robino, Antonietta; Rosendaal, Frits R; Rudan, Igor; Rueedi, Rico; Ruggiero, Daniela; Sala, Cinzia F; Schmidt, Marjanka K; Scott, Robert A; Shah, Mitul; Sorice, Rossella; Southey, Melissa C; Sovio, Ulla; Stampfer, Meir; Steri, Maristella; Strauch, Konstantin; Tanaka, Toshiko; Tikkanen, Emmi; Timpson, Nicholas J; Traglia, Michela; Truong, Thérèse; Tyrer, Jonathan P; Uitterlinden, André G; Velez Edwards, Digna R; Vitart, Veronique; Völker, Uwe; Vollenweider, Peter; Wang, Qin; Widen, Elisabeth; van Dijk, Ko Willems; Willemsen, Gonneke; Winqvist, Robert; Wolffenbuttel, Bruce H R; Zhao, Jing Hua; Zoledziewska, Magdalena; Zygmunt, Marek; Alizadeh, Behrooz Z; Boomsma, Dorret I; Ciullo, Marina; Cucca, Francesco; Esko, Tõnu; Franceschini, Nora; Gieger, Christian; Gudnason, Vilmundur; Hayward, Caroline; Kraft, Peter; Lawlor, Debbie A; Magnusson, Patrik K E; Martin, Nicholas G; Mook-Kanamori, Dennis O; Nohr, Ellen A; Polasek, Ozren; Porteous, David; Price, Alkes L; Ridker, Paul M; Snieder, Harold; Spector, Tim D; Stöckl, Doris; Toniolo, Daniela; Ulivi, Sheila; Visser, Jenny A; Völzke, Henry; Wareham, Nicholas J; Wilson, James F; Spurdle, Amanda B; Thorsteindottir, Unnur; Pollard, Katherine S; Easton, Douglas F; Tung, Joyce Y; Chang-Claude, Jenny; Hinds, David; Murray, Anna; Murabito, Joanne M; Stefansson, Kari; Ong, Ken K; Perry, John R B

2018-01-01

The timing of puberty is a highly polygenic childhood trait that is epidemiologically associated with various adult diseases. Using 1000 Genomes Project–imputed genotype data in up to ~370,000 women, we identify 389 independent signals (P < 5 × 10−8) for age at menarche, a milestone in female pubertal development. In Icelandic data, these signals explain ~7.4% of the population variance in age at menarche, corresponding to ~25% of the estimated heritability. We implicate ~250 genes via coding variation or associated expression, demonstrating significant enrichment in neural tissues. Rare variants near the imprinted genes MKRN3 and DLK1 were identified, exhibiting large effects when paternally inherited. Mendelian randomization analyses suggest causal inverse associations, independent of body mass index (BMI), between puberty timing and risks for breast and endometrial cancers in women and prostate cancer in men. In aggregate, our findings highlight the complexity of the genetic regulation of puberty timing and support causal links with cancer susceptibility. PMID:28436984

Age at menarche and digit ratio (2D:4D): relationships with body dissatisfaction, drive for thinness, and bulimia symptoms in women.

PubMed

Oinonen, Kirsten A; Bird, Jessica L

2012-03-01

This study examined the hypothesis that lower prenatal androgen exposure and earlier puberty are associated with more dysfunctional eating attitudes and behaviors. Relationships between both age at menarche (AAM) and 2D:4D (a marker of prenatal androgen exposure), and EDI-2-Body Dissatisfaction, EDI-2-Drive for Thinness, and EDI-2-Bulimia scores, were examined in women using correlations and regressions. Earlier menarche was associated with higher drive for thinness after controlling for BMI and negative affect, but only in women who were not exclusively heterosexual. Higher 2D:4D was associated with higher Bulimia and Body Dissatisfaction scores, but only in exclusively heterosexual women, and relationships disappeared when covariates were controlled. Later AAM and higher 2D:4D were unique predictors of higher Bulimia scores for exclusive heterosexuals when BMI was controlled. These findings suggest future research should examine sexual orientation as a mediator or moderator of prenatal and postnatal organizational hormonal effects on women's disordered eating attitudes and behaviors. Copyright © 2011 Elsevier Ltd. All rights reserved.

Polycystic ovary syndrome and intervening factors in adolescents from 15 to 18 years old.

PubMed

Faria, Franciane Rocha de; Gusmão, Laís Silveira; Faria, Eliane Rodrigues de; Gonçalves, Vivian Siqueira Santos; Cecon, Roberta Stofeles; Franceschini, Sylvia do Carmo Castro; Priore, Silvia Eloiza

2013-01-01

To assess the factors related to the presence of polycystic ovary syndrome (PCOS) in adolescents. This was a cross-sectional study, with female adolescents from 15 to 18 years old, divided into: group 1 (with a medical diagnosis of PCOS) and group 2 (not diagnosed with PCOS). The height-for-age index and the body mass index were used for classifying the nutritional status, and a semi-structured questionnaire was applied. The Mann-Whitney test, Fisher's exact test, Spearman correlation coefficients, and logistic regression were used. This study evaluated 485 adolescents with an average age of 16.3 ± 0.9 years old. The prevalence of PCOS was 6.2%. No difference was found between the groups regarding anthropometric parameters and period of contraceptive use; however, there were differences regarding the age at menarche (p < 0.004). Older age at menarche was a protection factor against the syndrome. An association was found between younger age at menarche and the development of the PCOS in adolescents. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

Influence of obesity on timing of puberty.

PubMed

Biro, Frank M; Khoury, Philip; Morrison, John A

2006-02-01

Timing of normal pubertal maturation has received increased attention over the past several years. Age of menarche showed a dramatic decrease in the first half of the 20th century in Western nations; since 1960, the decrease in age of menarche has slowed and, in some societies, has actually increased. More recently, age of onset of pubertal maturation appears to have decreased, especially in girls. Multiple studies have demonstrated that childhood levels of obesity and ponderosity are associated with earlier menarche in girls. Earlier maturation in boys, however, is associated with lower adiposity and ponderosity. Secular changes in the United States as well as around the world have noted increases in prevalence as well as extent of overweight. Factors contributing to these changes include increases in calories and fast food consumption, decreases in physical activity, and increases in television viewing. There appear to have been selective advantages to lower metabolic rate (the 'thrifty' gene hypothesis), and earlier maturation. However, changes in caloric consumption, caloric density and physical activity, combined with greater lifespan, may allow expression of the adverse consequences of these adaptations, such as the metabolic syndrome or cancers.

[Menarche, menstrual and sociodemographic characteristics of Puerto Rican female athletes in the XV and XVI Central American and Caribbean Games].

PubMed

Rivera, M A; Mendez Zamora, I; Matos, R M; Rivera, A

1993-09-01

This investigation described maturation, menstrual and socio-demographic characteristics of 65 Puerto Rican women athletes that were interviewed during the XVI Central American and Caribbean Games (CACG), Mexico City in 1990. The results were compared with those of Puerto Rican women athletes (n = 52) at the XV CACG, Santiago Dominican Republic, 1986. The quantitative variables (age, age at initiation of training, years of training, age at menarche, birth order, and family size) were not statistically different (t-independent, p > or = 0.05). The observed frequencies for the qualitative variables (menstrual characteristics, degree of certainty in the recall of age of menarche, use of oral contraceptives, and marital status) were very similar. the women at the XVI CAC in Mexico demonstrated similar maturational, menstrual and socio-demographic characteristics to the those athletes evaluated four years earlier in Santiago and based on their long history of training, both samples were representative of athletically mature athletes. The findings were very similar to those reported for olympic athletes and such data expands the available information on Puerto Rican women athletes.

Epidemiology of Uterine Fibroids – From Menarche to Menopause

PubMed Central

Wise, Lauren A.; Laughlin-Tommaso, Shannon K.

2015-01-01

Uterine leiomyomata (UL) have a substantial impact on women's health, but relatively few studies have identified opportunities for primary prevention of these neoplasms. Most established risk factors are not modifiable, including premenopausal age, African ancestry, age at menarche, and childbearing history. The main challenge in studying UL is that a large proportion of tumors are asymptomatic. Herein, we review the epidemiology of UL from published studies to date. We highlight the advantages of ultrasound screening studies and the ways in which their innovative methods have helped clarify the etiology of disease. We conclude with a discussion of promising new hypotheses. PMID:26744813

Risk factors for adenomyosis, leiomyoma and concurrent adenomyosis and leiomyoma.

PubMed

Güzel, Ali İrfan; Akselim, Burak; Erkılınç, Selçuk; Kokanalı, Kuntay; Tokmak, Aytekin; Dolmuş, Başar; Doğanay, Melike

2015-06-01

To evaluate the risk factors for adenomyosis, leiomyoma and concomitant adenomyosis and leiomyoma in patients with treatment-resistant menometrorrhagia. A retrospective study was conducted on 129 women who underwent abdominal hysterectomy for treatment-resistant menometrorrhagia. The patients were divided into four groups according to the postoperative histopathology: concomitant adenomyosis and leiomyoma (n = 33), adenomyosis only (n = 26), leiomyoma only (n = 48) and controls (n = 22). Patients without any organic uterine pathology constituted the control group. Age at menarche was higher in the concomitant adenomyosis and leiomyoma group compared to the adenomyosis only group (P = 0.006). The mean age (P = 0.007), age at menarche (P = 0.001) and gravidity (P = 0.001) were higher in the concomitant adenomyosis and leiomyoma group compared to the leiomyoma only group. Preoperative hemoglobin was lower in the concomitant adenomyosis and leiomyoma, adenomyosis only, and leiomyoma only groups than the control group (P < 0.008). On receiver operating characteristic analysis, hemoglobin <10.9 mg/dL had a sensitivity and specificity of 77% and 70%, respectively, in discrimination of any uterine organic pathology, including adenomyosis only, leiomyoma only, and concomitant adenomyosis and leiomyoma, from the control group. Patients in the adenomyosis group were older (OR, 1.20; 95%CI: 1.05-1.50) and had a lower age at menarche (OR, 0.42; 95%CI: 0.19-0.89) than the other groups. Preoperative anemia may be a useful predictor of adenomyosis. Older patients, and patients who had a lower age at menarche, were also more likely to have adenomyosis. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

Menarche, Menopause, Years of Menstruation, and the Incidence of Osteoporosis: The Influence of Prenatal Exposure to Diethylstilbestrol

PubMed Central

Troisi, Rebecca; Wise, Lauren A.; Palmer, Julie R.; Titus-Ernstoff, Linda; Strohsnitter, William C.; Hatch, Elizabeth E.

2014-01-01

Context: Estrogen is critical for bone formation and growth in women. Estrogen exposures occur throughout life, including prenatally, and change with reproductive events, such as menarche and menopause. Objective: The objective of this study was to investigate the association between age at menarche, age at menopause, and years of menstruation with incidence of osteoporosis and assess the impact of prenatal exposure to diethylstilbestrol (DES), a synthetic estrogen, on such associations. Design, Setting, and Participants: Participants were 5573 women in the National Cancer Institute Combined Cohort Study of DES (1994–2006). Data on reproductive history and medical conditions were collected through questionnaires at baseline in 1994 and subsequently in 1997, 2001, and 2006. Age-stratified Cox regression models were used to calculate multivariable incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Effect measure modification by prenatal DES exposure was assessed using cubic restricted spline regression models. Main Outcome Measure: Osteoporosis was the main outcome measure. Results: The IRRs for osteoporosis incidence with age at menarche less than 11 years and age at menopause of 50 years or younger were 0.82 (CI 0.59, 1.14) and 0.61 (CI 0.40, 0.92), respectively. Fewer than 25 years of menstruation was associated with an increased incidence of osteoporosis (IRR 1.80; CI 1.14, 2.86) compared with 35 years or more of menstruation. Associations were stronger among women who had not been prenatally exposed to DES. Conclusions: Our data support the hypothesis that lifetime cumulative exposure to estrogens is protective against osteoporosis. Furthermore, prenatal exposure to estrogen appears to modify these associations, although the mechanism by which this occurs is unknown. PMID:24248183

Adolescent and young adult female determinants of visceral adipose tissue at ages 26-28 years.

PubMed

Glueck, Charles J; Wang, Ping; Woo, Jessica G; Morrison, John A; Khoury, Philip R; Daniels, Stephen R

2015-04-01

To assess adolescent and young adult determinants of visceral adipose tissue (VAT) at ages 26-28 years. Prospective study (ages 9-28 years) of cardiometabolic measures, menarche age, menses irregularities, metabolic syndrome, impaired fasting glucose-type 2 diabetes mellitus, and VAT in 400 girls (248 black, 152 white). Adolescent (age 14-19) independent variables for greater VAT at ages 26-28 included larger mean waist circumference (partial R(2) = 30.8%), earlier age at menarche (0.9%), and white race (1.8%). Young adult (ages 20-28 years) independent variables for greater VAT included larger mean waist circumference (partial R(2) = 61.7%), greater triglyceride levels (3.3%), lower high-density lipoprotein cholesterol (1.0%), and greater insulin resistance (homeostasis model assessment-estimated insulin resistance; 0.4%). Independent variables for greater VAT when both adolescent and young adult variables were used included waist (tertile rank change from adolescence to young adulthood, partial R(2) = 58.3%), greater young adult triglyceride levels (4.4%), white race (1.8%), greater young adult homeostasis model assessment-estimated insulin resistance (age 20-28, 2.4%), and earlier menarche age (0.7%). Menses irregularities were not independently associated with young adult VAT. Adolescent girls with early menarche and larger waist circumference should be targets for primary prevention of accretion of VAT. In young adulthood, VAT is associated with dysregulated cardiometabolic profiles, which is greater for those with waist circumference increases from adolescence to adulthood. Waist circumference during young adulthood, and to a lesser degree during adolescence, is an inexpensive surrogate for VAT at ages 26-28 years. Copyright © 2015 Elsevier Inc. All rights reserved.

Genome-wide association study of sexual maturation in males and females highlights a role for body mass and menarche loci in male puberty

PubMed Central

Cousminer, Diana L.; Stergiakouli, Evangelia; Berry, Diane J.; Ang, Wei; Groen-Blokhuis, Maria M.; Körner, Antje; Siitonen, Niina; Ntalla, Ioanna; Marinelli, Marcella; Perry, John R.B.; Kettunen, Johannes; Jansen, Rick; Surakka, Ida; Timpson, Nicholas J.; Ring, Susan; Mcmahon, George; Power, Chris; Wang, Carol; Kähönen, Mika; Viikari, Jorma; Lehtimäki, Terho; Middeldorp, Christel M.; Hulshoff Pol, Hilleke E.; Neef, Madlen; Weise, Sebastian; Pahkala, Katja; Niinikoski, Harri; Zeggini, Eleftheria; Panoutsopoulou, Kalliope; Bustamante, Mariona; Penninx, Brenda W.J.H.; Murabito, Joanne; Torrent, Maties; Dedoussis, George V.; Kiess, Wieland; Boomsma, Dorret I.; Pennell, Craig E.; Raitakari, Olli T.; Hyppönen, Elina; Davey Smith, George; Ripatti, Samuli; McCarthy, Mark I.; Widén, Elisabeth

2014-01-01

Little is known about genes regulating male puberty. Further, while many identified pubertal timing variants associate with age at menarche, a late manifestation of puberty, and body mass, little is known about these variants' relationship to pubertal initiation or tempo. To address these questions, we performed genome-wide association meta-analysis in over 11 000 European samples with data on early pubertal traits, male genital and female breast development, measured by the Tanner scale. We report the first genome-wide significant locus for male sexual development upstream of myocardin-like 2 (MKL2) (P = 8.9 × 10−9), a menarche locus tagging a developmental pathway linking earlier puberty with reduced pubertal growth (P = 4.6 × 10−5) and short adult stature (p = 7.5 × 10−6) in both males and females. Furthermore, our results indicate that a proportion of menarche loci are important for pubertal initiation in both sexes. Consistent with epidemiological correlations between increased prepubertal body mass and earlier pubertal timing in girls, body mass index (BMI)-increasing alleles correlated with earlier breast development. In boys, some BMI-increasing alleles associated with earlier, and others with delayed, sexual development; these genetic results mimic the controversy in epidemiological studies, some of which show opposing correlations between prepubertal BMI and male puberty. Our results contribute to our understanding of the pubertal initiation program in both sexes and indicate that although mechanisms regulating pubertal onset in males and females may largely be shared, the relationship between body mass and pubertal timing in boys may be complex and requires further genetic studies. PMID:24770850

Renal cancer and pregnancy in two different female cohorts.

PubMed

Mydlo, Jack H; Chawla, Sameer; Dorn, Spencer; Volpe, Michael A; Shah, Sovrin; Imperato, Pascal J

2002-10-01

Although human renal cell carcinoma (RCC) is considered refractive to hormone therapy, this lesion can be induced in the Syrian hamster by exogenous estrogen. Human RCC also has been demonstrated to contain estrogen receptors. Since there are significant changes of estrogen levels during pregnancy, we wanted to investigate if there were any associations between the hormonal variations of pregnancy and renal cancer in women using two distinct cohorts. We reviewed the charts of 57 females who presented for treatment of renal cancer. We assessed the size of each tumor radiologically and pathologically, the tumor stage, the number of pregnancies and/or abortions/miscarriages, age at menarche, and use of oral contraceptives. We compared this cohort to a sample of 985 nuns, and then reviewed the literature on the association of pregnancy, contraceptives and renal cell carcinoma. We used analysis of multiple variables (ANOVA) and the student's t test to determine any significance (p<0.05). Our age range was 39 to 67 years, with a mean of 51. The tumor volumes ranged from 9 cm(3) to 1500 cm(3), and the number of pregnancies ranged from 1 to 14. Menarche ranged from 8 to 14. We did not find any significant correlation between menarche or the number of pregnancies and the size or stage of renal cancers. However, our nun population did not reveal any incidence or illness from renal cell carcinoma over a 20 year review. Although our first cohort did not demonstrate any significant associations between the number of pregnancies or age at menarche and RCC, our second cohort and a review of the literature supports the notion that pregnancy is a risk factor for renal cell carcinoma.

[Update on pubertal development among primary school students in Shanghai, 2014].

PubMed

Chen, Y; Zhang, Y T; Chen, C; Jiang, Y R; Song, Y J; Liu, S J; Jiang, F

2016-11-06

Objective: To investigate the current prevalence of pubertal development in healthy Shanghai schoolchildren. Methods: This study was a cross-sectional investigation focused on current pubertal development conducted in healthy Shanghai schoolchildren by multi-stage cluster sampling. The sample included 17 571 children in grades 1-5 investigated in June 2014. The data were weighted by inverse probability weighting (IPW) to make them more representative. At examination, stages of breast and pubic hair development were rated according to the Tanner method. Testicular volume was determined. Data on menarche and spermatorrhea were collected by the status quo method. The rates of precocious puberty, breast, and pubic hair development of Tanner stage ≥Ⅱ in girls aged 6-7 years, menarche in girls aged 6-9 years, and testicular volume ≥4 ml and pubic hair development of Tanner stage ≥Ⅱ in boys aged 6-8 years were calculated. All the data were weighted by IPW. Results: After data processing, 16 197 children's data were analyzed. In girls aged 6-7 years, 17.2% and 2.5% showed evidence of breast and pubic hair development at Tanner stage ≥Ⅱ, respectively. In girls aged 6-9 years, 0.3% had experienced menarche. Schoolgirls' rate of menarche was 4.7%. In girls aged 6-7 years, 19.0% were diagnosed with precocious puberty according to the classic criteria. In boys aged 6-8 years, 1.7% had testicular volume ≥4 ml, and 0.6% showed evidence of pubic hair development at Tanner stage ≥Ⅱ. Schoolboys' incidence rate of spermatorrhea was 0.1%. In boys aged 6-8 years, 2.3% were diagnosed with precocious puberty according to the classic criteria. All the numbers above were weighted. Conclusion: Proper education on adolescence and sex is essential for Shanghai schoolchildren.

Reproductive cancer risk factors among Alaska Native women: the Alaska Education and Research Towards Health (EARTH) Study.

PubMed

Redwood, Diana G; Lanier, Anne P; Johnston, Janet M; Murphy, Neil; Murtaugh, Maureen A

2012-01-01

The purpose of this study was to provide estimates for the prevalence of reproductive cancer risk factors among Alaska Native (AN) women who enrolled in the Alaska Education and Research Towards Health (EARTH) Study from 2004 to 2006. A total of 2,315 AN women 18 years or older completed reproductive health questions as part of a comprehensive health history questionnaire. The reproductive health section included menstrual status (age at menarche and menopause), pregnancy and live birth history, use of hormonal contraception, hormone replacement therapy, and history of hysterectomy and/or oophorectomy. A total of 463 (20%) of women experienced menarche before age 12 with a decline in mean age at menarche by age cohort. More than 86% had been pregnant (mean number of pregnancies, 3.8; mean number of live births, 2.9). More than one half of women (58%) had their first live birth between the ages of 18 and 24. Almost 28% of participants had completed menopause, of whom 24% completed menopause after age 52. Fewer than half (43%) reported ever using hormone replacement therapy. Almost two thirds (62%) reported ever using oral contraceptives, and fewer reported ever using birth control shots (30%) or implants (10%). This study is unique in reporting reproductive health factors among a large group of AN women. These data show that AN women have selective protective factors for reproductive cancers, including low nulliparity rates, low use of menopausal estrogens, and common use of contraceptive hormones. However, analysis by age cohorts indicates decreasing age at menarche that might increase the risk for reproductive cancers among AN women in the future. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Surreptitious learning: menarche and menstrual product advertisements.

PubMed

Simes, M R; Berg, D H

2001-01-01

The purpose of this study was to examine the messages conveyed in menstrual product advertisements with specific concern given to information that could be learned about menstruation and the female body by menarcheal girls. Over 200 advertisements from popular women's magazines were analyzed using constant comparative analysis. The core variable was Heightening Insecurities. The themes identified in menstrual product advertisements function to heighten insecurities in the female adolescent reader. The findings revealed that the advertisements were a reflection of the negative societal views of menstruation and, because the advertisements function to heighten insecurities, they also function to perpetuate and maintain the silence and shame which surrounds menstruation in our society.

Improving pre- and postmenarcheal 12-year-old girls' attitudes toward menstruation.

PubMed

Rembeck, Gun I; Gunnarsson, Ronny K

2004-08-01

Adolescence is a time of rapid changes, including risk for unwanted pregnancies and sexually transmitted infections. Education may improve understanding and attitudes toward menstruation among adolescents thus increasing their awareness of risks and enabling them to protect themselves accordingly. To investigate effects of education on attitudes, two interventions were compared in 345 12-year-old girls. The new, active intervention given to premenarcheal girls just before menarche resulted in improvements in attitudes toward menstruation compared with standard intervention. Thus, just before menarche girls should be offered education modeled after the active intervention. The education must be concrete and based on multisensory learning.

Testing times: identifying puberty in an identified skeletal sample.

PubMed

Henderson, Charlotte Y; Padez, Cristina

2017-06-01

Identifying the onset of puberty in skeletal remains can provide evidence of social changes associated with the onset of adulthood. This paper presents the first test of a skeletal method for identifying stages of development associated with the onset of puberty in a skeletal sample of known age and cause of death. Skeletal methods for assessing skeletal development associated with changes associated with puberty were recorded in the identified skeletal collection in Coimbra, Portugal. Historical data on the onset of menarche in this country are used to test the method. As expected, females mature faster than their male counterparts. There is some side asymmetry in development. Menarche was found to have been achieved by an average age of 15. Asymmetry must be taken into account when dealing with partially preserved skeletons. Age of menarche is consistent, although marginally higher, than the age expected based on historical data for this time and location. Skeletal development in males could not be tested against historical data, due to the lack of counterpart historical data. The ill health known to be present in this prematurely deceased population may have delayed skeletal development and the onset of puberty.

Developmental influences on fertility decisions by women: an evolutionary perspective

PubMed Central

Tickner, M.; McAllister, L. S.; Sheppard, P.

2016-01-01

Developmental environments are crucial for shaping our life course. Elements of the early social and biological environments have been consistently associated with reproduction in humans. To date, a strong focus has been on the relationship between early stress, earlier menarche and first child birth in women. These associations, found predominately in high-income countries, have been usefully interpreted within life-history theory frameworks. Fertility, on the other hand—a missing link between an individual's early environment, reproductive strategy and fitness—has received little attention. Here, we synthesize this literature by examining the associations between early adversity, age at menarche and fertility and fecundity in women. We examine the evidence that potential mechanisms such as birth weight, childhood body composition, risky health behaviours and developmental influences on attractiveness link the early environment and fecundity and fertility. The evidence that menarche is associated with fertility and fecundity is good. Currently, owing to the small number of correlational studies and mixed methodologies, the evidence that early adversity predicts fecundity and fertility is not conclusive. This area of research is in its infancy; studies examining early adversity and adult fertility decisions that can also examine likely biological, social and psychological pathways present opportunities for future fertility research. PMID:27022073

A review of the risk factors for lower extremity overuse injuries in young elite female ballet dancers.

PubMed

Bowerman, Erin Anne; Whatman, Chris; Harris, Nigel; Bradshaw, Elizabeth

2015-06-01

The objective of this study was to review the evidence for selected risk factors of lower extremity overuse injuries in young elite female ballet dancers. An electronic search of key databases from 1969 to July 2013 was conducted using the keywords dancers, ballet dancers, athletes, adolescent, adolescence, young, injury, injuries, risk, overuse, lower limb, lower extremity, lower extremities, growth, maturation, menarche, alignment, and biomechanics. Thirteen published studies were retained for review. Results indicated that there is a high incidence of lower extremity overuse injuries in the target population. Primary risk factors identified included maturation, growth, and poor lower extremity alignment. Strong evidence from well-designed studies indicates that young elite female ballet dancers suffer from delayed onset of growth, maturation, menarche, and menstrual irregularities. However, there is little evidence that this deficit increases the risk of overuse injury, with the exception of stress fractures. Similarly, there is minimal evidence linking poor lower extremity alignment to increased risk of overuse injury. It is concluded that further prospective, longitudinal studies are required to clarify the relationship between growth, maturation, menarche, and lower extremity alignment, and the risk of lower extremity overuse injury in young elite female ballet dancers.

Site-Specific Advantages in Skeletal Geometry and Strength at the Proximal Femur and Forearm in Young Female Gymnasts

PubMed Central

Dowthwaite, Jodi N.; Rosenbaum, Paula F.; Scerpella, Tamara A.

2012-01-01

Purpose We evaluated site-specific skeletal adaptation to loading during growth,comparing radius (RAD) and femoral neck (FN) DXA scans in young female gymnasts (GYM) and non-gymnasts (NON). Methods Subjects from an ongoing longitudinal study (8-26 yrs old) underwent annual DXA scans (proximal femur, forearm, total body) and anthropometry, completing maturity and physical activity questionnaires. This cross-sectional analysis used the most recent data meeting the following criteria: gynecological age ≤2.5 yrs post-menarche; GYM annual mean gymnastic exposure ≥5.0 h/wk in the prior year. Bone geometric and strength indices were derived from scans for 173 subjects (8-17 yrs old) via hip structural analysis (femoral narrow neck, NN) and similar radius formulae (1/3 and Ultradistal (UD)). Maturity was coded as M1 (Tanner I breast), M2 (pre-menarche, ≥Tanner II breast) or M3 (post-menarche). ANOVA and chi square compared descriptive data. Two factor ANCOVA adjusted for age, height, total body non-bone lean mass and percent body fat; significance was tested for main effects and interactions between gymnastic exposure and maturity. Results At the distal radius, GYM means were significantly greater than NON means for all variables (p<0.05). At the proximal femur, GYM exhibited narrower periosteal and endosteal dimensions, but greater indices of cortical thickness, BMC, aBMD and section modulus, with lower buckling ratio (p <0.05). However, significant interactions between maturity and loading were detected for the following: 1) FN bone mineral content (BMC), NN buckling ratio (GYM BMC advantages only in M1 and M3; for BMC and buckling ratio, M1 advantages were greatest; 2) 1/3 radius BMC, width, endosteal diameter, cortical cross-sectional area, section modulus (GYM advantages primarily post-menarche); 3) UD radius BMC and axial compressive strength (GYM advantages were larger with greater maturity, greatest post-menarche). Conclusions Maturity-specific comparisons suggested site-specific skeletal adaptation to loading during growth, with greater advantages at the radius versus the proximal femur. At the radius, GYM advantages included greater bone width, cortical cross-sectional area and cortical thickness; in contrast, at the femoral neck, GYM bone tissue cross-sectional area and cortical thickness were greater, but bone width was narrower than in NON. Future longitudinal analyses will evaluate putative maturity-specific differences. PMID:22342799

[Sexual maturation of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)].

PubMed

Kahl, H; Schaffrath Rosario, A; Schlaud, M

2007-01-01

Following the standstill in maturity acceleration in the eighties of the twentieth century, now a further shift in maturity development towards younger ages is the issue of an international and also German discussion. The collection of sexual maturity data in boys and girls as part of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) is intended to pro vide population-representative information on sexual maturation and to evaluate associations between maturity status and selected health and social data. Girls were interviewed regarding their first menstrual period (menarche) and boys regarding voice change (status-quo method). Pubic hair was self-assessed by children and adolescents from 10 to 17 years of age, based on drawings of Tanner's defined developmental stages. The median age for menarche, for voice change and pubic hair stages were calculated using a logit model. At an age of 10 years, 42.4 % of girls and 35.7 % of boys report the development of pubic hair. At 17 years of age, the majority of girls and boys have reached the stages PH5 (girls 57.5 %, boys 47.8 %) and PH6 (girls 23.6 %, boys 46.5 %) according to Tanner. The average age for each pubic hair stage is lower in girls (PH2 10.8; PH3 11.7; PH4 12.3; PH5 13.4 years) than in boys (PH2 10.9; PH3 12.6; PH4 13.4; PH5 14.1). The median age at menarche is 12.8 years, the median for voice change (voice low) 15.1 years. Significant differences in age at menarche are found in girls depending on socioeconomic status (12.7/12.9/13.0 years for low/middle/high status) and between girls with and without migration background (12.5/12.9 years). No differences in age at menarche can be seen between East and West Germany or cities and rural areas. The association between maturity status and BMI is more pronounced in girls than in boys. Overall, the onset of maturity development in German children and adolescents is not significantly earlier than in other European studies.

Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study.

PubMed

Neves, Amanda Gonçalves; Kasawara, Karina Tamy; Godoy-Miranda, Ana Carolina; Oshika, Flávio Hideki; Chaim, Elinton Adami; Surita, Fernanda Garanhani

2017-10-01

The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age. We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals. Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity. Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.

Developmental influences on fertility decisions by women: an evolutionary perspective.

PubMed

Coall, D A; Tickner, M; McAllister, L S; Sheppard, P

2016-04-19

Developmental environments are crucial for shaping our life course. Elements of the early social and biological environments have been consistently associated with reproduction in humans. To date, a strong focus has been on the relationship between early stress, earlier menarche and first child birth in women. These associations, found predominately in high-income countries, have been usefully interpreted within life-history theory frameworks. Fertility, on the other hand--a missing link between an individual's early environment, reproductive strategy and fitness--has received little attention. Here, we synthesize this literature by examining the associations between early adversity, age at menarche and fertility and fecundity in women. We examine the evidence that potential mechanisms such as birth weight, childhood body composition, risky health behaviours and developmental influences on attractiveness link the early environment and fecundity and fertility. The evidence that menarche is associated with fertility and fecundity is good. Currently, owing to the small number of correlational studies and mixed methodologies, the evidence that early adversity predicts fecundity and fertility is not conclusive. This area of research is in its infancy; studies examining early adversity and adult fertility decisions that can also examine likely biological, social and psychological pathways present opportunities for future fertility research. © 2016 The Author(s).

Menstrual Cycle and the Prevalence of Premenstrual Syndrome/Premenstrual Dysphoric Disorder in Adolescent Athletes.

PubMed

Czajkowska, Mariola; Drosdzol-Cop, Agnieszka; Gałązka, Iwona; Naworska, Beata; Skrzypulec-Plinta, Violetta

2015-12-01

The purpose of this study was to assess the menstrual cycle, menstrual disorders and premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD) in girls and young women participating in competitive sports. The impact of PMS/PMDD symptoms on the quality of life was also analyzed. The prospective study encompassed 125 girls and young women with the aim to determine the presence of menstrual disorders and the prevalence of PMS/PMDD. The studied group was composed of 75 female athletes aged 16 to 22 years. The control group included 50 healthy girls and young women who did not practice competitive sports. The studied athletes and the controls prospectively evaluated their 2 consecutive menstrual cycles by using a questionnaire. The research tools were a purpose-built questionnaire, a daily log of PMS symptoms according to the American College of Obstetricians and Gynecologists' guidelines, and a daily log of PMDD symptoms based on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria. To determine the impact of competitive sports on the menstrual cycle, menstrual disorders, and the prevalence of PMS/PMDD in girls and young women. Intensive physical exercise delayed menarche. PMDD was diagnosed in 8% and PMS in 42.4% of all respondents. The prevalence of PMDD did not differ significantly between the groups (9.33% versus 6.00%). PMS was significantly more frequent among athletes than among controls (49.33% versus 32%, P = .045). The prevalence of PMS correlated significantly with mean age (P = .00001) and age at menarche (P = .03) in athletes. PMS was more frequent in older athletes and in girls with older age at menarche. Competitive sports, older mean age, older age at menarche, length of sporting career, and intensity of training are conducive to PMS. The prevalence of PMS increases with the duration and intensification of competitive exercises. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Marriage patterns and some issues related to adolescent marriage in Bangladesh.

PubMed

Islam, M M; Mahmud, M

1996-09-01

Data from the 1989 Bangladesh Fertility Survey are used to examine marriage patterns among adolescents, factors associated with adolescent marriage, and socioeconomic characteristics of married adolescents. Findings indicate that 100% of females married before the age of 30 years. The proportion of those never married increased after 1974 and among females aged 10-14 years and 15-19 years. The proportion of those never married increased from 73.4% to 95.8% among women aged 10-14 years and from 11.3% to 48.6% among women aged 15-19 years. In 1989 only 4% were married after age 20. 55% of total marriages occurred among women aged 13-15 years. 80% of total marriages occurred under 16 years of age. The highest mean age of marriage was found among women aged 20-29 years at the time of the survey. 63.9% of women who married before the age of 20 years married after menarche, 18.1% married before menarche, and 18.0% married during menarche. The average age at menarche was 13.4 years. 13.9% of marriages were dissolved among women who married before the age of 20 years, and 46% remarried. 8.5% of marriages were dissolved among ever married women who married after the age of 20 years, and only 24.4% remarried. Teenage marriage was more prevalent in rural areas and in Dhaka division, followed by Rajshahi division. About 70% of married adolescents were illiterate or had no formal education, and almost 86% did not work outside the home. Only 26% of married adolescents had husbands with more than a primary education. Marriages took place earlier among families with some land. 92.6% of married adolescents lived in poorly constructed housing. Logistic findings indicate that female education was closely associated with an increased chance of adolescent marriage. Low age at marriage was also influenced strongly by husband's occupation. Regional differences were significant covariates.

Father absence and reproduction-related outcomes in Malaysia, a transitional fertility population.

PubMed

Sheppard, Paula; Snopkowski, Kristin; Sear, Rebecca

2014-06-01

Father absence is consistently associated with children's reproductive outcomes in industrialized countries. It has been suggested that father absence acts as a cue to particular environmental conditions that influence life history strategies. Much less is known, however, about the effects of father absence on such outcomes in lower-income countries. Using data from the 1988 Malaysian Family Life Survey (n = 567), we tested the effect of father absence on daughters' age at menarche, first marriage, and first birth; parity progression rates; and desired completed family size in Malaysia, a country undergoing an economic and fertility transition. Father absence during later childhood (ages 8 to 15), although not during earlier childhood, was associated with earlier progressions to first marriage and first birth, after controlling for other confounders. Father absence does not affect age at menarche, desired family size, or progression from first to second birth. The patterns found in this transitional population partly mirror those in developed societies, where father absence accelerates reproductive events. There is, however, a notable contrast between the acceleration in menarche for father-absent girls consistently found in developed societies and the lack of any association in our findings. The mechanisms through which father absence affects reproduction may differ in different ecological contexts. In lower-income contexts, direct paternal investment or influence may be of more importance in determining reproductive behavior than whether fathers act as a cue to environmental conditions.

The effect of early pregnancy on the formation of obstetric fistula.

PubMed

Browning, Andrew; Mbise, Frederick; Foden, Phil

2017-09-01

To assess the effect of early pregnancy on obstetric fistula. A prospective observational study was conducted among patients with obstetric fistula caused by a long obstructed labor who presented at Selian Lutheran Hospital, Tanzania, or Kitovu Hospital, Uganda, between January 1, 2015, and January 31, 2016. Demographic and clinical variables were evaluated. Among 270 patients, 162 (60.0%) experienced their first pregnancy up to 2 years after menarche (early group) and 108 (40.0%) experienced their first pregnancy more than 2 years after menarche (late group). No significant differences between the early and late groups were found for median age at presentation (30.0 vs 28.0 years), median parity (both 2.0), stillbirth (n=145 [89.5%] vs n=95 [88.0%]), median duration of labor (both 2.0 days), home delivery (n=31 [19.1%] vs n=17 [15.7%]), cesarean delivery (n=79 [48.8%] vs 58 [53.7%]), median time from obstetric fistula formation to presentation (48.0 vs 24.0 months), and obstetric fistula classifications. Obstetric fistula occurred during the first pregnancy in 99 (61.1%) women in the early group and 71 (65.7%) in the late group (P=0.440). Frequency of obstetric fistula during the first pregnancy is not increased among women who experience their first pregnancy within 2 years of menarche. © 2017 International Federation of Gynecology and Obstetrics.

Determinants of prolactin in postmenopausal Chinese women in Singapore.

PubMed

Katz, Tiffany A; Wu, Anna H; Stanczyk, Frank Z; Wang, Renwei; Koh, Woon-Puay; Yuan, Jian-Min; Oesterreich, Steffi; Butler, Lesley M

2018-01-01

Mechanistic and observational data together support a role for prolactin in breast cancer development. Determinants of prolactin in Asian populations have not been meaningfully explored, despite the lower risk of breast cancer in Asian populations. Determinants of plasma prolactin were evaluated in 442 postmenopausal women enrolled in the Singapore Chinese Health Study, a population-based prospective cohort study. At baseline all cohort members completed an in-person interview that elicited information on diet, menstrual and reproductive history, and lifestyle factors. One year after cohort initiation we began collecting blood samples. Quantified were plasma concentrations of prolactin, estrone, estradiol, testosterone, androstenedione, and sex hormone-binding globulin (SHBG). Analysis of covariance method was used for statistical analyses with age at blood draw, time since last meal, and time at blood draw as covariates. Mean prolactin levels were 25.1% lower with older age at menarche (p value = 0.001), and 27.6% higher with greater years between menarche and menopause (p value = 0.009). Prolactin levels were also positively associated with increased sleep duration (p value = 0.005). The independent determinants of prolactin were years from menarche to menopause, hours of sleep, and the plasma hormones estrone and SHBG (all p values < 0.01). The role of prolactin in breast cancer development may involve reproductive and lifestyle factors, such as a longer duration of menstrual cycling and sleep patterns.

The characteristics of bone turnover in the second decade in relation to age and puberty development in healthy Japanese male and female subjects--Japanese Population-based Osteoporosis Study.

PubMed

Matsukura, T; Kagamimori, S; Nishino, H; Yamagami, T; Iki, M; Kajita, E; Kagawa, Y; Yoneshima, H; Matsuzaki, T; Marumo, F

2003-01-01

There are few studies that clarify the characteristics of bone turnover in children and adolescents. Furthermore, little has been published on changes in urinary CrossLaps(TM) (CTx) in Japanese subjects. To investigate biochemical markers of bone turnover in subjects, in relation to age and puberty development. We measured serum bone specific alkaline phosphatase (B-Alp) and CTx in 1207 Japanese subjects aged 9-18 years. As an indicator of puberty development, the age that pubic hair appeared in males and menstruation started in females was obtained from questionnaires. B-Alp and CTx/Cr (creatinine) had high values before and just after the indicators and was lower thereafter, reaching a plateau in both genders. There was no significant difference in these values in males 5-6 years, or 7 years and more after the appearance of pubic hair. B-Alp and CTx/Cr values 7 years and more after menarche were significantly lower than those 5-6 years after menarche, however the differences were relatively small. Subjects in the second decade can be divided into three groups: 'before the appearance of pubic hair for males and menarche for females', 'up to and including 3-4 years after them' and '5-6 years and more after them'.

[Profile of adolescents with repeated pregnancies attended at a prenatal clinic].

PubMed

Persona, Lia; Shimo, Antonieta Keiko Kakuda; Tarallo, Maria Celina

2004-01-01

This study identified the biopsychosocial profile of adolescent with repeated pregnancies, who were attended at a prenatal clinic. Data were collected through patient records and interviews and were subject to quantitative analysis. Based on the obtained results and in accordance with literature, factors that are strongly associated with the occurrence of pregnancy repetition were selected in the adolescents' profiles. These are: early menarche; first sexual intercourse shortly after menarche; school repetition; school dropout; non remunerated occupation; low family income; involvement with older partners; living with the partner; consensual union with the partner; one partner; low condom use; family history of adolescent pregnancy; father's absence because of death or abandonment; positive family reaction to previous pregnancy; previous abortion; adolescent's positive concepts about previous delivery; and absence from previous postpartum consultations.

Cyclones, bi-cycles, and psychoanalysis: the witch-of-us? complex and The Wizard of Oz.

PubMed

Stern, Jeffrey

2003-01-01

Works of applied psychoanalysis normally use psychoanalytic theory to reveal the secret meanings of works of art. An attempt is made to reverse the directionality of such analyses and see whether a work of art, The Wizard of Oz, has something to teach psychoanalysis about adolescent female psychosexual development. The author argues that the popularity and importance of the film is an effect of its symbolic representation of a girl's entry into menarche, and the meaning of this milestone for herself and for her mother. He addresses ideas about feminine castration fears (or what more recently have been called fears of genital injury), issues about menopause, and fantasies--both surprising and violent--around the meanings of menarche for both mother and daughter.

Menstruation and Menstrual Problems

MedlinePlus

... occurs as part of a woman's monthly menstrual cycle. Menstruation occurs between menarche (pronounced muh-NAHR-kee ), a girl's first period, and menopause , when menstrual cycles end. 1 The average menstruation time in normally ...

Mapping the knowledge and understanding of menarche, menstrual hygiene and menstrual health among adolescent girls in low- and middle-income countries.

PubMed

Chandra-Mouli, Venkatraman; Patel, Sheila Vipul

2017-03-01

Menstruation is a natural physiological process that requires proper management. Unlike other normal bodily processes, menstruation is linked with religious and cultural meanings that can affect the perceptions of young girls as well as the ways in which the adults in the communities around them respond to their needs. This review aims to answer the following questions: (1) how knowledgeable are adolescent girls in low- and middle-income countries about menstruation and how prepared are they for reaching menarche, (2) who are their sources of information regarding menstruation, (3) how well do the adults around them respond to their information needs, (4) what negative health and social effects do adolescents experience as a result of menstruation, and (5) how do adolescents respond when they experience these negative effects and what practices do they develop as a result? Using a structured search strategy, articles that investigate young girls' preparedness for menarche, knowledge of menstruation and practices surrounding menstrual hygiene in LMIC were identified. A total of 81 studies published in peer-reviewed journals between the years 2000 and 2015 that describe the experiences of adolescent girls from 25 different countries were included. Adolescent girls in LMIC are often uninformed and unprepared for menarche. Information is primarily obtained from mothers and other female family members who are not necessarily well equipped to fill gaps in girls' knowledge. Exclusion and shame lead to misconceptions and unhygienic practices during menstruation. Rather than seek medical consultation, girls tend to miss school, self-medicate and refrain from social interaction. Also problematic is that relatives and teachers are often not prepared to respond to the needs of girls. LMIC must recognize that lack of preparation, knowledge and poor practices surrounding menstruation are key impediments not only to girls' education, but also to self-confidence and personal development. In addition to investment in private latrines with clean water for girls in both schools and communities, countries must consider how to improve the provision of knowledge and understanding and how to better respond to the needs of adolescent girls.

Pubertal timing and substance use: associations between and within families across late adolescence.

PubMed

Dick, D M; Rose, R J; Viken, R J; Kaprio, J

2000-03-01

In the present study, between-family analyses of data from adolescent twin girls offer new evidence that early menarche is associated with earlier initiation and greater frequency of smoking and drinking. The role of personality factors and peer relationships in that association was investigated, and little support was found for their involvement. Novel within-family analyses replicating associations of substance use with pubertal timing in contrasts of twin sisters selected for extreme discordance for age at menarche are reported. Within-family replications demonstrated that the association of pubertal timing with substance use cannot be explained solely by between-family confounds. Within-family analyses demonstrated contextual modulation of the influence of pubertal timing: Its impact on drinking frequency is apparent only among girls in urban settings. Sibling comparisons illustrate a promising analytic tool for studying diverse developmental outcomes.

Life history theory and dental development in four species of catarrhine primates.

PubMed

Dirks, Wendy; Bowman, Jacqui E

2007-09-01

Dental development was reconstructed in several individuals representing four species of catarrhine primates--Symphalangus syndactylus, Hylobates lar, Semnopithecus entellus priam, and Papio hamadryas--using the techniques of dental histology. Bar charts assumed to represent species-typical dental development were constructed from these data and estimated ages at first and third molar emergence were plotted on them along with ages at weaning, menarche, and first reproduction from the literature. The estimated age at first molar emergence appears to occur at weaning in the siamang, lar gibbon, and langur, and just after weaning in the baboon. Age at menarche and first reproduction occur earlier relative to dental development in both cercopithecoids than in the hylobatids, suggesting that early reproduction may be a derived trait in cercopithecoids. The results are examined in the context of life history theory.

Urethral Caruncle Presented as Premature Menarche in a 4-Year-Old Girl.

PubMed

Gamage, Manori; Beneragama, D

2018-01-01

Urethral caruncle (UC) is a benign fleshy outgrowth at the urethral meatus. It was first described by Samuel Sharp in 1750 and occurs mainly at the posterior lip of the urethra, and the exact aetiology is still uncertain. More often it was seen in the postmenopausal women, and only few cases are reported in young girls. Patients may be asymptomatic and could find this as an incidental finding or they may present with symptoms such as dysuria, bleeding per vagina, haematuria, a mass protruding through vagina, and acute retention of urine. Here, we report the case history of a 4-year-old girl presented with vaginal bleeding which was taken as she has attended menarche and found to have urethral caruncle which was the cause for bleeding. Histology confirmed the diagnosis, and girl was completely cured following surgical excision.

Gonadal dysfunction in morbidly obese adolescent girls.

PubMed

Chin, Vivian; Censani, Marisa; Lerner, Shulamit; Conroy, Rushika; Oberfield, Sharon; McMahon, Donald; Zitsman, Jeffrey; Fennoy, Ilene

2014-04-01

To describe gonadal dysfunction and evaluate polycystic ovary syndrome (PCOS) and its association with metabolic syndrome (MeS) among girls in a morbidly obese adolescent population. In a cross-sectional study of 174 girls, height, weight, waist circumference, Tanner stage, reproductive hormones, carbohydrate and lipid markers, drug use, and menstrual history were obtained at baseline. Exclusion criteria were menarcheal age <2 years, hormonal contraceptive or metformin use, Tanner stage <4, and incomplete data on PCOS or MeS classification. University medical center outpatient clinic. Ninety-eight girls ages 13-19.6 years, Tanner 5, average body mass index of 46.6 kg/m(2), menarche at 11.4 years, and average menarcheal age of 5 years. None. Polycystic ovary syndrome and MeS. Ninety-eight girls were divided into four groups: PCOS by National Institutes of Health criteria (PCOSN, n = 24), irregular menses only (n = 25), elevated T (≥55 ng/dL) only (n = 6), and obese controls (n = 43). Metabolic syndrome by modified Cook criteria affected 32 girls or 33% overall: 6 of 24 PCOSN, 7 of 25 irregular menses only, 4 of 6 elevated T only, and 15 of 43 obese controls. Polycystic ovary syndrome by National Institutes of Health criteria and its individual components were not associated with MeS after adjusting for body mass index. Unlike obese adults, PCOSN and its individual components were not associated with MeS in the untreated morbidly obese adolescent population. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

[Comparative study of height and age at menarche according to the socioeconomic level in Venezuela].

PubMed

López Contreras, M; Tovar Escobar, G; Farid Coupal, N; Landaeta Jiménez, M; Méndez Castellano, H

1981-12-01

This is a retrospective study based on growth and development data published in Venezuela by various authors in the period 1936-1978. The data on height for males of the middle and high socioeconomic strata show growth curves which are very similar to the standards for British children. Likewise, the girls of the same socioeconomic condition follow the British standards, but only up to about 10-12 years of age. After that age, the girls studied by the Venezuelan authors, show a pattern of early maturation with a corresponding lower adult height compared with their British counterparts. There were differences in the growth curves according to the socioeconomic strata. These differences were more marked in the girls data. A secular increase for height was discerned, from the published data, in all socioeconomic strata and in both sexes. The data on sexual maturation showed a tendency for progressively early menarche in Venezuelan girls. These changes in growth in height and age of menarche were more notorious and came about at an earlier age in the upper socioeconomic strata. They were less marked, not constant, and came about later in the lower socioeconomic groups. The secular changes in height and sexual maturation apparent from these data, could be explained by an improvement in the environmental conditions, especially nutrition and hygiene of the population, and also be genetic heterosis from European immigration and with improvement in communications.

Skeletal maturity of the hand in an East African group from Sudan.

PubMed

Elamin, Fadil; Abdelazeem, Nihal; Elamin, Ahmed; Saif, Duaa; Liversidge, Helen M

2017-08-01

Studies of skeletal maturity from Africa indicate a delay, reflected in a negative relative skeletal age (RSA). This study aims to evaluate the influence of age, socioeconomic status (SES) and nutritional status on skeletal maturation in a large sample of children from North Sudan. The sample consisted 665 males and 1018 females from 3-25 years from Khartoum. Height, weight, age of menarche and, SES were recorded of patients attending for dental treatment. Skeletal age was assigned from hand-wrist radiographs using the Greulich-Pyle (GP) atlas (1952). RSA (difference between skeletal and chronological ages) was compared in groups divided by age, sex, height-for-age and body-mass-index z scores, and SES. Spearman's correlation and student t-test was used to compare groups. Delayed skeletal age was noted across all age in boys. In girls, a delay was observed between ages 6-10, while advancement occurred between ages 13-18. Maturity was delayed in low height groups (p < .05) and low SES groups. RSA was negatively associated with HAZ in low SES males (R = -0.0.27, p < .001) and low SES females (R = -0.32, p < .001). There were statistically significant skeletal delays in North Sudanese males and most pre-menarche females, low height and low SES groups. Post-menarche females were advanced relative to males and GP references. Low SES impacts were statistically correlated to skeletal delay. © 2017 Wiley Periodicals, Inc.

Menarche and menstruation through the eyes of pubescent students in eastern Taiwan: implications in sociocultural influence and gender differences issues.

PubMed

Chang, Yu-Ting; Lin, Mei-Ling

2013-03-01

Menstruation is a significant part of women's lives. It has been studied from many perspectives to draw various conclusions about biological and physiological development, gender differences, and sociocultural environments. The purpose of this study was to explore how male and female pubescent students perceive and interpret menarche and menstruation and how their perceptions reflect gender differences and the sociocultural environment in eastern Taiwan. This was an exploratory qualitative study that employed focus group interviews. Data were collected from 20 girls and 27 boys, aged 10-12 years, who were recruited from two elementary schools. Participants engaged in 19 focus group discussions, which lasted 45-60 minutes each. Discussion transcripts were collected, encoded, categorized, and analyzed using the Atlas V 5.0 software. The central theme in menarche and menstruation experiences among pubescent students in eastern Taiwan can be summarized as, "Struggling to grow up amidst contradictions," an attitude that reflects gender divisions and sociocultural representations and practices. Generally, participants' views on menstruation fell within five subthemes: "Ambiguous," "Disregarded," "Dirty," "Personal," and "Transitional." These themes were analyzed within the contexts of society, school, and family. In line with previous research, this study shows the need for more individual reproductive health consultations, reliable sex education, and well-planned health policies to assist pubescent students manage menstruation. In addition, this study suggests that the subjugation of girls and women remains a critical issue that must be addressed and challenged.

All about Menstruation (For Children)

MedlinePlus

... en español Todo sobre la menstruación People (especially girls) talk a lot about periods. But what exactly ... a period and what makes it happen? A girl's first period, called menarche (say: MEH-nar-kee), ...

Physical development and sexual orientation in men and women: an analysis of NATSAL-2000.

PubMed

Bogaert, Anthony F

2010-02-01

In the present study, three physical development characteristics-weight, height, and age of menarche-were examined for their relation to sexual orientation. Participants were men and women comprising the National Survey of Sexual Attitudes and Lifestyles-2000 (N > 11,000). Participants completed self-report measures of sexual orientation, height, weight, and, for women, age of menarche. Results indicated that gay/bisexual men were significantly shorter and lighter than heterosexual men. There were no significant differences between lesbians and heterosexual women in height, weight, and age of puberty. The results add to literature suggesting that, relative to heterosexual men, gay/bisexual men may have different patterns of growth and development because of early biological influences (e.g., exposure to atypical levels of androgens prenatally). However, the present results do not support a number of studies suggesting that lesbian/bisexual women are taller and heavier than heterosexual women.

Cessation of reproduction: an analytic view of menopause.

PubMed

Spencer, Richard P

2002-10-01

While there is evidence for genetic control of ovarian and follicular development, only recently have reports appeared on genetic components involved in ovarian failure. Unlike predictions of a stable population, age at menarche is decreasing, while female life span is increasing. This leads to examination of genotype-environment interactions. Evolution of the large human brain size has been accompanied by a reduction in size of the gastrointestinal tract. Consequences, in terms of altered diet and effects on menarche/menstruation/menopause were discussed. In the earliest days of human evolution, genotoxic agents and marginal diets could have produced heritable changes in cessation of menstruation. Toxic alterations may still be apparent, such as epidemiological studies on the effects of smoking on age at menopause. Attempts to reconstruct some of the recent past history, from coprolites to findings in frozen human specimens, have to be extended still further into the past.

Maternal Early Life Factors Associated with Hormone Levels and the Risk of Having a Child with an Autism Spectrum Disorder in the Nurses Health Study II

PubMed Central

Lyall, Kristen; Pauls, David L.; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto

2012-01-01

It is not known whether reproductive factors early in the mother’s life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in a cohort study of 61,596 women, including 743 cases. Overall, early life factors were not associated with ASD, though early age at menarche (RR for age 10 or less = 1.54, 95% CI 1.18, 2.02, p = 0.0002) and BMI at age 18 of ≥30 (RR 2.03, 95% CI 1.34, 3.08, p = 0.0008) were significantly associated with increased risk of ASD. Further work should investigate the potential influence of these factors. PMID:20700638

Maternal early life factors associated with hormone levels and the risk of having a child with an autism spectrum disorder in the nurses health study II.

PubMed

Lyall, Kristen; Pauls, David L; Santangelo, Susan L; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto

2011-05-01

It is not known whether reproductive factors early in the mother's life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in a cohort study of 61,596 women, including 743 cases. Overall, early life factors were not associated with ASD, though early age at menarche (RR for age 10 or less = 1.54, 95% CI 1.18, 2.02, p = 0.0002) and BMI at age 18 of ≥30 (RR 2.03, 95% CI 1.34, 3.08, p = 0.0008) were significantly associated with increased risk of ASD. Further work should investigate the potential influence of these factors.

Evaluation of irregular menses in perimenarcheal girls: a pilot study.

PubMed

Browner-Elhanan, Karen J; Epstein, Jonathan; Alderman, Elizabeth M

2003-12-01

Acyclic vaginal bleeding in girls within three years of menarche is most commonly attributed to an immature hypothalamic-pituitary-ovarian axis. Assuming this diagnosis may preclude the practitioner from performing more definitive studies and thereby diagnosing other, treatable causes of menstrual irregularities. A retrospective chart review of 178 girls presenting to an inner-city hospital-based adolescent clinic within three years of menarche was performed. Personal and family medical and menarcheal history was assessed, and findings on physical and laboratory examination performed were evaluated. Of the 178 girls still perimenarcheal at presentation, 47 were the focus of this study. Of these, 39 had no significant findings on physical examination, while 3 had signs of functional ovarian hyperandrogenism (FOH) including obesity, hirsutism, and moderate acne with corresponding LH/FSH ratios>3, although pelvic ultrasound examination revealed normal ovaries. Four of the 39 patients with normal physical exams had LH/FSH testing done, and 1 of the 4 had an abnormal LH/FSH ratio, indicating possible FOH. Two of the 47 patients were pregnant. Other laboratory abnormalities included microcytic, hypochromic anemia in patients, and an elevated Erythrocyte Sedimentation Rate in a patient later diagnosed with a rheumatologic disorder. Those perimenarcheal girls presenting with irregular menses and findings including obesity, acne, or pallor, were likely to have treatable causes of menstrual irregularities. In one of the four girls with a normal physical examination, hormonal testing indicated possible FOH, thus suggesting that hormonal evaluation of perimenarcheal girls with menstrual irregularities may be justified, as it may reveal previously unsuspected pathology.

Randomised trial of LHRH analogue treatment on final height in girls with onset of puberty aged 7.5-8.5 years

PubMed Central

Cassio, A.; Cacciari, E.; Balsamo, A.; Bal, M.; Tassinari, D.

1999-01-01

OBJECTIVE—To study the effectiveness of luteinising hormone releasing hormone (LHRH) analogues in improving final height in girls affected by early puberty.
PATIENTS—Forty six consecutive girls with onset of puberty aged 7.5-8.5 years randomly divided into two groups: one treated with 3.75 mg triptorelin intramuscularly every four weeks (group 1); and the other with no treatment (group 2).
RESULTS—Mean (SD) chronological age at onset of menarche was significantly higher in group 1 than in group 2 (11.9 (1.0) v 10.8 (0.7) years). However, mean (SD) height at menarche (152.7 (7.2) v 152.5(5.7) cm) and mean (SD) growth after menarche (4.9 (3.0) v 5.4(2.2) cm) were similar in both groups. The mean (SD) final height was similar in the two groups (group 1, 158.1 (6.2) cm; group 2, 158.6 (6.0) cm) and not significantly different from target height. Fourteen of 20 patients in group 1 and 12 of 18 patients in group 2 showed final height equal to or higher than target height. Final heights of girls with poor initial height prognosis were significantly lower than those of girls with good prognosis, but in patients with the same initial height prognosis, both groups showed final heights similar and not significantly different from their target heights.
CONCLUSIONS—LHRH analogue has no apparent effect on final height in subjects with onset of puberty between 7.5 and 8.5years.

 PMID:10490438

Dietary soy effects on mammary gland development during the pubertal transition in nonhuman primates

PubMed Central

Dewi, Fitriya N.; Wood, Charles E.; Lees, Cynthia J.; Willson, Cynthia J.; Register, Thomas C.; Tooze, Janet A.; Franke, Adrian A.; Cline, J. Mark

2013-01-01

While epidemiologic studies suggest that soy intake early in life may reduce breast cancer risk, there are also concerns that exposure to soy isoflavones during childhood may alter pubertal development and hormonal profiles. Here, we assessed the effect of a high-soy diet on pubertal breast development, sex hormones, and growth in a nonhuman primate model. Pubertal female cynomolgus monkeys were randomized to receive a diet modeled on a typical North American diet with one of two protein sources for ~4.5 years: i) casein/lactalbumin (CL, n=12, as control) or ii) soy protein isolate with a human equivalent dose of 120 mg/day isoflavones (SOY, n=17), which is comparable to approximately four servings of soy foods. Pubertal exposure to the SOY diet did not alter onset of menarche, indicators of growth and pubertal progression, or circulating estradiol and progesterone concentrations. Greater endometrial area was seen in the SOY group on the first of 4 postmenarchal ultrasound measurements (P<0.05). There was a subtle effect of diet on breast differentiation whereby the SOY group showed higher numbers of differentiated large-sized lobular units and a lower proportion with immature ducts following menarche (P<0.05). Numbers of small lobules and terminal end buds and mammary epithelial cell proliferation did not differ by diet. Expression of progesterone receptor was lower in immature lobules of soy-fed animals (P<0.05). Our findings suggest that consumption of soy starting before menarche may result in modest effects consistent with a more differentiated breast phenotype in adulthood. PMID:23771522

Knowledge, attitudes and perceptions of the teacher's role in sexuality education in public schools in Nigeria.

PubMed

Asekun-Olarinmoye, Esther O; Fawole, Olufunmilayo I; Dairo, Magbagbeola D; Amusan, Oluwatoyin A

2007-01-01

The purpose of this study was to describe the knowledge, attitude, and perception of teachers of their role in the sexuality education of secondary school students with a viewto suggesting strategies for improvement. The study was a descriptive cross-sectional survey. Information was collected from 305 secondary school teachers selected by multi-stage random sampling method from Osun state, Nigeria using a pre-tested semi-structured questionnaire. Median age of respondents was 36 +/- 8.18 years. Male/female ratio was 1:1.2. Knowledge about key reproductive issues was poor and inadequate. Knowledge of more than one contraceptive method was low (39.0%), Condom was the most frequently mentioned (59.3%). The teachers exhibited poor perception of their role in sexuality education of their students. 52.8% placed the sole responsibility for sexuality education on parents and only 20.7% found that it should start before age 10 years. Mean menarcheal age was 13.1 +/- 1.7 y. A statistically significant association was found between respondents' gender and knowledge of menarcheal age (p = .03); and between class taught and knowledge of menarcheal age (p = .003). 86.90% had positive attitude towards inclusion of sexuality education in the school curriculum; however, 43.6% felt that contraceptive methods should not be part of the course content. An urgent need exists for education and re-orientation of teachers through seminars and workshops, in-service training education program to equip them properly for the task. Policy makers need to formulate a definite, explicit, and workable sexuality education policy.

Menarche as a predictor of risk-taking behavior in a sample of Hungarian adolescent girls.

PubMed

Varga-Tóth, Andrea; Maróti-Nagy, Ágnes; Németh, Gábor; Paulik, Edit

2017-05-24

Background The age at the time of the first sexual intercourse is declining, and the prevalence of smoking is increasing in adolescent girls in developed countries. Objective To assess the relationship between menarche and tobacco smoking and sexual activity in adolescent girls. Subjects Girls between 14 and 18 years, attending primary or secondary school. Methods Socio-demographic characteristics (age, living place, educational level of parents, self-estimated financial background), onset and parameters of periods, and risk behaviors (smoking, sexual activity) were measured by self-administered questionnaires. A multivariate logistic regression analysis was used to assess the relationship between tobacco use and sexual activity and socio-demographic characteristics, menarche and presence of other risk behaviors. Results Adolescent girls who had an earlier onset of their periods were about twice as likely to smoke as girls with later onset of their first period [odds ratio (OR): 2.28, confidence interval (CI): 1.14-4.55]. Being sexually active meant more than 7-fold odds of being a regular tobacco user (OR: 7.24, CI: 4.39-11.94). Regarding sexual activity, increasing age (OR: 4.42, CI: 3.45-5.67) and regular smoking (OR: 7.07, CI: 4.24-11.80) increased, while poor financial status decreased (OR: 0.35, CI: 0.13-0.97) the odds of being sexually active. Conclusion In light of these findings, the reconsideration of health and sexual education in Hungary is needed. Implementation of these programs at an earlier age should be desirable to avoid unfavorable consequences, such as early pregnancy.

Joint associations between genetic variants and reproductive factors in glioma risk among women.

PubMed

Wang, Sophia S; Hartge, Patricia; Yeager, Meredith; Carreón, Tania; Ruder, Avima M; Linet, Martha; Inskip, Peter D; Black, Amanda; Hsing, Ann W; Alavanja, Michael; Beane-Freeman, Laura; Safaiean, Mahboobeh; Chanock, Stephen J; Rajaraman, Preetha

2011-10-15

In a pooled analysis of 4 US epidemiologic studies (1993-2001), the authors evaluated the role of 5 female reproductive factors in 357 women with glioma and 822 controls. The authors further evaluated the independent association between 5 implicated gene variants and glioma risk among the study population, as well as the joint associations of female reproductive factors (ages at menarche and menopause, menopausal status, use of oral contraceptives, and menopausal hormone therapy) and these gene variants on glioma risk. Risk estimates were calculated as odds ratios and 95% confidence intervals that were adjusted for age, race, and study. Three of the gene variants (rs4295627, a variant of CCDC26; rs4977756, a variant of CDKN2A and CDKN2B; and rs6010620, a variant of RTEL1) were statistically significantly associated with glioma risk in the present population. Compared with women who had an early age at menarche (<12 years of age), those who reported menarche at 12-13 years of age or at 14 years of age or older had a 1.7-fold higher risk and a 1.9-fold higher risk of glioma, respectively (P for trend = 0.009). Postmenopausal women and women who reported ever having used oral contraceptives had a decreased risk of glioma. The authors did not observe joint associations between these reproductive characteristics and the implicated glioma gene variants. These results require replication, but if confirmed, they would suggest that the gene variants that have previously been implicated in the development of glioma are unlikely to act through the same hormonal mechanisms in women.

An Ethnography of the Navajo Reproductive Cycle.

ERIC Educational Resources Information Center

Wright, Anne

1982-01-01

Describes the reproductive cycle (menarche, menstrual cycle, fertility and contraceptive use, and menopause) as experienced by two groups of contemporary Navajo women. Eighty Navajo women, 40 traditional and 40 acculturated, participated in the 1978 research project which focused on influences of menopause. (ERB)

AGE AT MENARCHE IN GIRLS EXPOSED PERINATALLY TO POLYBROMINATED BIPHENYL. (R825300)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Anti-Müllerian hormone levels and antral follicle count in women enrolled in in vitro fertilization cycles: relationship to lifestyle factors, chronological age and reproductive history.

PubMed

Nardo, Luciano G; Christodoulou, Dimitra; Gould, Della; Roberts, Steve A; Fitzgerald, Cheryl T; Laing, Ian

2007-01-01

The aims of this prospective study were to investigate the relationship between anti-Müllerian hormone (AMH) and antral follicle count (AFC), and to determine whether these markers of ovarian reserve correlate with lifestyle factors, ethnicity, chronological age and reproductive history. Participants were 136 normo-ovulatory women undergoing infertility work-up within 3 months of their first ovarian stimulation cycle for in vitro fertilization. On day 3 of a spontaneous menstrual cycle, a blood sample for measurement of plasma AMH levels was taken and a transvaginal ultrasound scan to determine the AFC (follicles measuring 2-5 mm in diameter) was performed. Information about smoking, body mass index, alcohol consumption, ethnic origin, chronological age, age at menarche, years since menarche and gravidity were recorded using a case report form. The main outcome measures were plasma AMH concentrations and total number of small antral follicles (AFC). Median plasma levels of AMH were 2.0 ng/ml (interquartile range 1.1-3.6) and AFC was 10 (interquartile range 7-15). A positive correlation between AMH and AFC (r = 0.54, p < 0.0001) was found. AMH and AFC correlated negatively with age (r = -0.30, p < 0.001 and r = -0.27, p = 0.001 respectively) and number of years since menarche (r = -0.23, p = 0.007 and r = -0.21, p = 0.015 respectively), but not with any of the other measures. Circulating AMH levels and AFC correlated with each other and declined significantly with age. There were only weak, non-significant, correlations with lifestyle factors and reproductive history. These putative markers could be used individually or together to assess the age-related decline of ovarian function in normo-ovulatory candidates for IVF.

[Associated factors related to first spermatorrhea and menarche among high and primary school students, in Chongqing].

PubMed

Li, K Q; Wang, H; Guo, J; Yuan, B C; Guan, P Y

2016-02-01

To understand the status and correlative factors on menarche and first spermatorrhea among children and adolescents, in Chongqing, in order to provide theoretical basis for carrying out sex and health education in this population. By random stratified and cluster sampling, 10 498 students (5 372 boys and 5 126 girls), 5 to 18 years old and living in Chongqing urban districts, were enrolled. General situation and physical features of the population were studied. Statistics analysis system included logistic regression methods, t-test and chi-square test. For urban kids, first experience of spermatorrhea was 0.218 years later than those living in the rural areas (Z=-73.287,P<0.001), but median age for girls in urban areas was 0.073 years earlier than in rural areas (Z=-71.589,P<0.001). Except for factor as mother's education level in the family (χ(2)=21.564, P<0.001), other family or environment related factors did not show significant difference between the two groups of boys (P>0.05). However, significant difference appeared in average family income (χ(2)=6.175,P=0.046) between two groups of girls. Data from the logistic analysis showed that BMI, hip circumference, height, weight, number of children in the family, time of sleep and the diet structure were associated with menarche. Correlative factors of boys' first spermatorrhea would include: high-energy snacks, hip circumference, weight, height, school type and mother' s education level (P<0.05). First spermatorrhea and menstruation of boys and girls were closely related to environment of the family, diet and the time of sleep.

Differences in anthropometric and ultrasonographic parameters between adolescent girls with regular and irregular menstrual cycles: a case-study of 835 cases.

PubMed

Radivojevic, Ubavka D; Lazovic, Gordana B; Kravic-Stevovic, Tamara K; Puzigaca, Zarko D; Canovic, Fadil M; Nikolic, Rajko R; Milicevic, Srboljub M

2014-08-01

Exploring the relation between the age, time since menarche, anthropometric parameters and the growth of the uterus and ovaries in postmenarcheal girls. Cross sectional. Department of Human reproduction at a tertiary pediatric referral center. Eight hundred thirty-five adolescent girls. Postmenarcheal girls were classified according to the regularity of their menstrual cycles in 2 groups (regular and irregular cycles) and compared. Anthropometric measurements and ultrasonographic examination of the pelvis was conducted with all participants. Anthropometric and ultrasonographic parameters were evaluated. Results of our study showed that girls with regular and irregular cycles differed in height, weight, body mass index, percentage of body fat and ovarian volumes. The size of the ovaries decreases in the group of girls with regular cycles (r = 0.14; P < .005), while it increases in girls with irregular cycles (r = 0.15; P < .001) with advancing age. Uterine volume in all patients increases gradually with age reaching consistent values at 16 years (r = 0.5; P < .001). Age at menarche, the time elapsed since menarche, the height, weight, body mass index and percentage of body fat in patients correlated with uterine volume. Ovarian volume correlated with patients' weight, BMI and percentage of fat. Uterus continues to grow in postmenarcheal years, with increasing height and weight of girls, regardless of the regularity of cycles. Postmenarcheal girls with irregular cycles were found to have heavier figures and larger ovaries. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

[Sociodemographic characteristics, risk factors and reproductive history in subjects with fibromyalgia--results of a population-based case-control study].

PubMed

Schochat, T; Beckmann, C

2003-02-01

According to recent studies, 1.3 to 4.8% of the population of Western industrialized nations suffer from fibromyalgia, with 80 to 90% of the affected persons being women. This preponderance of women, mostly in their reproductive years, suggests an association between fibromyalgia and sex hormones. Within the framework of a population-based cross-sectional study of 3174 female residents of Bad Säckingen aged 35 to 74 years a stratified random sample of 653 women was clinically examined and surveyed. Thirty-six of these women fulfilled the ACR criteria of fibromyalgia. Forty-four women suffered from chronic widespread pain without having fibromyalgia (chronic pain group); 408 had no chronic pain (controls). Compared to the control group, subjects with fibromyalgia have a 3.6-fold risk, while compared to the chronic pain group, there is a 3.9-fold risk of having a lower social level. Subjects with fibromyalgia drink less alcohol than subjects from the chronic pain group and the control group. After adjusting for age, multivariate analyses demonstrated that, in comparison to controls, subjects with fibromyalgia have a significantly later menarche (OR=2.2 for >14 years) and had never been pregnant (OR=0.3). The comparison of the chronic pain group and controls did not demonstrate these associations. The associations with a low social level, low alcohol intake, late menarche and rare pregnancies are specific for subjects with fibromyalgia. These factors distinguish subjects with fibromyalgia from subjects with other chronic pain conditions as well as from subjects with no chronic pain. The same hormonal factors responsible for a delayed menarche and a reduced fertility may be relevant in the development of fibromyalgia.

Age at menopause, reproductive history, and venous thromboembolism risk among postmenopausal women: the Women's Health Initiative Hormone Therapy clinical trials.

PubMed

Canonico, Marianne; Plu-Bureau, Geneviève; O'Sullivan, Mary Jo; Stefanick, Marcia L; Cochrane, Barbara; Scarabin, Pierre-Yves; Manson, Joann E

2014-03-01

This study aims to investigate venous thromboembolism (VTE) risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause, as well as any interaction with randomized hormone therapy (HT) assignment, among postmenopausal women. Using pooled data from the Women's Health Initiative HT clinical trials including 27,035 postmenopausal women aged 50 to 79 years who had no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause by Cox proportional hazards models. Linear trends, quadratic relationships, and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. During follow-up, 426 women reported a first VTE, including 294 non-procedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected, and there was not a significant association between VTE and age at menarche, age at menopause, parity, oophorectomy, or time since menopause. However, analyses restricted to non-procedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (P < 0.01). Compared with women aged 40 to 49 years at menopause, those who had early menopause (age <40 y) or late menopause (age >55 y) had a significantly increased VTE risk (hazard ratio [95% CI]: 1.8 [1.2-2.7] and 1.5 [1.0-2.4], respectively). Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for non-procedure-related VTE.

Ages at Menarche and Menopause and Reproductive Lifespan As Predictors of Exceptional Longevity in Women: The Women's Health Initiative

PubMed Central

Shadyab, Aladdin H.; Macera, Caroline A.; Shaffer, Richard A.; Jain, Sonia; Gallo, Linda C.; Gass, Margery L.S.; Waring, Molly E.; Stefanick, Marcia L.; LaCroix, Andrea Z.

2016-01-01

Objective To investigate associations between reproductive factors and survival to age 90 years. Methods This was a prospective study of postmenopausal women from the Women's Health Initiative recruited from 1993-1998 and followed until the last outcomes evaluation on August 29, 2014. Participants included 16,251 women born on or before August 29, 1924 for whom survival to age 90 during follow-up was ascertained. Women were classified as having survived to age 90 (exceptional longevity) or died before age 90. Multivariable logistic regression models were used to evaluate associations of ages at menarche and menopause (natural or surgical) and reproductive lifespan with longevity, adjusting for demographic, lifestyle, and reproductive characteristics. Results Participants were on average aged 74.7 years (range, 69-81 years) at baseline. Of 16,251 women, 8,892 (55%) survived to age 90. Women aged ≥12 years at menarche had modestly increased odds of longevity (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.00-1.19). There was a significant trend toward increased longevity for later age at menopause (natural or surgical; Ptrend =0.01), with ORs (95% CIs) of 1.19 (1.04-1.36) and 1.18 (1.02-1.36) for 50-54 and ≥55 compared with <40 years, respectively. Later age at natural menopause as a separate exposure was also significantly associated with increased longevity (Ptrend =0.02). Longer reproductive lifespan was significantly associated with increased longevity (Ptrend=0.008). The odds of longevity were 13% (OR, 1.13; 95% CI, 1.03-1.25) higher in women with >40 compared with <33 reproductive years. Conclusions Reproductive characteristics were associated with late-age survival in older women. PMID:27465713

From menarche to menopause: the fertile life span of celiac women.

PubMed

Santonicola, Antonella; Iovino, Paola; Cappello, Carmelina; Capone, Pietro; Andreozzi, Paolo; Ciacci, Carolina

2011-10-01

We evaluated menopause-associated disorders and fertile life span in women with celiac disease (CD) under untreated conditions and after long-term treatment with a gluten-free diet. The participants were 33 women with CD after menopause (untreated CD group), 25 celiac women consuming a gluten-free diet at least 10 years before menopause (treated CD group), and 45 healthy volunteers (control group). The Menopause Rating Scale questionnaire was used to gather information on menopause-associated disorders. The International Physical Activity Questionnaire was used to acquire information on physical activity. Untreated celiac women had a shorter duration of fertile life span than did the control women because of an older age of menarche and a younger age of menopause (P < 0.01). The scores for hot flushes, muscle/joint problems, and irritability were higher in untreated celiac women than in the control women (higher by 49.4%, 121.4%, and 58.6%, respectively; P < 0.05). In comparison with untreated CD, long-lasting treatment of CD was not associated with a significant difference in the duration of fertile life span, but was only associated with a significant reduction in muscle/joint problems (a reduction of 47.1%; P < 0.05). Late menarche and early menopause causes a shorter fertile period in untreated celiac women compared with control women. A gluten-free diet that started at least 10 years before menopause prolongs the fertile life span of celiac women. The perception of intensity of hot flushes and irritability is more severe in untreated celiac women than in controls. Low physical exercise and/or poorer quality of life frequently reported by untreated celiac women might be the cause of reduced discomfort tolerance, thus increasing the subjective perception of menopausal symptoms.

Age at menopause, reproductive history and venous thromboembolism risk among postmenopausal women

PubMed Central

Canonico, Marianne; Plu-Bureau, Geneviève; O’Sullivan, Mary Jo; Stefanick, Marcia L.; Cochrane, Barbara; Scarabin, Pierre-Yves; Manson, JoAnn E.

2013-01-01

Objectives To investigate VTE risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy and time since menopause, as well as any interaction with randomized HT assignment among postmenopausal women. Methods Using pooled data from the Women’s Health Initiative HT clinical trials including 27,035 postmenopausal women ages 50 to 79 years with no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy and time since menopause by Cox proportional hazard models. Linear trends, quadratic relationships and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. Results During the follow-up, 426 women reported a first VTE, including 294 nonprocedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected and there was any significant association of VTE with age at menarche, age at menopause, parity, oophorectomy or time since menopause. However, analyses restricted to nonprocedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (p<0.01). Compared to women aged 40 to 49 years at menopause, those with early menopause (age<40 years) or with late menopause (age>55 years) had a significant increased VTE risk (HR=1.8;95%CI:1.2–2.7 and HR=1.5;95%CI:1.0–2.4, respectively). Conclusion Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for nonprocedure-related VTE. PMID:23760439

Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers.

PubMed

Longworth, Brooke; Fary, Robyn; Hopper, Diana

2014-09-01

To determine any differences between the prevalence of adolescent idiopathic scoliosis in ballet dancers who are girls compared with age-matched nondancers, and to establish if any relations exist between the presence of scoliosis and generalized joint hypermobility, age of menarche, body mass index (BMI), and the number of hours of dance training per week. Cross-sectional, matched pair study. Dance school. Dancers (n=30) between the ages of 9 and 16 years were recruited from a certified dance school in Western Australia; each dancer provided a consenting age-matched nondancer (n=30). Not applicable. Measurements were taken for angle of trunk rotation using a scoliometer (presence of scoliosis) and for height and weight to produce generalized joint hypermobility using Beighton criteria and an age-adjusted BMI, respectively. A subjective questionnaire regarding age of menarche and participation in dance and other sports was completed. Thirty percent of dancers tested positive for scoliosis compared with 3% of nondancers. Odds ratio calculations suggest that dancers were 12.4 times more likely to have scoliosis than nondancers of the same age. There was a higher rate of hypermobility in the dancer group (70%) compared with the nondancers (3%); however, there were no statistically significant relations between scoliosis and hypermobility, age of menarche, BMI, or hours of dance per week. Adolescent dancers, similar to adult dancers, are at significantly higher risk of developing scoliosis than nondancers of the same age. Vigilant screening and improved education of dance teachers and parents of dance students may be beneficial in earlier detection and, consequently, reducing the risk of requiring surgical intervention. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Premenstrual syndrome and dysmenorrhea: urban-rural and multiethnic differences in perception, impacts, and treatment seeking.

PubMed

Wong, Li Ping

2011-10-01

Attitudes toward menarche and menstruation are largely influenced by sociological, cultural, and family environmental factors. Recognizing the influential effects that these factors might have on shaping adolescents' attitudes is crucial in designing a more effective means of transmitting health information. This study aimed to gather an in-depth understanding of perceptions, impacts, and treatment seeking on menstruation-related issues from an ethnically mixed group of rural and urban girls. In total, 27 focus group discussions (172 participants) were conducted between November 2008 and April 2009. Participants were adolescent girls aged 13-19 years, recruited from 7 public secondary schools in the Federal Territory of Kuala Lumpur and 4 public secondary schools from the rural districts of Kelantan, in Malaysia. Many participants revealed that they were not given or had not received detailed information about the mechanism or physiology of menstruation prior to its onset. Thus, many described the onset of menarche as shocking, an event for which they were unprepared, and which has had a tremendous impact on their emotions. More positive acceptance of menarche was reported in the urban than with the rural groups. Despite the high prevalence of premenstrual syndrome and dysmenorrhea, participants across urban-rural and ethnic groups perceived the problems as completely normal, hence they relied on self-care methods and did not want to seek professional treatment. More rural girls compared to urban girls were embarrassed to talk to their mothers or consult their physicians regarding menstruation-related problems. Menstruation-related education would have a positive impact in improving adolescent girls' knowledge and in nurturing a positive attitude toward menstruation-related matters at home, at school, and in the community. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Complex sources of variance in female dominance rank in a nepotistic society

PubMed Central

Lea, Amanda J.; Learn, Niki H.; Theus, Marcus J.; Altmann, Jeanne; Alberts, Susan C.

2016-01-01

Many mammalian societies are structured by dominance hierarchies, and an individual’s position within this hierarchy can influence reproduction, behaviour, physiology and health. In nepotistic hierarchies, which are common in cercopithecine primates and also seen in spotted hyaenas, Crocuta crocuta, adult daughters are expected to rank immediately below their mother, and in reverse age order (a phenomenon known as ‘youngest ascendancy’). This pattern is well described, but few studies have systematically examined the frequency or causes of departures from the expected pattern. Using a longitudinal data set from a natural population of yellow baboons, Papio cynocephalus, we measured the influence of maternal kin, paternal kin and group size on female rank positions at two life history milestones, menarche and first live birth. At menarche, most females (73%) ranked adjacent to their family members (i.e. the female held an ordinal rank in consecutive order with other members of her maternal family); however, only 33% of females showed youngest ascendancy within their matriline at menarche. By the time they experienced their first live birth, many females had improved their dominance rank: 78% ranked adjacent to their family members and 49% showed youngest ascendancy within their matriline. The presence of mothers and maternal sisters exerted a powerful influence on rank outcomes. However, the presence of fathers, brothers and paternal siblings did not produce a clear effect on female dominance rank in our analyses, perhaps because females in our data set co-resided with variable numbers and types of paternal and male relatives. Our results also raise the possibility that female body size or competitive ability may influence dominance rank, even in this classically nepotistic species. In total, our analyses reveal that the predictors of dominance rank in nepotistic rank systems are much more complex than previously thought. PMID:26997663

Impact of Reproductive History and Exogenous Hormone Use on Cognitive Function in Midlife and Late Life

PubMed Central

Karim, Roksana; Dang, Ha; Henderson, Victor W.; Hodis, Howard N.; St John, Jan; Brinton, Roberta D.; Mack, Wendy J.

2016-01-01

Background/objectives Given the potent role of sex hormones on brain chemistry and function, we investigated the association of reproductive history indicators of hormonal exposures, including reproductive period, pregnancy, and use of hormonal contraceptives, on mid- and late-life cognition in postmenopausal women. Design Analysis of baseline data from two randomized clinical trials, the Women’s Isoflavone Soy Health (WISH) and the Early vs Late Intervention Trial of Estradiol (ELITE). Setting University academic research center Participants 830 naturally menopausal women Measurements Participants were uniformly evaluated with a cognitive battery and a structured reproductive history. Outcomes were composite scores for verbal episodic memory, executive functions, and global cognition. Reproductive variables included ages at pregnancies, menarche, and menopause, reproductive period, number of pregnancies, and use of hormones for contraception and menopausal symptoms. Multivariable linear regression evaluated associations between cognitive scores (dependent variable) and reproductive factors (independent variables), adjusting for age, race/ethnicity, income and education. Results On multivariable modeling, age at menarche ≥ 13 years of age was inversely associated with global cognition (p= 0.05). Last pregnancy after age 35 was positively associated with verbal memory (p=0.03). Use of hormonal contraceptives was positively associated with global cognition (p trend=0.04), and verbal memory (p trend=0.007). The association between hormonal contraceptive use and verbal memory and executive functions was strongest for more than 10 years of use. Reproductive period was positively associated with global cognition (p=0.04) and executive functions (p=0.04). Conclusion In this sample of healthy postmenopausal women, reproductive life events related to sex hormones, including earlier age at menarche, later age at last pregnancy, length of reproductive period, and use of oral contraceptives are positively related to aspects of cognition in later life. PMID:27996108

Pleased to be pregnant? Positive pregnancy attitudes among sexually active adolescent females in the United States.

PubMed

Lau, May; Lin, Hua; Flores, Glenn

2014-08-01

To identify factors associated with a positive pregnancy attitude among sexually active US teen females. Secondary database analysis of the National Survey of Family Growth. Adolescent females 15-19 years old. Nationally representative sample. Bivariate and multivariable analyses were performed of the 2002 and 2006-08 cycles to examine whether sociodemographic factors, contraceptive history, sexual education and behavior history, medical services history, and family and sexual attitudes were associated with a positive pregnancy attitude among sexually active teen females. Among the 975 sexually active US adolescent females surveyed, 15% reported a positive pregnancy attitude. Compared with adolescent females with a negative pregnancy attitude, those females with a positive pregnancy attitude were significantly (P < .05) more likely to have public insurance (43% vs 20%), to be poor (33% vs 10%), to have reached menarche at an earlier age (12 years old vs 13 years old), ever have HIV tested (35% vs 23%), but less likely to have ever been forced to have sex (1% vs 10%). In multivariable analyses, Latino race/ethnicity was associated with triple the odds, and African-American double the odds, of a positive pregnancy attitude. Older age of menarche and higher family income were associated with reduced odds of a positive pregnancy attitude. One in 7 sexually active US adolescent females had a positive pregnancy attitude. Minority race/ethnicity was associated with greater odds of a positive pregnancy attitude, whereas older age of menarche and a higher family income were associated with lower odds of a positive pregnancy attitude. Assessing pregnancy attitudes for these groups of adolescent females might prove useful to decrease adolescent pregnancy rates. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Factors affecting onset of puberty in Denizli province in Turkey.

PubMed

Semiz, Serap; Kurt, Funda; Kurt, Devrim Tanil; Zencir, Mehmet; Sevinç, Ozgür

2009-01-01

The relationship between the possible factors affecting pubertal onset and pubertal timing was investigated in the Denizli province in Turkey. A total number of 3311 subjects (1562 girls, 1749 boys) aged 6-16.5 years participated in this study. Body mass index (BMI) was calculated. Pubertal stages were assessed according to methods of Marshall and Tanner. Testicular volume was determined using Prader orchidometer. Menarcheal age was recorded. All parents and students completed different questionnaires on demographic variables affecting pubertal timing such as socioeconomic conditions, psychosocial factors, exercise, nutritional status, chronic diseases, migration and birth weight. Using distribution percentiles of pubertal stages according to age, the relation between pubertal timing and factors affecting puberty was investigated. There was no significant association between exercise, birth weight, migration, chronic disease, and socioeconomic status and age of puberty onset. Menarcheal age of overweight and obese girls was significantly lower than that of girls with normal weight. In-family stress was the cause of early puberty in girls and of delayed puberty in boys.

Cultural perceptions and practices around menarche and adolescent menstruation in the United States.

PubMed

Stubbs, Margaret L

2008-01-01

This overview details the persistence of negative characterizations of the menstrual cycle as a feature of the current cultural context in which girls begin menstrual life in the United States. In addition, research on girls' current menstrual attitudes and experiences within this context are reviewed. Current research suggests that girls are not very knowledgeable about menstruation, and that menstrual education continues to provide girls with mixed messages, such as: menstruation is a normal, natural event, but it should be hidden. Girls' attitudes and expectations about menstruation are negatively biased and have been found to contribute to self-objectification, body shame, and lack of agency in sexual decision-making. Although preparation has been found to be associated with more positive menarcheal and menstrual experiences, specificity about what constitutes "good" preparation has not been well articulated. Implications for promoting the menstrual cycle among young girls as a vital sign in service of monitoring their health are discussed.

American Girls: Their Growth and Development

ERIC Educational Resources Information Center

Zacharias, Leona; Rand, William M.

1978-01-01

Presents statistics of a girl's age, height, and weight at menarche, and the possible effect on these variables of various factors such as her health, genetic inheritance, socioeconomic circumstances, and environment. The behavior of present day adolescents cannot be attributed to earlier physical and sexual development. (Author/IRT)

Oral contraceptives modify the effect of GATA3 polymorphisms on the risk of asthma at the age of 18 years via DNA methylation.

PubMed

Guthikonda, Kranthi; Zhang, Hongmei; Nolan, Vikki G; Soto-Ramírez, Nelís; Ziyab, Ali H; Ewart, Susan; Arshad, Hasan S; Patil, Veeresh; Holloway, John W; Lockett, Gabrielle A; Karmaus, Wilfried

2014-01-01

The prevalence of asthma in girls increases after puberty. Previous studies have detected associations between sex hormones and asthma, as well as between sex hormones and T helper 2 (Th2) asthma-typical immune responses. Therefore, we hypothesized that exogenous or endogenous sex hormone exposure (represented by oral contraceptive pill (OCP) use and early menarche, respectively) are associated with DNA methylation (DNA-M) of the Th2 transcription factor gene, GATA3, in turn affecting the risk of asthma in girls, possibly in interaction with genetic variants. Blood samples were collected from 245 female participants aged 18 years randomly selected for methylation analysis from the Isle of Wight birth cohort, UK. Information on use of OCPs, age at menarche, and concurrent asthma were assessed by questionnaire. Genome-wide DNA-M was determined using the Illumina Infinium HumanMethylation450 beadchip. In a first stage, we tested the interaction between sex hormone exposure and genetic variants on DNA-M of specific cytosine-phosphate-guanine (CpG) sites. In a second stage, we determined whether these CpG sites interact with genetic variants in GATA3 to explain the risk of asthma. Interactions between OCP use and seven single nucleotide polymorphisms (SNPs) of GATA3 were analyzed for 14 CpG sites (stage 1). The interaction between OCP use and SNP rs1269486 was found to be associated with the methylation level of cg17124583 (P = 0.002, false discovery rate (FDR) adjusted P = 0.04). DNA-M of this same CpG site was also influenced by the interaction between age at menarche and rs1269486 (P = 0.0017). In stage 2, we found that cg17124583 modified the association of SNP rs422628 with asthma risk at the age of 18 years (P = 0.006, FDR adjusted P = 0.04). Subjects with genotype AG showed an increase in average risk ratio (RR) from 0.31 (95% CI: 0.10 to 0.8) to 11.65 (95% CI: 1.71 to 79.5) when methylation level increased from 0.02 to 0.12, relative to genotype AA. A two-stage model consisting of genetic variants in the GATA3 gene, OCP use, age at menarche, and DNA-M may explain how sex hormones in women can increase the asthma prevalence after puberty.

BLOOD LEAD AND SECONDARY SEXUAL CHARACTERISTICS AND MENSES IN U.S. GIRLS

EPA Science Inventory

Blood Lead and Secondary Sexual Characteristics and Menses in U.S. Girls. *T. Wu, P. Mendola, and G.M. Buck (SUNY at Buffalo, Buffalo, NY 14214)

Purpose: To investigate the association between blood lead and puberty (presence of public hair, breast development, and menarch...

The Relationship between Puberty and Social Emotion Processing

ERIC Educational Resources Information Center

Goddings, Anne-Lise; Burnett Heyes, Stephanie; Bird, Geoffrey; Viner, Russell M.; Blakemore, Sarah-Jayne

2012-01-01

The social brain undergoes developmental change during adolescence, and pubertal hormones are hypothesized to contribute to this development. We used fMRI to explore how pubertal indicators (salivary concentrations of testosterone, oestradiol and DHEA; pubertal stage; menarcheal status) relate to brain activity during a social emotion task.…

Puberty and Physical Self-Perceptions of Competitive Female Figure Skaters: An Interdisciplinary Approach

ERIC Educational Resources Information Center

Monsma, Eva V.; Malina, Robert M.; Feltz, Deborah L.

2006-01-01

This study considered the interrelationships among biological maturation and its physical correlates, social physique anxiety, and appearance-related physical self-perceptions in 113 adolescent female figure skaters participating in solo (n = 73) or partner contexts (n = 40). Participants were interviewed about their menarcheal status, underwent a…

Measuring Physical Status and Timing in Early Adolescence: A Developmental Perspective.

ERIC Educational Resources Information Center

Brooks-Gunn, J.; Warren, Michelle P.

1985-01-01

This paper reviews some of the maturational events that are applicable in studying psychological effects of pubertal status and timing. Nine changes are reviewed (bone, height, weight, body fat, breast, body hair, penile, testicular, and menarcheal changes) in terms of measurement techniques, psychometric properties, and intercorrelations with…

Cumulative Estrogen Exposure and Prospective Memory in Older Women

ERIC Educational Resources Information Center

Hesson, Jacqueline

2012-01-01

This study looked at cumulative lifetime estrogen exposure, as estimated with a mathematical index (Index of Cumulative Estrogen Exposure (ICEE)) that included variables (length of time on estrogen therapy, age at menarche and menopause, postmenopausal body mass index, time since menopause, nulliparity and duration of breastfeeding) known to…

Menstruation, Menarche, and Sexuality in the Public School Curriculum: School Nurses' Perceptions.

ERIC Educational Resources Information Center

Swenson, Ingrid Elizabeth; And Others

1995-01-01

Examines the involvement of 39 school nurses in curricula related to human reproduction, including contraception. Results suggest that the nurses are significantly involved in teaching about reproductive health and sexuality. Data about nurses' involvement provides a basis for evaluating their roles and for making recommendations for subsequent…

Adolescence Behaviour Problems: How to Tackle or Prevent?

ERIC Educational Resources Information Center

Kumar, V. Jurist Lionial

2013-01-01

Adolescence is a transitional stage of physical and mental human development that occurs between child hood and adulthood. Adolescent period starts with puberty. The period during which the capability for sexual reproduction is attained; it is marked by changes in both primary and secondary sexual characteristics and is dated from menarche in…

Contextual and Developmental Predictors of Sexual Initiation Timing among Mexican-Origin Girls

ERIC Educational Resources Information Center

Bámaca-Colbert, Mayra Y.; Greene, Kaylin M.; Killoren, Sarah E.; Noah, Aggie J.

2014-01-01

Using data from a longitudinal study of Mexican-origin girls (ages 11-17 at Time 1), we examined sociocultural (i.e., family structure, nativity, and acculturation), interpersonal (i.e., supportive parenting and conflict), and developmental (i.e., menarche timing and autonomy expectations) predictors of sexual initiation. Using Cox proportional…

Early Motherhood in an Intergenerational Perspective: The Experiences of a British Cohort.

ERIC Educational Resources Information Center

Manlove, Jennifer

1997-01-01

Uses nationally representative, longitudinal data from Great Britain to examine the fertility patterns of daughters (N=2,183) of teen mothers. Explores how early motherhood is reproduced across generations, including an earlier inherited age of menarche, poor family and educational environments, and an early ideal age of childbearing. (RJM)

Age at Menarche and Choice of College Major: Implications for STEM Majors

ERIC Educational Resources Information Center

Brenner-Shuman, Anna; Waren, Warren

2013-01-01

Even though boys and girls in childhood perform similarly in math and spatial thinking, after puberty fewer young women pursue majors that emphasize abilities such as science, technology, engineering, and math (STEM) in college. If postpubertal feminization contributes to a lower likelihood of choosing STEM majors, then young women who enter…

Body mass index distribution affects discrepancies in weight classifications in children

USDA-ARS?s Scientific Manuscript database

The aim of the present study was to investigate the effect of body mass index (BMI) distribution, ethnicity, and age at menarche on the consistency in the prevalence of underweight and overweight as defined by the Centers for Disease Control and Prevention (CDC) and the International Obesity Task Fo...

Becoming a Woman: Considerations in Educating Adolescents about Menstruation. Revised 1988. Working Paper No. 169.

ERIC Educational Resources Information Center

Stubbs, Margaret L.; And Others

This paper reports findings that have emerged from several studies conducted concerning young girls' and boys' attitudes toward menstruation. The research work discussed included: (1) cross-sectional data about menarcheal experience and about attitudes toward menstruation from early adolescent girls in grades six through nine; (2) cross-sectional…

The Development of Menstrual-Related Beliefs and Behaviors during Early Adolescence.

ERIC Educational Resources Information Center

Brooks-Gunn, Jeanne; Ruble, Diane N.

1982-01-01

A cross-sectional and a longitudinal study were conducted to answer questions about (1) the development and nature of premenstrual adolescent girls' expectations about menstrual symptoms, (2) expectations for and beliefs about menstrual symptoms as they relate to the actual experience of menarche, and (3) sources of information about menstruation…

Persistent osteopenia in ballet dancers with amenorrhea and delayed menarche despite hormone therapy: a longitudinal study.

PubMed

Warren, Michelle P; Brooks-Gunn, Jeanne; Fox, Richard P; Holderness, Claire C; Hyle, Emily P; Hamilton, William G; Hamilton, Linda

2003-08-01

To investigate the role of estrogen deprivation and replacement in amenorrheic and nonamenorrheic dancers on hormone therapy and calcium. Clinical, placebo-controlled, randomized trial study.Healthy volunteers in an academic research environment. Fifty-five dancers (mean age: 22.0 +/- 4.6, age at menarche: 14.7 +/- 2.3 years), including 24 amenorrheics. Amenorrheics were randomized in a controlled trial to receive placebo or Premarin, 0.625 mg for 25 days monthly, with Provera, 10 mg, for 10 of these 25 days (hormone therapy) for 2 years. These women were compared to normally menstruating controls. The study participants also received 1250 mg of calcium per day. Bone mineral density (BMD) measured at the foot, wrist, and lumbar spine. Our overall results showed no difference in BMD between the treated or placebo groups, indicating that hormone therapy did not change or normalize BMD when compared to normals. Five patients (all on placebo) who resumed menses during the study showed an increase in BMD without normalization. These findings suggest that mechanisms other than hypoestrogenism may be involved with the osteopenia associated with exercise-induced amenorrhea.

PubMed Central

Lambert, Yves; Paré, Lucie

1990-01-01

Various authors have suggested the possibility of a link between biological age and sexual activity. Zelnick (1981) described the relationship between sexual activity and age at menarche. To determine the relationship between biological age and age at first sexual intercourse, we presented a questionnaire to 450 students attending a comprehensive secondary school in Montreal. Age at menarche and age at first conscious ejaculation were used to measure biological age. A partial correlation was made between biological age and age at first sexual intercourse by controlling for chronological age. The results were r = 0.24 (p <0.029) for female students and r = 0.21 (p <0.08) for male students. The value of the correlation was weak but significant where the female students were concerned. For the male students, the value of the correlation could not be determined due to the insufficient number of respondents. Biological age would appear to be an indicator of the age at which sexual activity first occurs. This indicator could be used by clinicians directly, and to develop a more general model for determining the age at which sexual activity first occurs. PMID:21234038

Pubertal timing and adolescent sexual behavior in girls.

PubMed

Moore, Sarah R; Harden, K Paige; Mendle, Jane

2014-06-01

Girls who experience earlier pubertal timing relative to peers also exhibit earlier timing of sexual intercourse and more unstable sexual relationships. Although pubertal development initiates feelings of physical desire, the transition into romantic and sexual relationships involves complex biological and social processes contributing both to physical maturation and to individual interpretations of pubertal experiences. Using a sample of female sibling pairs (n = 923 pairs) from the National Longitudinal Study of Adolescent Health, the present study investigated associations among menarche and perceived pubertal timing, age of first sexual intercourse (AFI), and adolescent dating and sexual behavior using a behavioral genetic approach. Genetic factors influencing age at menarche and perceived pubertal timing predicted AFI through shared genetic pathways, whereas genetic factors related only to perceived pubertal timing predicted engagement in dating, romantic sex, and nonromantic sex in the previous 18 months. These results suggest that a girl's interpretation of her pubertal timing beyond objective timing is important to consider for the timing and the contexts of romantic and reproductive behavior. PsycINFO Database Record (c) 2014 APA, all rights reserved.

'This is a natural process': managing menstrual stigma in Nepal.

PubMed

Crawford, Mary; Menger, Lauren M; Kaufman, Michelle R

2014-01-01

Menstrual stigma has been demonstrated in many societies. However, there is little research on menstrual attitudes in South Asia, despite religiously-based menstrual restrictions imposed on women. To understand menstrual stigma in this context, we conducted qualitative research with women in Nepal. Nepali Hinduism forbids menstruating women to enter a temple or kitchen, share a bed with a husband or touch a male relative. During menstruation, women are 'untouchable'. There has been virtually no research on how Nepali women make meaning of these practices. The current study employed focus groups and individual interviews to understand how some Nepali women experience menarche and menstrual stigma. We explored how women describe their experiences and the strategies they adopt to manage age-old stigma in a rapidly modernising society where they have multiple roles as workers, wives and mothers. Participants reported they experienced menarche with little preparation, which caused distress, and were subjected to ongoing stigmatisation as menstruating women. They described coping strategies to reduce the effects of this stigma. This study provides a unique perspective on coping with menstrual stigma in South Asia.

[Pubertal growth of 1,453 healthy children according to age at pubertal growth spurt onset. The Barcelona longitudinal growth study].

PubMed

Carrascosa, Antonio; Yeste, Diego; Moreno-Galdó, Antonio; Gussinyé, Miquel; Ferrández, Ángel; Clemente, María; Fernández-Cancio, Mónica

2018-02-20

Pubertal growth pattern differs according to age at pubertal growth spurt onset which occurs over a five years period (girls: 8-13 years, boys: 10-15 years). The need for more than one pubertal reference pattern has been proposed. We aimed to obtain five 1-year-age-interval pubertal patterns. Longitudinal (6 years of age-adult height) growth study of 1,453 healthy children to evaluate height-for-age, growth velocity-for-age and weight-for-age values. According to age at pubertal growth spurt onset girls were considered: very-early matures (8-9 years, n=119), early matures (9-10 years, n=157), intermediate matures (10-11 years, n=238), late matures (11-12 years, n=127) and very-late matures (12-13 years, n=102), and boys: very-early matures (10-11 years, n=110), early matures (11-12 years, n=139), intermediate matures (12-13 years, n=225), late matures (13-14 years, n=133) and very-late matures (14-15 years, n=103). Age at menarche and growth up to adult height were recorded. In both sexes, statistically-significant (P<.0001) and clinically-pertinent differences in pubertal growth pattern (mean height-for-age, mean growth velocity-for-age and mean pubertal height gain, values) were found among the five pubertal maturity groups and between each group and the whole population, despite similar adult height values. The same occurred for age at menarche and growth from menarche to adult height (P<.05). In both sexes, pubertal growth spurt onset is a critical milestone determining pubertal growth and sexual development. The contribution of our data to better clinical evaluation of growth according to the pubertal maturity tempo of each child will obviate the mistakes made when only one pubertal growth reference is used. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women's Health Initiative.

PubMed

LeBlanc, Erin S; Kapphahn, Kristopher; Hedlin, Haley; Desai, Manisha; Parikh, Nisha I; Liu, Simin; Parker, Donna R; Anderson, Matthew; Aroda, Vanita; Sullivan, Shannon; Woods, Nancy F; Waring, Molly E; Lewis, Cora E; Stefanick, Marcia

2017-01-01

The aim of the study was to understand the association between women's reproductive history and their risk of developing type 2 diabetes. We hypothesized that characteristics signifying lower cumulative endogenous estrogen exposure would be associated with increased risk. Prospective cohort analysis of 124,379 postmenopausal women aged 50 to 79 years from the Women's Health Initiative (WHI). We determined age of menarche and final menstrual period, and history of irregular menses from questionnaires at baseline, and calculated reproductive length from age of menarche and final menstrual period. Presence of new onset type 2 diabetes was from self-report. Using multivariable Cox proportional hazards models, we assessed associations between reproductive variables and incidence of type 2 diabetes. In age-adjusted models, women with the shortest (<30 y) reproductive periods had a 37% (95% CI, 30-45) greater risk of developing type 2 diabetes than women with medium-length reproductive periods (36-40 y). Women with the longest (45+ y) reproductive periods had a 23% (95% CI, 12-37) higher risk than women with medium-length periods. These associations were attenuated after full adjustment (HR 1.07 [1.01, 1.14] for shortest and HR 1.09 [0.99, 1.22] for longest, compared with medium duration). Those with a final menstrual period before age 45 and after age 55 had an increased risk of diabetes (HR 1.04; 95% CI, 0.99-1.09 and HR 1.08; 95% CI, 1.01-1.14, respectively) compared to those with age of final menstrual period between 46 and 55 years. Timing of menarche and cycle regularity was not associated with risk after full adjustment. Reproductive history may be associated with type 2 diabetes risk. Women with shorter and longer reproductive periods may benefit from lifestyle counseling to prevent type 2 diabetes.

Ages at menarche and menopause and reproductive lifespan as predictors of exceptional longevity in women: the Women's Health Initiative.

PubMed

Shadyab, Aladdin H; Macera, Caroline A; Shaffer, Richard A; Jain, Sonia; Gallo, Linda C; Gass, Margery L S; Waring, Molly E; Stefanick, Marcia L; LaCroix, Andrea Z

2017-01-01

The aim of the present study was to investigate associations between reproductive factors and survival to age 90 years. This was a prospective study of postmenopausal women from the Women's Health Initiative recruited from 1993 to 1998 and followed until the last outcomes evaluation on August 29, 2014. Participants included 16,251 women born on or before August 29, 1924 for whom survival to age 90 during follow-up was ascertained. Women were classified as having survived to age 90 (exceptional longevity) or died before age 90. Multivariable logistic regression models were used to evaluate associations of ages at menarche and menopause (natural or surgical) and reproductive lifespan with longevity, adjusting for demographic, lifestyle, and reproductive characteristics. Participants were on average aged 74.7 years (range, 69-81 y) at baseline. Of 16,251 women, 8,892 (55%) survived to age 90. Women aged at least 12 years at menarche had modestly increased odds of longevity (odds ratio [OR], 1.09; 95% CI, 1.00-1.19). There was a significant trend toward increased longevity for later age at menopause (natural or surgical; Ptrend = 0.01), with ORs (95% CIs) of 1.19 (1.04-1.36) and 1.18 (1.02-1.36) for 50 to 54 and at least 55 compared with less than 40 years, respectively. Later age at natural menopause as a separate exposure was also significantly associated with increased longevity (Ptrend = 0.02). Longer reproductive lifespan was significantly associated with increased longevity (Ptrend = 0.008). The odds of longevity were 13% (OR 1.13; 95% CI, 1.03-1.25) higher in women with more than 40 compared with less than 33 reproductive years. Reproductive characteristics were associated with late-age survival in older women.

Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: Findings from the Women’s Health Initiative

PubMed Central

LeBlanc, Erin S; Kapphahn, Kristopher; Hedlin, Haley; Desai, Manisha; Parikh, Nisha I.; Liu, Simin; Parker, Donna R.; Anderson, Matthew; Aroda, Vanita; Sullivan, Shannon; Woods, Nancy F.; Waring, Molly E.; Lewis, Cora E.; Stefanick, Marcia

2016-01-01

Objective To understand the association between women’s reproductive history and their risk of developing type 2 diabetes. We hypothesized that characteristics signifying lower cumulative endogenous estrogen exposure would be associated with increased risk. Methods Prospective cohort analysis of 124,379 postmenopausal women aged 50–79 from the Women’s Health Initiative. We determined age of menarche and final menstrual period, and history of irregular menses from questionnaires at baseline, and calculated reproductive length from age of menarche and final menstrual period. Presence of new onset type 2 diabetes was from self-report. Using multivariable Cox proportional hazards models, we assessed associations between reproductive variables and incidence of type 2 diabetes. Results In age-adjusted models, women with the shortest (<30 years) reproductive periods had a 37% (95% CI = 30–45%) greater risk of developing type 2 diabetes than women with medium-length reproductive periods (36 to 40 years). Women with the longest (45+ years) reproductive periods had a 23% (95% CI = 12–37%) higher risk than women with medium-length periods. These associations were attenuated after full adjustment (HR of 1.07 [1.01, 1.14] for shortest and HR of 1.09 [0.99, 1.22] for longest, compared to medium duration). Those with a final menstrual period before age 45 and after age 55 had an increased risk of diabetes (HR 1.04, 95% CI 0.99, 1.09 and HR 1.08, 95% CI 1.01, 1.14, respectively) compared to those with age of final menstrual period between 46 and 55. Timing of menarche and cycle regularity were not associated with risk after full adjustment. Conclusions Reproductive history may be associated with type 2 diabetes risk. Women with shorter and longer reproductive periods may benefit from lifestyle counseling to prevent type 2 diabetes. PMID:27465714

Body mass index in relation to truncal asymmetry of healthy adolescents, a physiopathogenetic concept in common with idiopathic scoliosis: summary of an electronic focus group debate of the IBSE

PubMed Central

2013-01-01

There is no generally accepted scientific theory for the cause of adolescent idiopathic scoliosis (AIS). As part of its mission to widen understanding of scoliosis etiology, the International Federated Body on Scoliosis Etiology (IBSE).introduced the electronic focus group (EFG) as a means of increasing debate on knowledge of important topics. This has been designated as an on-line Delphi discussion. The text for this debate was written by Dr TB Grivas. It is based on published research from Athens, Greece evaluating schoolchildren age 11–17 years for the relation of body mass index (BMI) to each of truncal asymmetry (TA) and menarcheal status. Girls with relatively lower BMI were found to have a significant excess of severe TAs and significantly later menarche confirming the well-known relation of BMI to menarche. Together with other evidence linking nutritional status to skeletal growth, the observations suggest energy balance via the hypothalamus is related to trunk asymmetry. As with a recent speculative hypothesis for the pathogenesis of AIS in girls, Grivas et al. suggest that the severe TAs involve a genetically-determined selectively increased sensitivity (up-regulation) of the hypothalamus to circulating leptin with asymmetry as an adverse response to stress (hormesis). The TA is expressed bilaterally via the sympathetic nervous system to produce left-right asymmetry in ribs and/or vertebrae leading to severe TAs when beyond the capacity of postural mechanisms of the somatic nervous system to control the shape distortion in the trunk. This EFG discusses the findings and interpretations of the paper by Grivas and colleagues as research at the borderland between the genesis of TA (physiogenesis) and AIS (pathogenesis). It is suggested that TAs, here regarded in common with AIS, result from the combination of secondary sexual development affecting body composition, adolescent skeletal growth velocity, and an asymmetry process. The possible involvement of epigenetic factors is not considered. PMID:23799971

Are Elite Female Soccer Athletes at Risk for Disordered Eating Attitudes, Menstrual Dysfunction, and Stress Fractures?

PubMed

Prather, Heidi; Hunt, Devyani; McKeon, Kathryn; Simpson, Scott; Meyer, E Blair; Yemm, Ted; Brophy, Robert

2016-03-01

To determine the prevalence of stress fractures, menstrual dysfunction and disordered eating attitudes in elite female soccer athletes. Cross-sectional descriptive study. Female soccer athletes were recruited from a national level youth soccer club, an NCAA Division I university team, and a women's professional team. Two hundred twenty female soccer athletes with a mean age of 16.4 ± 4 years and BMI of 20.8 ± 2 kg/m(2) completed the study, representing all athletes from the included teams. One-time surveys completed by the athletes. Height and weight were recorded, and body mass index (BMI) was calculated for each athlete. Athletes reported age of menarche, history of missing 3 or more menses within a 12-month period and stress fracture. The Eating Attitudes Test (EAT-26) was used to assess the athlete's body perception and attitudes toward eating. Of the 220 soccer athletes, 3 athletes (1.6%) had a low BMI for their age, and 19 (8.6%) reported stress fractures of the lower extremity. Among athletes who had reached menarche, the average onset was 13 + 1 year; menstrual dysfunction were present in 21 (19.3%). On the EAT-26, 1 player scored in the high risk range (>20) and 17 (7.7%) scored in the intermediate risk range (10-19) for eating disorders. Athletes with an EAT-26 score ≥ 10 points had a significantly higher prevalence of menstrual dysfunction in the past year compared to athletes with an EAT-26 score of less than 10 (P = .02). Elite female soccer athletes are susceptible to stress fractures and menstrual dysfunction and have delayed onset of menarche despite normal BMI and appropriate body perception and attitudes towards eating. Further studies are needed to better understand stress fracture risk in female soccer athletes and in other team sports to determine how these findings relate to long-term bone health in this population. Copyright © 2016. Published by Elsevier Inc.

Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study.

PubMed

Merritt, Melissa A; Riboli, Elio; Murphy, Neil; Kadi, Mai; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Dossus, Laure; Dartois, Laureen; Clavel-Chapelon, Françoise; Fortner, Renée T; Katzke, Verena A; Boeing, Heiner; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Palli, Domenico; Sieri, Sabina; Tumino, Rosario; Sacerdote, Carlotta; Panico, Salvatore; Bueno-de-Mesquita, H Bas; Peeters, Petra H; Lund, Eiliv; Nakamura, Aurelie; Weiderpass, Elisabete; Quirós, J Ramón; Agudo, Antonio; Molina-Montes, Esther; Larrañaga, Nerea; Dorronsoro, Miren; Cirera, Lluís; Barricarte, Aurelio; Olsson, Åsa; Butt, Salma; Idahl, Annika; Lundin, Eva; Wareham, Nicholas J; Key, Timothy J; Brennan, Paul; Ferrari, Pietro; Wark, Petra A; Norat, Teresa; Cross, Amanda J; Gunter, Marc J

2015-10-30

Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled >500,000 women and men from 1992 to 2000, who were residing in a given town/geographic area in 10 European countries. The current analysis included 322,972 eligible women aged 25-70 years with 99 % complete follow-up for vital status. We assessed reproductive characteristics reported at the study baseline including parity, age at the first birth, breastfeeding, infertility, oral contraceptive use, age at menarche and menopause, total ovulatory years, and history of oophorectomy/hysterectomy. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for mortality were determined using Cox proportional hazards regression models adjusted for menopausal status, body mass index, physical activity, education level, and smoking status/intensity and duration. During a mean follow-up of 12.9 years, 14,383 deaths occurred. The HR (95 % CI) for risk of all-cause mortality was lower in parous versus nulliparous women (0.80; 0.76-0.84), in women who had ever versus never breastfed (0.92; 0.87-0.97), in ever versus never users of oral contraceptives (among non-smokers; 0.90; 0.86-0.95), and in women reporting a later age at menarche (≥15 years versus <12; 0.90; 0.85-0.96; P for trend = 0.038). Childbirth, breastfeeding, oral contraceptive use, and a later age at menarche were associated with better health outcomes. These findings may contribute to the development of improved strategies to promote better long-term health in women.

Age of menarche and knowledge about menstrual hygiene management among adolescent school girls in Amhara province, Ethiopia: implication to health care workers & school teachers.

PubMed

Gultie, Teklemariam; Hailu, Desta; Workineh, Yinager

2014-01-01

Effective menstrual hygiene has direct and indirect effect on achieving millennium development goals two (universal education), three (gender equality and women empowerment) and, five (improving maternal health). However, in Ethiopiait is an issue which is insufficiently acknowledged in the reproductive health sector. The objective of this study therefore, is to assess the age of menarche and knowledge of adolescents about menstrual hygiene management in Amhara province. School based cross sectional study was conducted from November 2012 to June 2013. Multistage stage sampling technique was used. The school was first clustered in to grades & sections and thenparticipants were selected by lottery method. A pretested &structured questionnaire was used. Data were entered, cleaned and analyzed using SPSS version 16.0. Finally, multivariate analysis was used to assess independent effect of predictors. In this study, 492 students were included, making a response rate of 100%. Mean age at menarche was 14.1±1.4 years. The main sources of information about menstrual hygiene management were teachers for 212 (43.1%). Four hundred forty six (90.7%) respondents had high level knowledge about menstrual hygiene management. Most of the respondents 457 (92.9%) and 475 (96.5%) had access for water and toilet facility respectively. Place of residence (AOR = 1.8, 95%CI: [1.42-1.52]) and educational status of their mothers' (AOR = 95%CI: [1.15-13.95]) were independent predictors of knowledge about menstrual hygiene management. Knowledge of respondents about menstrual hygiene management was very high. School teachers were the primary source of information. Place of residence and their mother's educational status were independent predictors of menstrual hygiene management. Thus, the government of Ethiopia in collaboration with its stalk holders should develop and disseminatereproductive health programmes on menstrual hygiene management targeting both parents and their adolescents. Moreover, parents should be made aware about the need to support their children with appropriate sanitary materials.

Do breast-feeding and other reproductive factors influence future risk of rheumatoid arthritis? Results from the Nurses' Health Study.

PubMed

Karlson, Elizabeth W; Mandl, Lisa A; Hankinson, Susan E; Grodstein, Francine

2004-11-01

To explore the contribution of female hormonal factors occurring prior to the onset of rheumatoid arthritis (RA), such as age at menarche, parity, age at first birth, breast-feeding, use of oral contraceptives (OCs), irregular menstrual cycles, and postmenopausal hormone (PMH) use, to the subsequent development of RA in a large female cohort. We studied female reproductive and hormonal risk factors for RA in a cohort of 121,700 women enrolled in the longitudinal Nurses' Health Study. The diagnosis of incident RA (between 1976 and 2002) in 674 women was confirmed by a connective tissue disease screening questionnaire and blinded medical record review for American College of Rheumatology criteria. Sixty percent of the patients with RA were rheumatoid factor positive. The relationship between potential risk factors, including age, age at menarche, parity, age at first birth, total lifetime history of breast-feeding, use of OCs, and irregular menstrual cycles and the multivariate-adjusted risk of RA was estimated using Cox proportional hazards models. Using a multivariate model that adjusted for age, body mass index, smoking, parity, and other hormonal factors, we observed a strong trend for decreasing risk of RA with increasing duration of breast-feeding (P for trend = 0.001). For women who breast-fed (compared with parous women who did not breast-feed), the risk ratios (RRs) and 95% confidence intervals (95% CIs) were as follows: breast-feeding for < or =3 total months, RR 1.0 (95% confidence interval [95% CI] 0.8-1.2); for 4-11 total months, RR 0.9 (95% CI 0.7-1.1); for 12-23 total months, RR 0.8 (95% CI 0.6-1.0); and for > or =24 total months, RR 0.5 (95% CI 0.3-0.8). Very irregular menstrual cycles were associated with an increased risk of RA (RR 1.4, 95% CI 1.0-2.0). Age at menarche < or =10 years was associated with an increased risk of seropositive RA (RR 1.6, 95% CI 1.1-2.4) but not significantly associated with risk of RA. Parity, total number of children, age at first birth, and OC use were not associated with an increased risk of RA in this cohort. In this large cohort, breast-feeding for >12 months was inversely related to the development of RA. This apparent effect was dose-dependent, with a significant trend toward lower risk with longer duration of breast-feeding. Irregular menstrual cycles and earlier age at menarche increased the risk of RA. Other reproductive hormonal factors were not associated with RA risk.

Puberty: Maturation, Timing and Adjustment, and Sexual Identity Developmental Milestones among Lesbian, Gay, and Bisexual Youth

ERIC Educational Resources Information Center

Grossman, Arnold H.; Foss, Alexander H.; D'Augelli, Anthony R.

2014-01-01

This study examined pubertal maturation, pubertal timing and outcomes, and the relationship of puberty and sexual identity developmental milestones among 507 lesbian, gay, and bisexual youth. The onset of menarche and spermarche occurred at the mean ages of 12.05 and 12.46, respectively. There was no statistically significant difference in…

The Female Athlete Triad: Prevalence in Military Women

DTIC Science & Technology

1997-07-01

women, 9% had amenorrhea, 6% oligomenorrhea, and 12% had onset of menarche older than 14 years of age. Excluding all women on hormonal birth control , the...hormonal birth control , only 1% had both an ED and MI, and 3.5% of women AR also had MI. Part 3 of the study evaluated the bone mineral density (BMD) of all

A Life History Assessment of Early Childhood Sexual Abuse in Women

ERIC Educational Resources Information Center

Vigil, Jacob M.; Geary, David C.; Byrd-Craven, Jennifer

2005-01-01

Life history theory provided a framework for examining the relations among child sexual abuse (CSA), childhood adversity, and patterns of reproductive development and behavior. A community survey that assessed CSA, life history variables (e.g., age of menarche), and social and family background was administered to 623 women (mean age=26.9 years).…

Premature Ovarian Failure in French Canadian Leigh Syndrome.

PubMed

Ghaddhab, Chiraz; Morin, Charles; Brunel-Guitton, Catherine; Mitchell, Grant A; Van Vliet, Guy; Huot, Céline

2017-05-01

In all surviving girls with Leigh syndrome, French Canadian variety, a mitochondrial disease, we detected premature ovarian failure, manifested as absent or arrested breast development, lack of menarche, high follicle-stimulating hormone, a prepubertal uterus, and small ovaries. Pubertal onset and progression should be evaluated in girls with mitochondrial diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

The Impact of Self-Components on Attitudes toward Sex among African American Preadolescent Girls: The Moderating Role of Menarche.

ERIC Educational Resources Information Center

Townsend, Tiffany G.

2002-01-01

Identified factors that helped prevent attitudes tolerant of risky sexual behavior among inner-city, African American, preadolescent girls age 10-13 years. Survey data indicated that feminine gender role orientation, self-concept, and ethnic identity related to attitudes less tolerant of risky sexual behaviors. Masculine gender role orientation…

Puberty and Physical Self-Perceptions of Competitive Female Figure Skaters II: Maturational Timing, Skating Context, and Ability Status

ERIC Educational Resources Information Center

Monsma, Eva V.

2008-01-01

One study of figure skaters found that menarcheal status was a stronger predictor than age in explaining the variance in their self-perceptions. Postmenarcheal skaters had significantly lower self-esteem and physical self-concept and were less satisfied with their appearance than premenarcheal skaters. Surprisingly, skating context (i.e., skating…

Assessment of pubertal development in Egyptian girls.

PubMed

Hosny, Laila A; El-Ruby, Mona O; Zaki, Moushira E; Aglan, Mona S; Zaki, Maha S; El Gammal, Mona A; Mazen, Inas M

2005-06-01

Puberty is a significant event of human growth and maturation associated with marked physiological and psychological changes. The aim of this study was to assess normal pubertal development in Egyptian girls to define normal, precocious and delayed puberty. The present study included a cross-sectional sample of 1,550 normal Egyptian girls of high and middle socioeconomic class living in Cairo. Their ages ranged from 6.5 to 18.5 years. Pubertal assessment was made according to Tanner staging. The mean menarcheal age (MMA) was estimated using probit analysis. Weight and height were measured and body mass index (BMI) was calculated. The mean age at breast bud stage (B2) was 10.71+/-1.6, pubic hair stage (PH2) was 10.46+/-1.36, while axillary hair stage (A2) was 11.65+/-1.62 and MMA was 12.44 years. The mean age at attainment of puberty was compared with those of other Egyptian studies and other populations. Girls of the present study started pubertal development and achieved menarche earlier than those of previous Egyptian studies confirming a secular trend. Differences between the present study and other worldwide studies can be attributed to various genetic, racial, geographical, nutritional, and secular trend factors.

A breast cancer case-control study in Girona, Spain. Endocrine, familial and lifestyle factors.

PubMed

Viladiu, P; Izquierdo, A; de Sanjosé, S; Bosch, F X

1996-10-01

This study was designed to explore risk factors for breast cancer with emphasis on the detection of clinical markers of the hormonal imbalance during the perimenarche. Three hundred and thirty women diagnosed with breast cancer and 346 population controls were identified and interviewed in Girona, Spain between 1986 and 89. Cases were more likely than controls to have had long menstrual periods in the first 5 years after menarche [odds ratio (OR) = 3.0], to experience menopause at a late age (OR = 1.5) and to report acne during adolescence (OR = 1.6). Family history of breast cancer was associated with an increased risk (OR = 2.3). Cases reported a lower use of drug treatments for anxiety and sleep disorders than controls. Moderate alcohol drinkers and smokers were at lower risk for breast cancer. No statistically significant association with breast cancer was observed for number of children, age at last pregnancy, oral contraceptive use, hormonal treatment after menopause and weight perception during the teenage years. Hormonal changes in the years following menarche may be relevant to breast cancer risk. The roles of menstrual period length and acne during adolescence should be further explored.

[Epidemiologic variables in postmenopausal women].

PubMed

Murillo-Uribe, A; Carranza-Lira, S; Martínez-Trejo, N A; Santos González, J E

1999-10-01

The objective was to know the characteristics of presentation, its clinical aspects and the modification in the diagnostic tools in a selected population of Mexican women with spontaneous menopause. The age at menarche, age at menopause, marital status, age at marriage, number of pregnancies and occupation of 1,099 women with spontaneous menopause were studied. In 619 women which were not receiving nor had received hormone replacement therapy the clinical, laboratory such as glucose, lipids, hormones, bone remodeling biochemistry; and X ray studies such as densitometry and mammography were analyzed. The age average of menarche presentation was at 13 years, and that of spontaneous menopause at 48.1 years 78% were married, with an age at marriage of 23 years, 66% had home duties. The screening tests showed that 30% of patients required cardiovascular evaluation, 40% showed alterations on lipids levels and at least 40% had some alteration on bone remodeling biochemistry or in densitometry. The mammography was normal in 81%. This study showed that most of the data in these group of women were similar to those of other populations, and many of them need intensive surveillance and adequate therapeutic prescriptions to diminish risk factors.

The relationship between puberty and social emotion processing

PubMed Central

Goddings, Anne-Lise; Burnett Heyes, Stephanie; Bird, Geoffrey; Viner, Russell M; Blakemore, Sarah-Jayne

2012-01-01

The social brain undergoes developmental change during adolescence, and pubertal hormones are hypothesized to contribute to this development. We used fMRI to explore how pubertal indicators (salivary concentrations of testosterone, oestradiol and DHEA; pubertal stage; menarcheal status) relate to brain activity during a social emotion task. Forty-two females aged 11.1 to 13.7 years underwent fMRI scanning while reading scenarios pertaining either to social emotions, which require the representation of another person’s mental states, or to basic emotions, which do not. Pubertal stage and menarcheal status were used to assign girls to early or late puberty groups. Across the entire sample, the contrast between social versus basic emotion resulted in activity within the social brain network, including dorsomedial prefrontal cortex (DMPFC), the posterior superior temporal sulcus, and the anterior temporal cortex (ATC) in both hemispheres. Increased hormone levels (independent of age) were associated with higher left ATC activity during social emotion processing. More advanced age (independent of hormone levels) was associated with lower DMPFC activity during social emotion processing. Our results suggest functionally dissociable effects of pubertal hormones and age on the adolescent social brain. PMID:23106734

The timing and role of initiation rites in preparing young people for adolescence and responsible sexual and reproductive behaviour in Malawi.

PubMed

Munthali, Alister C; Zulu, Eliya M

2007-12-01

This paper examines timing of puberty and mechanisms through which society prepares adolescents to understand and deal with it in Malawi. Data from a national representative survey of adolescents and in-depth interviews also conducted with adolescents are used. SPSS was used to analyse survey data while N6 was used to analyse qualitative data. Results show that the onset of menarche in girls and various pubertal body changes in boys can be a cause of joy, excitement, or distress depending on how adolescents understand what this means to them at this critical stage when they start defining and comprehending their sexuality. Much more emphasis is put on educating girls about reproductive implications of menarche than on what is expected of boys as sexual beings, which may contribute to boys' greater indulgence in risky sexual behaviors than girls. The significance of initiation ceremonies in some communities provides an important platform through which programs can reach many adolescents and intervene, particularly in addressing the widely held notion among initiates that attending these ceremonies symbolizes that one is not a child anymore and can have sex.

The Timing and role of Initiation Rites in Preparing Young People for Adolescence and Responsible Sexual and Reproductive Behaviour in Malawi

PubMed Central

Munthali, Alister C.; Zulu, Eliya M.

2008-01-01

This paper examines timing of puberty and mechanisms through which society prepares adolescents to understand and deal with it in Malawi. Data from a national representative survey of adolescents and in-depth interviews also conducted with adolescents are used. SPSS was used to analyse survey data while N6 was used to analyse qualitative data. Results show that the onset of menarche in girls and various pubertal body changes in boys can be a cause of joy, excitement, or distress depending on how adolescents understand what this means to them at this critical stage when they start defining and comprehending their sexuality. Much more emphasis is put on educating girls about reproductive implications of menarche than on what is expected of boys as sexual beings, which may contribute to boys’ greater indulgence in risky sexual behaviors than girls. The significance of initiation ceremonies in some communities provides an important platform through which programs can reach many adolescents and intervene, particularly in addressing the widely held notion among initiates that attending these ceremonies symbolizes that one is not a child anymore and can have sex. PMID:18458746

Association of Allergic Rhinitis in Female University Students with Socio-economic Factors and Markers of Estrogens Levels.

PubMed

Wronka, I; Kliś, K; Jarzebak, K

2016-01-01

The aim of this study is to investigate the association of allergic rhinitis in female university students with socio-economic factors and sex-hormone markers, including age at menarche, menstrual disorders, and selected anthropometrics indexes. The research was conducted among 640 female university students, aged 19-25 years. The measurements of body height, body mass, waist and hip circumference were taken. Each person completed a questionnaire. The occurrence of allergy was determined on the basis of answers to the questions whether the allergy and its allergens were defined on the basis of medical workup. We found that a significantly larger number of cases of allergic rhinitis were recorded in the university students coming from families of high socio-economic level than those from lower level. Allergic rhinitis also was more frequent in the students who spent their childhood in cities than in those who lived in the countryside. The prevalence of allergic rhinitis was inversely correlated to the number of siblings. There were no differences in the prevalence of allergic rhinitis in relation to the birth order. The estrogen level seemed unassociated with rhinitis. However, there were slightly more allergic among females with an earlier age of menarche.

Menstrual pattern and menstrual disorders among adolescents: an update of the Italian data.

PubMed

Rigon, Franco; De Sanctis, Vincenzo; Bernasconi, Sergio; Bianchin, Luigi; Bona, Gianni; Bozzola, Mauro; Buzi, Fabio; Radetti, Giorgio; Tatò, Luciano; Tonini, Giorgio; De Sanctis, Carlo; Perissinotto, Egle

2012-08-14

The most striking event in the whole process of female puberty is the onset of menstruation. To our knowledge, no large population-based studies have been performed on the topic of menstrual health among Italian adolescents in recent years. The aims of this study were to produce up-to-date information on the menstrual pattern of Italian girls attending secondary school, and to estimate the prevalence of menstrual cycle abnormalities in this population. This was a cross-sectional study on a population-based sample of Italian adolescents aged 13-21 years attending secondary school. Only girls who had already started menstruating were requested to participate. Information was collected by means of a questionnaire that included items on the girls' demographic details, anthropometrics, smoking and drinking habits, use of contraceptive pills, and socioeconomic status. The questions on the girls' menstrual pattern concerned their age at menarche, duration of the most recent menstruation intervals (<21, 21-35, >35 days, variable), average days of bleeding (<4, 4-6, >6 days), and any menstrual problems and their frequency. A total of 6,924 questionnaires were administered and 4,992 (71%) were returned. One hundred girls failed to report their date of birth, so 4,892 subjects were analyzed. The girls' mean age was 17.1 years (SD ±1.4); their mean age at menarche was 12.4 (±1.3) years, median 12.4 years (95%CI 12.3-12.5). In our sample population, 3.0% (95%CI 2.5%-3.4%) of the girls had menstruation intervals of less than 21 days, while it was more than 35 days in 3.4% (95%CI 2.9%-3.9%). About 9% of the girls (95%CI 7.7%-9.4%) said the length of their menstruation interval was currently irregular. Short bleeding periods (<4 days) were reported in 3.2% of the sample population (95%CI 2.7%-3.7%), long periods (>6 days) in 19% (95%CI 17.9%-20.1%). Menstruation-related abdominal pain was reported by about 56% of our sample. About 6.2% of the girls (95%CI 5.4%-7.0%) were suffering from dysmenorrhea. In conclusion, to the best of our knowledge, this is one of the largest studies on menstrual patterns and menstrual disorders among Italian adolescent girls. Adolescent girls referring persistent oligomenorrhoea, in first two years from menarche, had a higher risk for developing a persistent menstrual irregularity. They had longer bleeding periods (>6 days) and this has practical implications because it makes these adolescents potentially more susceptible to iron deficiency anemia. Clinicians need to identify menstrual abnormalities as early as possible in order to minimize their possible consequences and sequelae, and to promote proper health information.We recommend that adolescents should be encouraged to chart their menstrual frequency and regularity prospectively from the menarche onwards.

The Development of Reproductive Strategy in Females: Early Maternal Harshness [right arrow] Earlier Menarche [right arrow] Increased Sexual Risk Taking

ERIC Educational Resources Information Center

Belsky, Jay; Steinberg, Laurence; Houts, Renate M.; Halpern-Felsher, Bonnie L.

2010-01-01

To test a proposition central to J. Belsky, L. Steinberg, and P. Draper's (1991) evolutionary theory of socialization--that pubertal maturation plays a role in linking early rearing experience with adolescent sexual risk taking (i.e., frequency of sexual behavior) and, perhaps, other risk taking (e.g., alcohol, drugs, delinquency)--the authors…

Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China; A 10/66 population-based cohort study.

PubMed

Prince, Martin J; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jimenez-Velazquez, Ivonne Z; Llibre Rodriguez, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Chua, Kia-Chong; Dewey, Michael E; Liu, Zhaorui; Mayston, Rosie; Valhuerdi, Adolfo

2018-01-01

Exposure to endogenous estrogen may protect against dementia, but evidence remains equivocal. Such effects may be assessed more precisely in settings where exogenous estrogen administration is rare. We aimed to determine whether reproductive period (menarche to menopause), and other indicators of endogenous estrogen exposure are inversely associated with dementia incidence. Population-based cohort studies of women aged 65 years and over in urban sites in Cuba, Dominican Republic, Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, including ages at menarche, birth of first child, and menopause, and parity, with ascertainment of incident 10/66 dementia, and mortality, three to five years later. 9,428 women participated at baseline, with 72-98% responding by site. The 'at risk' cohort comprised 8,466 dementia-free women. Mean age varied from 72.0 to 75.4 years, lower in rural than urban sites and in China than in Latin America. Mean parity was 4.1 (2.4-7.2 by site), generally higher in rural than urban sites. 6,854 women with baseline reproductive period data were followed up for 26,463 person years. There were 692 cases of incident dementia, and 895 dementia free deaths. Pooled meta-analysed fixed effects, per year, for reproductive period (Adjusted Sub-Hazard Ratio [ASHR] 1.001, 95% CI 0.988-1.015) did not support any association with dementia incidence, with no evidence for effect modification by APOE genotype. No association was observed between incident dementia and; ages at menarche, birth of first child, and menopause: nulliparity; or index of cumulative endogenous estrogen exposure. Greater parity was positively associated with incident dementia (ASHR 1.030, 95% CI 1.002-1.059, I2 = 0.0%). We found no evidence to support the theory that natural variation in cumulative exposure to endogenous oestrogens across the reproductive period influences dementia incidence in late life.

Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China; A 10/66 population-based cohort study

PubMed Central

Acosta, Daisy; Guerra, Mariella; Jimenez-Velazquez, Ivonne Z.; Salas, Aquiles; Sosa, Ana Luisa; Valhuerdi, Adolfo

2018-01-01

Background Exposure to endogenous estrogen may protect against dementia, but evidence remains equivocal. Such effects may be assessed more precisely in settings where exogenous estrogen administration is rare. We aimed to determine whether reproductive period (menarche to menopause), and other indicators of endogenous estrogen exposure are inversely associated with dementia incidence. Methods Population-based cohort studies of women aged 65 years and over in urban sites in Cuba, Dominican Republic, Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, including ages at menarche, birth of first child, and menopause, and parity, with ascertainment of incident 10/66 dementia, and mortality, three to five years later. Results 9,428 women participated at baseline, with 72–98% responding by site. The ‘at risk’ cohort comprised 8,466 dementia-free women. Mean age varied from 72.0 to 75.4 years, lower in rural than urban sites and in China than in Latin America. Mean parity was 4.1 (2.4–7.2 by site), generally higher in rural than urban sites. 6,854 women with baseline reproductive period data were followed up for 26,463 person years. There were 692 cases of incident dementia, and 895 dementia free deaths. Pooled meta-analysed fixed effects, per year, for reproductive period (Adjusted Sub-Hazard Ratio [ASHR] 1.001, 95% CI 0.988–1.015) did not support any association with dementia incidence, with no evidence for effect modification by APOE genotype. No association was observed between incident dementia and; ages at menarche, birth of first child, and menopause: nulliparity; or index of cumulative endogenous estrogen exposure. Greater parity was positively associated with incident dementia (ASHR 1.030, 95% CI 1.002–1.059, I2 = 0.0%). Conclusions We found no evidence to support the theory that natural variation in cumulative exposure to endogenous oestrogens across the reproductive period influences dementia incidence in late life. PMID:29489847

Association between Small Fetuses and Puberty Timing: A Systematic Review and Meta-Analysis

PubMed Central

Deng, Xu; Li, Wenyan; Luo, Yan; Liu, Shudan; Wen, Yi; Liu, Qin

2017-01-01

Background: Epidemiological studies reporting the effect of small fetuses (SF) on puberty development have shown inconsistent results. Objective: To examine current study evidence and determine the strength and direction of the association between SF and puberty timing. Methods: PubMed, OVID, Web of Science, EBSCO, and four Chinese databases were searched from their date of inception to February 2016. All cohort studies that examined the association between SF and puberty timing in children were identified. Two reviewers independently screened the studies, assessed the quality of included studies, and extracted the data. The quality of the included cohort studies was assessed by the Newcastle–Ottawa Scale. Risk ratio (RR), Weighted Mean Difference (WMD), and 95% confidence intervals (CIs) were calculated and pooled by RevMan5.3 (Cochrane Collaboration, London, UK). Results: A total of 10 cohort studies involving 2366 subjects was included in the final analysis. The pooled estimates showed that SF did not significantly increase the number of pubertal children in boys (RR: 0.97; 95% CI: 0.82 to 1.15), or in girls (RR: 0.91; 95% CI: 0.79 to 1.04). Compared with the control group, the SF group had an earlier onset of puberty in girls (WMD: −0.64; 95% CI: −1.21 to −0.06), and in precocious pubarche (PP) girls (WMD: −0.10; 95% CI: −0.13 to −0.07). There was no difference in the onset of puberty in boys (WMD: −0.48; 95% CI: −1.45 to 0.50) between SF and control groups. The pooled result indicated an earlier age at menarche in girls born small for gestational age (WMD: −0.30; 95% CI: −0.58 to −0.03), but no difference in the age at menarche in the SF group of PP girls. Conclusions: SF may be associated with an earlier age of onset of puberty, especially among girls, as well as earlier age at menarche for girls. Well-designed studies with larger sample sizes and long-term follow-up among different countries and ethnicities are needed. PMID:29137163

Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey

PubMed Central

Luby, Stephen P; Halder, Amal K; Islam, Khairul; Opel, Aftab; Shoab, Abul K; Ghosh, Probir K; Rahman, Mahbubur; Mahon, Therese; Unicomb, Leanne

2017-01-01

Background Many adolescent girls in low-income and middle-income countries lack appropriate facilities and support in school to manage menstruation. Little research has been conducted on how menstruation affects school absence. This study examines the association of menstrual hygiene management knowledge, facilities and practice with absence from school during menstruation among Bangladeshi schoolgirls. Methods We conducted a nationally representative, cross-sectional study in Bangladeshi schools from March to June 2013 among girls 11 to 17 years old who reached menarche. We sampled 700 schools from 50 urban and 50 rural clusters using a probability proportional to size technique. We interviewed 2332 schoolgirls and conducted spot checks in each school for menstrual hygiene facilities. To assess factors associated with reported school absence, we estimated adjusted prevalence difference (APD) for controlling confounders’ effect using generalised estimating equations to account for school-level clustering. Results Among schoolgirls who reached menarche, 41% (931) reported missing school, an average of 2.8 missed days per menstrual cycle. Students who felt uncomfortable at school during menstruation (99% vs 32%; APD=58%; CI 54 to 63) and who believed menstrual problems interfere with school performance (64% vs 30%; APD=27; CI 20 to 33) were more likely to miss school during menstruation than those who did not. School absence during menstruation was less common among girls attending schools with unlocked toilet for girls (35% vs 43%; APD=−5.4; CI −10 to –1.6). School absence was more common among girls who were forbidden from any activities during menstruation (41% vs 33%; APD=9.1; CI 3.3 to 14). Conclusion Risk factors for school absence included girl’s attitude, misconceptions about menstruation, insufficient and inadequate facilities at school, and family restriction. Enabling girls to manage menstruation at school by providing knowledge and management methods prior to menarche, privacy and a positive social environment around menstrual issues has the potential to benefit students by reducing school absence. PMID:28694347

The Role of Mother in Informing Girls About Puberty: A Meta-Analysis Study

PubMed Central

Sooki, Zahra; Shariati, Mohammad; Chaman, Reza; Khosravi, Ahmad; Effatpanah, Mohammad; Keramat, Afsaneh

2016-01-01

Context Family, especially the mother, has the most important role in the education, transformation of information, and health behaviors of girls in order for them to have a healthy transition from the critical stage of puberty, but there are different views in this regard. Objectives Considering the various findings about the source of information about puberty, a meta-analysis study was conducted to investigate the extent of the mother’s role in informing girls about puberty. Data Sources This meta-analysis study was based on English articles published from 2000 to February 2015 in the Scopus, PubMed, and Science direct databases and on Persian articles in the SID, Magiran, and Iran Medex databases with determined key words and their MeSH equivalent. Study Selection Quantitative cross-sectional articles were extracted by two independent researchers and finally 46 articles were selected based on inclusion criteria. STROBE list were used for evaluation of studies. Data Extraction The percent of mothers as the current and preferred source of gaining information about the process of puberty, menarche, and menstruation from the perspective of adolescent girls was extracted from the articles. The results of studies were analyzed using meta-analysis (random effects model) and the studies’ heterogeneity was analyzed using the I2 calculation index. Variance between studies was analyzed using tau squared (Tau2) and review manager 5 software. Results The results showed that, from the perspective of teenage girls in Iran and other countries, in 56% of cases, the mother was the current source of information about the process of puberty, menarche, and menstruation. The preferred source of information about the process of puberty, menarche, and menstruation was the mother in all studies at 60% (Iran 57%, and other countries 66%). Conclusions According to the findings of this study, it is essential that health professionals and officials of the ministry of health train mothers about the time, trends, and factors affecting the start of puberty using a multi-dimensional approach that involves religious organizations, community groups, and peer groups. PMID:27331056

Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia.

PubMed

Tegegne, Teketo Kassaw; Sisay, Mitike Molla

2014-10-29

Adolescence in girls has been recognized as a special period marked with the onset of menarche. Even though menstruation is a natural process, it is associated with misconceptions, malpractices and challenges among girls in developing countries. However, much is not documented; school-absenteeism and dropout are a common problem among girls in rural Ethiopia. Focusing among school girls, this study has examined knowledge about menstruation, determinants of menstrual management and its influence on school-attendance in Northeast Ethiopia. We conducted a mixed-method research combining quantitative and qualitative methods in Northeast Ethiopia. The quantitative study was conducted among 595 randomly selected adolescent school girls. Nine in-depth interviews; five school-dropout girls and four female teachers, and four focus group discussions among school girls were conducted in 2013. The mean age at menarche was 13.98 (±1.17) years. About 51% of girls had knowledge about menstruation and its management. Only a third of the girls used sanitary napkins as menstrual absorbent during their last menstruation. Girls from urban areas, had mothers of secondary and above education and, families of higher monthly expenditure had more chance of using sanitary napkins than their counterparts. More than half of the girls reported to have been absent from school during their menstruation period. Those who did not use sanitary napkins were more likely to be absent from school [AOR-95% C.I: 5.37 (3.02 - 9.55)]. Fifty eight percent of girls reported that their school-performance had declined after they had menarche. In addition, the qualitative study indicated that school-dropout was common among girls who experienced teasing and humiliation by classmates when their clothes were stained with blood as they do not use sanitary napkins. Though there is an effort to increase girls' school enrollment, lack of basic needs, like sanitary napkins that facilitate routine activates of girls at early adolescence are observed to deter girls' school-attendance in rural Ethiopia. Special support for girl students, especially when they have their first menstruation and separate functioning sanitary facilities are necessities that should be in school at all times if gender equality and girls empowerment is to be achieved.

Child maltreatment and household dysfunction: associations with pubertal development in a British birth cohort

PubMed Central

Li, Leah; Denholm, Rachel; Power, Chris

2014-01-01

Background: We aimed to establish the association between adverse childhood experiences (maltreatment and household dysfunction) and pubertal maturation, which is associated with later health outcome(s). Methods: The 1958 British birth cohort (n = 17 638) includes all born in one week, March 1958, followed up to mid adulthood. Pubertal stage was rated by medical personnel at 11 and 16 years of age (y). Childhood maltreatment (neglect or abuse) and household dysfunction scores were constructed from information ascertained in childhood and at 45 y. Results: Childhood neglect, assessed at 7 y, was associated with late pubertal development on several markers after adjusting for early life circumstances: relative risk ratio (RRRadjusted) was 1.13 (95% CI: 1.06,1.21) and 1.06 (1.00,1.12) for late menarche and breast development (females) per unit increase in neglect score ranging 0–7, respectively; 1.14 (1.08,1.20) for late voice change and 1.07 (1.02,1.13) for pubic hair growth (males). The RRRadjusted for late pubic hair (females) and genitalia and facial hair (males) development was 1.04 (P = 0.052 to 0.085). Abuse score (0–3, for physical, sexual or psychological abuse) was associated in females with late menarche [RRRadjusted = 1.17 (1.01,1.36)] and in males with late pubic hair growth [RRRadjusted = 1.16 (1.01,1.34)] per unit increase, but not with other pubertal markers. Neither score (neglect or abuse) was associated with early puberty, but sexual abuse was associated with early [RRRadjusted = 1.86 (1.06,3.29)] as well as late menarche [RRRadjusted = 1.66 (1.02,2.71)] and witnessing abuse with early genitalia development [RRRadjusted = 1.57 (1.02,2.41)]. Household dysfunction score was not associated consistently with pubertal markers. Conclusions: Cumulative neglect by 7 y was associated with delayed development of several pubertal markers. The underlying role of pubertal development in linking childhood neglect with future adult health warrants further consideration. PMID:24706731

Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey.

PubMed

Alam, Mahbub-Ul; Luby, Stephen P; Halder, Amal K; Islam, Khairul; Opel, Aftab; Shoab, Abul K; Ghosh, Probir K; Rahman, Mahbubur; Mahon, Therese; Unicomb, Leanne

2017-07-09

Many adolescent girls in low-income and middle-income countries lack appropriate facilities and support in school to manage menstruation. Little research has been conducted on how menstruation affects school absence. This study examines the association of menstrual hygiene management knowledge, facilities and practice with absence from school during menstruation among Bangladeshi schoolgirls. We conducted a nationally representative, cross-sectional study in Bangladeshi schools from March to June 2013 among girls 11 to 17 years old who reached menarche. We sampled 700 schools from 50 urban and 50 rural clusters using a probability proportional to size technique. We interviewed 2332 schoolgirls and conducted spot checks in each school for menstrual hygiene facilities. To assess factors associated with reported school absence, we estimated adjusted prevalence difference (APD) for controlling confounders' effect using generalised estimating equations to account for school-level clustering. Among schoolgirls who reached menarche, 41% (931) reported missing school, an average of 2.8 missed days per menstrual cycle. Students who felt uncomfortable at school during menstruation (99% vs 32%; APD=58%; CI 54 to 63) and who believed menstrual problems interfere with school performance (64% vs 30%; APD=27; CI 20 to 33) were more likely to miss school during menstruation than those who did not. School absence during menstruation was less common among girls attending schools with unlocked toilet for girls (35% vs 43%; APD=-5.4; CI -10 to -1.6). School absence was more common among girls who were forbidden from any activities during menstruation (41% vs 33%; APD=9.1; CI 3.3 to 14). Risk factors for school absence included girl's attitude, misconceptions about menstruation, insufficient and inadequate facilities at school, and family restriction. Enabling girls to manage menstruation at school by providing knowledge and management methods prior to menarche, privacy and a positive social environment around menstrual issues has the potential to benefit students by reducing school absence. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Association between Small Fetuses and Puberty Timing: A Systematic Review and Meta-Analysis.

PubMed

Deng, Xu; Li, Wenyan; Luo, Yan; Liu, Shudan; Wen, Yi; Liu, Qin

2017-11-13

Background : Epidemiological studies reporting the effect of small fetuses (SF) on puberty development have shown inconsistent results. Objective : To examine current study evidence and determine the strength and direction of the association between SF and puberty timing. Methods : PubMed, OVID, Web of Science, EBSCO, and four Chinese databases were searched from their date of inception to February 2016. All cohort studies that examined the association between SF and puberty timing in children were identified. Two reviewers independently screened the studies, assessed the quality of included studies, and extracted the data. The quality of the included cohort studies was assessed by the Newcastle-Ottawa Scale. Risk ratio (RR), Weighted Mean Difference (WMD), and 95% confidence intervals (CIs) were calculated and pooled by RevMan5.3 (Cochrane Collaboration, London, UK). Results : A total of 10 cohort studies involving 2366 subjects was included in the final analysis. The pooled estimates showed that SF did not significantly increase the number of pubertal children in boys (RR: 0.97; 95% CI: 0.82 to 1.15), or in girls (RR: 0.91; 95% CI: 0.79 to 1.04). Compared with the control group, the SF group had an earlier onset of puberty in girls (WMD: -0.64; 95% CI: -1.21 to -0.06), and in precocious pubarche (PP) girls (WMD: -0.10; 95% CI: -0.13 to -0.07). There was no difference in the onset of puberty in boys (WMD: -0.48; 95% CI: -1.45 to 0.50) between SF and control groups. The pooled result indicated an earlier age at menarche in girls born small for gestational age (WMD: -0.30; 95% CI: -0.58 to -0.03), but no difference in the age at menarche in the SF group of PP girls. Conclusions : SF may be associated with an earlier age of onset of puberty, especially among girls, as well as earlier age at menarche for girls. Well-designed studies with larger sample sizes and long-term follow-up among different countries and ethnicities are needed.

Age of Menarche and Knowledge about Menstrual Hygiene Management among Adolescent School Girls in Amhara Province, Ethiopia: Implication to Health Care Workers & School Teachers

PubMed Central

2014-01-01

Background Effective menstrual hygiene has direct and indirect effect on achieving millennium development goals two (universal education), three (gender equality and women empowerment) and, five (improving maternal health). However, in Ethiopiait is an issue which is insufficiently acknowledged in the reproductive health sector. The objective of this study therefore, is to assess the age of menarche and knowledge of adolescents about menstrual hygiene management in Amhara province. Method School based cross sectional study was conducted from November 2012 to June 2013. Multistage stage sampling technique was used. The school was first clustered in to grades & sections and thenparticipants were selected by lottery method. A pretested &structured questionnaire was used. Data were entered, cleaned and analyzed using SPSS version 16.0. Finally, multivariate analysis was used to assess independent effect of predictors. Findings In this study, 492 students were included, making a response rate of 100%. Mean age at menarche was 14.1±1.4 years. The main sources of information about menstrual hygiene management were teachers for 212 (43.1%). Four hundred forty six (90.7%) respondents had high level knowledge about menstrual hygiene management. Most of the respondents 457 (92.9%) and 475 (96.5%) had access for water and toilet facility respectively. Place of residence (AOR = 1.8, 95%CI: [1.42–1.52]) and educational status of their mothers’ (AOR = 95%CI: [1.15–13.95]) were independent predictors of knowledge about menstrual hygiene management. Conclusion Knowledge of respondents about menstrual hygiene management was very high. School teachers were the primary source of information. Place of residence and their mother’s educational status were independent predictors of menstrual hygiene management. Thus, the government of Ethiopia in collaboration with its stalk holders should develop and disseminatereproductive health programmes on menstrual hygiene management targeting both parents and their adolescents. Moreover, parents should be made aware about the need to support their children with appropriate sanitary materials. PMID:25268708

Maternal Early Life Factors Associated with Hormone Levels and the Risk of Having a Child with an Autism Spectrum Disorder in the Nurses Health Study II

ERIC Educational Resources Information Center

Lyall, Kristen; Pauls, David L.; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto

2011-01-01

It is not known whether reproductive factors early in the mother's life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in…

Genetic evidence for natural selection in humans in the contemporary United States.

PubMed

Beauchamp, Jonathan P

2016-07-12

Recent findings from molecular genetics now make it possible to test directly for natural selection by analyzing whether genetic variants associated with various phenotypes have been under selection. I leverage these findings to construct polygenic scores that use individuals' genotypes to predict their body mass index, educational attainment (EA), glucose concentration, height, schizophrenia, total cholesterol, and (in females) age at menarche. I then examine associations between these scores and fitness to test whether natural selection has been occurring. My study sample includes individuals of European ancestry born between 1931 and 1953 who participated in the Health and Retirement Study, a representative study of the US population. My results imply that natural selection has been slowly favoring lower EA in both females and males, and are suggestive that natural selection may have favored a higher age at menarche in females. For EA, my estimates imply a rate of selection of about -1.5 mo of education per generation (which pales in comparison with the increases in EA observed in contemporary times). Although they cannot be projected over more than one generation, my results provide additional evidence that humans are still evolving-albeit slowly, especially compared with the rapid changes that have occurred over the past few generations due to cultural and environmental factors.

[Consumptions of Meat and Dairy Products, Zinc Intake and Pubertal Development in Adolescents in Chengdu].

PubMed

Luo, Jiao; Yang, Ming-zhe; Duan, Ruo-nan; Tian, Guo; Bao, Yu-xin; Chen, Yan-rong; Xue, Hong-mei; Liu, Yan; Cheng, Guo

2015-09-01

To determine the associations between meat, dairy and zinc intake and pubertal development in adolescents in Chengdu. A total of 1320 children and adolescents aged 9-15 years in Chengdu were recruited using a stratified cluster sampling strategy. Dietary intake was assessed by the food frequency questionnaire (FFQ) and 3-day 24-hour dietary recall. Pubertal development was evaluated through physical examinations. Consumptions of meat and dairy, and zinc intake were compared between groups with different levels of pubertal development according to the Tanner criteria. The median age of spermarche was 13. 00 years. The boys who had had spermarche consumed more meat (including red meat) and dairy products than those who had not yet (P<0. 05). Daily consumption of total meat was positively correlated with the level of pubertal development (P<0. 05). The median age of menarche was 12. 11 years. The girls who had had menarche consumed more meat and less diiry products than those who had not yet (P<0. 05). Daily consumption of dairy products was negatively associated with breast development and the level of pubertal development (P < 0. 05). Consumptions of meat, red meat and dairy products are associated with pubertal development in adolescents in Chengdu. However, the differences between boys and girls warrant further studies.

Hormonal and reproductive risk factors of papillary thyroid cancer: A population-based case-control study in France.

PubMed

Cordina-Duverger, Emilie; Leux, Christophe; Neri, Monica; Tcheandjieu, Catherine; Guizard, Anne-Valérie; Schvartz, Claire; Truong, Thérèse; Guénel, Pascal

2017-06-01

The three times higher incidence of thyroid cancer in women compared to men points to a role of female sex hormones in its etiology. However the effects of these factors are poorly understood. We analyzed the association between thyroid cancer and hormonal and reproductive factors among women enrolled in CATHY, a population-based case-control study conducted in France. The study included 430 cases of papillary thyroid cancer and 505 controls frequency-matched on age and area of residence. The odds ratios for thyroid cancer increased with age at menarche (p trend 0.05). Postmenopausal women were at increased risk, as compared to premenopausal women, particularly if menopause followed an ovariectomy, and for women with age at menopause <55years. In addition, use of oral contraceptives and menopausal hormone therapy reduced the association with thyroid cancer by about one third, and breastfeeding by 27%. Overall, these findings provide evidence that the risk of thyroid cancer increases with later age at menarche and after menopause, and decreases with use of oral contraceptives and menopausal hormone therapy. These findings confirm an implication of hormonal factors in papillary thyroid cancer risk, whose mechanisms need to be elucidated. Copyright © 2017 Elsevier Ltd. All rights reserved.

Genetic evidence for natural selection in humans in the contemporary United States

PubMed Central

Beauchamp, Jonathan P.

2016-01-01

Recent findings from molecular genetics now make it possible to test directly for natural selection by analyzing whether genetic variants associated with various phenotypes have been under selection. I leverage these findings to construct polygenic scores that use individuals’ genotypes to predict their body mass index, educational attainment (EA), glucose concentration, height, schizophrenia, total cholesterol, and (in females) age at menarche. I then examine associations between these scores and fitness to test whether natural selection has been occurring. My study sample includes individuals of European ancestry born between 1931 and 1953 who participated in the Health and Retirement Study, a representative study of the US population. My results imply that natural selection has been slowly favoring lower EA in both females and males, and are suggestive that natural selection may have favored a higher age at menarche in females. For EA, my estimates imply a rate of selection of about −1.5 mo of education per generation (which pales in comparison with the increases in EA observed in contemporary times). Although they cannot be projected over more than one generation, my results provide additional evidence that humans are still evolving—albeit slowly, especially compared with the rapid changes that have occurred over the past few generations due to cultural and environmental factors. PMID:27402742

Uterine Junctional Zone Thickness, Cervical Length and Bioelectrical Impedance Analysis of Body Composition in Women with Endometriosis

PubMed Central

Ayas, Selçuk; Bayraktar, Mesut; Gürbüz, Ayşe; Alkan, Akif; Eren, Sadiye

2012-01-01

Objective: We aimed to evaluate uterine junctional zone thickness, cervical length and bioelectrical impedance analysis of body composition in women with endometriosis. Material and Methods: This is a prospective study conducted in a tertiary teaching hospital. A total of 73 patients were included in the study. Endometriosis was surgically diagnosed in 36 patients (study group). The control group included 37 patients. Main outcome measure(s): Bioelectrical impedance analysis was used to measure body composition. Uterine junctional zone thickness and cervical length were measured by transvaginal ultrasonography. Results: Patients’ characteristics (age, gravida, parity, live baby, age of menarche, lengths of menstrual cycle, percentage of patients with dysmenorrhea, positive family history), body mass index (BMI) (kg/m2), amount of body fat (kg), percentage of body fat were not statistically different between the two groups (p>0.05). The length of menstruation and cervical length were longer in women with endometriosis. Similarly, the inner myometrium was thicker in women with endometriosis than the control group. Conclusion: The relation between endometriosis and demographic features such as age, gravida, parity, gravida, BMI, lengths of the menstrual cycle, age of menarche are controversial. Longer cervical length and thicker inner myometrial layer may be important in the etiopathogenesis of endometriosis. PMID:25207044

Cow milk consumption, insulin-like growth factor-I, and human biology: a life history approach.

PubMed

Wiley, Andrea S

2012-01-01

To assess the life history consequences of cow milk consumption at different stages in early life (prenatal to adolescence), especially with regard to linear growth and age at menarche and the role of insulin-like growth factor I (IGF-I) in mediating a relationship among milk, growth and development, and long-term biological outcomes. United States National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and review of existing literature. The literature tends to support milk's role in enhancing growth early in life (prior to age 5 years), but there is less support for this relationship during middle childhood. Milk has been associated with early menarche and with acceleration of linear growth in adolescence. NHANES data show a positive relationship between milk intake and linear growth in early childhood and adolescence, but not middle childhood, a period of relatively slow growth. IGF-I is a candidate bioactive molecule linking milk consumption to more rapid growth and development, although the mechanism by which it may exert such effects is unknown. Routine milk consumption is an evolutionarily novel dietary behavior that has the potential to alter human life history parameters, especially vis-à-vis linear growth, which in turn may have negative long-term biological consequences. Copyright © 2011 Wiley Periodicals, Inc.

External-environmental and internal-health early life predictors of adolescent development.

PubMed

Hartman, Sarah; Li, Zhi; Nettle, Daniel; Belsky, Jay

2017-12-01

A wealth of evidence documents associations between various aspects of the rearing environment and later development. Two evolutionary-inspired models advance explanations for why and how such early experiences shape later functioning: (a) the external-prediction model, which highlights the role of the early environment (e.g., parenting) in regulating children's development, and (b) the internal-prediction model, which emphasizes internal state (i.e., health) as the critical regulator. Thus, by using data from the NICHD Study of Early Child Care and Youth Development, the current project draws from both models by investigating whether the effect of the early environment on later adolescent functioning is subject to an indirect effect by internal-health variables. Results showed a significant indirect effect of internal health on the relation between the early environment and adolescent behavior. Specifically, early environmental adversity during the first 5 years of life predicted lower quality health during childhood, which then led to problematic adolescent functioning and earlier age of menarche for girls. In addition, for girls, early adversity predicted lower quality health that forecasted earlier age of menarche leading to increased adolescent risk taking. The discussion highlights the importance of integrating both internal and external models to further understand the developmental processes that effect adolescent behavior.

Incidence, puberty, and fertility in 45,X/47,XXX mosaicism: Report of a patient and a literature review.

PubMed

Lim, Han Hyuk; Kil, Hong Ryang; Koo, Sun Hoe

2017-05-09

Turner syndrome (TS), characterized by short stature and premature ovarian failure, is caused by chromosomal aberrations with total or partial loss of one of the two X chromosomes. Spontaneous puberty, menarche, and pregnancy occur in some patients depending on the abnormality of the X. Moreover, spontaneous pregnancy is uncommon (<0.5%) for TS with 45,X monosomy. Among TS patients, 45,X/47,XXX karyotype is extremely rare. Previous reports have demonstrated that TS with 45,X/47,XXX is less severe than common TS due to higher occurrence of puberty (83%), menarche (57-67%), and fertility (14%) and lower occurrence of congenital anomalies (<5%). However, TS mosaicism may not reduce the frequency of short stature. We diagnosed a 10-year-girl with TS with 45,X/47,XXX mosaicism who presented with short stature. She showed mild TS phenotype including short stature but had spontaneous puberty. Based on our case and previous reports, we expect that girls with 45,X/47,XXX mosaicism may progress through puberty normally, without estrogen therapy. Therefore, it is necessary to consider specific guidelines for clinical decisions surrounding pubertal development and fertility in TS with 45,X/47,XXX karyotype. © 2017 Wiley Periodicals, Inc.

Dysmenorrhoea and coping strategies among secondary school adolescents in Ilala District, Tanzania.

PubMed

Pembe, Andrea B; Ndolele, Ntaholija T

2011-09-01

Dysmenorrhoea is common problem among adolescents worldwide. Its prevalence varies greatly in different populations and ethnic groups. Adolescents with severe dysmenorrhoea may miss classes and other social activities. The aim of this study was to determine the prevalence and coping strategies for dysmenorrhoea among secondary school adolescents in Ilala municipal, Tanzania. A cross sectional study was conducted in eight public and private secondary schools in Ilala municipal. A total of 880 girls in form II and form III who had attained menarche were interviewed using a self administered questionnaire between August and October 2007. The mean age at menarche was 13.3 years with the youngest at nine years and the oldest at sixteen years. Six hundred fifty two (74.1%) girls had dysmenorrhoea. Backache, breast tenderness and non specific joint pains were significantly more common symtoms among adolescents with dysmenorrhoea than without dysmenorrhoea. Medication was used by 362 (55.5 %) girls to relieve dysmenorrhoea. Commonest medications used were paracetamol and diclofenac. Adolescents who missed school due to dysmenorrhoea were 154 (23.6%) and 140 (21.5%) missed social activities. High proportion of secondary school adolescents has dysmenorrhoea in Ilala municipal with a significant number missing school and social activities. Reproductive health education in primary and secondary schools should be enhanced to increase awareness and care seeking.

Association between Obesity and Puberty Timing: A Systematic Review and Meta-Analysis

PubMed Central

Li, Wenyan; Liu, Qin; Deng, Xu; Chen, Yiwen; Liu, Shudan; Story, Mary

2017-01-01

This systematic review and meta-analysis examined the associations between obesity and puberty timing based on scientific evidence. Eight electronic databases were searched up to February 2017 for eligible studies, and two reviewers screened the articles and extracted the data independently. A total of 11 cohort studies with 4841 subjects met the inclusion criteria. Compared with the group of normal-weight girls, the obese group had more girls with menarche (RR: 1.87, 95% CI: 1.59–2.19, 2 studies). The number of girls with early puberty was significantly higher in the obese group than the normal weight group (RR: 2.44, 95% CI: 1.32–4.52, 5 studies). However, no differences were detected between girls who were obese or normal weight at age of menarche (WMD: −0.53 years, 95% CI: −1.24–0.19, 2 studies). There is no consistent result in the relationship between obesity and timing of pubertal onset in boys. Obesity may contribute to early onset of puberty in girls, while in boys, there is insufficient data. Given the limited number of cohort studies included in this meta-analysis, high-quality studies with strong markers of puberty onset, as well as standardized criteria for defining obesity are needed. PMID:29064384

Association between Obesity and Puberty Timing: A Systematic Review and Meta-Analysis.

PubMed

Li, Wenyan; Liu, Qin; Deng, Xu; Chen, Yiwen; Liu, Shudan; Story, Mary

2017-10-24

This systematic review and meta-analysis examined the associations between obesity and puberty timing based on scientific evidence. Eight electronic databases were searched up to February 2017 for eligible studies, and two reviewers screened the articles and extracted the data independently. A total of 11 cohort studies with 4841 subjects met the inclusion criteria. Compared with the group of normal-weight girls, the obese group had more girls with menarche (RR: 1.87, 95% CI: 1.59-2.19, 2 studies). The number of girls with early puberty was significantly higher in the obese group than the normal weight group (RR: 2.44, 95% CI: 1.32-4.52, 5 studies). However, no differences were detected between girls who were obese or normal weight at age of menarche (WMD: -0.53 years, 95% CI: -1.24-0.19, 2 studies). There is no consistent result in the relationship between obesity and timing of pubertal onset in boys. Obesity may contribute to early onset of puberty in girls, while in boys, there is insufficient data. Given the limited number of cohort studies included in this meta-analysis, high-quality studies with strong markers of puberty onset, as well as standardized criteria for defining obesity are needed.

Menstrual pattern and menstrual disorders among adolescents: an update of the Italian data

PubMed Central

2012-01-01

Background The most striking event in the whole process of female puberty is the onset of menstruation. To our knowledge, no large population-based studies have been performed on the topic of menstrual health among Italian adolescents in recent years. The aims of this study were to produce up-to-date information on the menstrual pattern of Italian girls attending secondary school, and to estimate the prevalence of menstrual cycle abnormalities in this population. Methods This was a cross-sectional study on a population-based sample of Italian adolescents aged 13–21 years attending secondary school. Only girls who had already started menstruating were requested to participate. Information was collected by means of a questionnaire that included items on the girls’ demographic details, anthropometrics, smoking and drinking habits, use of contraceptive pills, and socioeconomic status. The questions on the girls’ menstrual pattern concerned their age at menarche, duration of the most recent menstruation intervals (<21, 21–35, >35 days, variable), average days of bleeding (<4, 4–6, >6 days), and any menstrual problems and their frequency. Results A total of 6,924 questionnaires were administered and 4,992 (71%) were returned. One hundred girls failed to report their date of birth, so 4,892 subjects were analyzed. The girls’ mean age was 17.1 years (SD ±1.4); their mean age at menarche was 12.4 (±1.3) years, median 12.4 years (95%CI 12.3–12.5). In our sample population, 3.0% (95%CI 2.5%-3.4%) of the girls had menstruation intervals of less than 21 days, while it was more than 35 days in 3.4% (95%CI 2.9%-3.9%). About 9% of the girls (95%CI 7.7%-9.4%) said the length of their menstruation interval was currently irregular. Short bleeding periods (<4 days) were reported in 3.2% of the sample population (95%CI 2.7%-3.7%), long periods (>6 days) in 19% (95%CI 17.9%-20.1%). Menstruation-related abdominal pain was reported by about 56% of our sample. About 6.2% of the girls (95%CI 5.4%-7.0%) were suffering from dysmenorrhea. Conclusions In conclusion, to the best of our knowledge, this is one of the largest studies on menstrual patterns and menstrual disorders among Italian adolescent girls. Adolescent girls referring persistent oligomenorrhoea, in first two years from menarche, had a higher risk for developing a persistent menstrual irregularity. They had longer bleeding periods (>6 days) and this has practical implications because it makes these adolescents potentially more susceptible to iron deficiency anemia. Clinicians need to identify menstrual abnormalities as early as possible in order to minimize their possible consequences and sequelae, and to promote proper health information. We recommend that adolescents should be encouraged to chart their menstrual frequency and regularity prospectively from the menarche onwards. PMID:22892329

Is Estrogen a Therapeutic Target for Glaucoma?

PubMed Central

Dewundara, Samantha; Wiggs, Janey; Sullivan, David A.; Pasquale, Louis R.

2016-01-01

Objective To provide an overview of the association between estrogen and glaucoma. Methods A literature synthesis of articles published in peer review journals screened through May 05, 2015 using the PubMed database. Key words used were “estrogen and glaucoma,” “reproductive factors and glaucoma,” “estrogen, nitric oxide and eye.” Forty three journal articles were included. Results Markers for lifetime estrogen exposure have been measured by several studies and show that the age of menarche onset, oral contraceptive (OC) use, bilateral oophorectomy, age of menopause onset and duration between menarche to menopause are associated with primary open angle (POAG) risk. The Blue Mountain Eye Study found a significantly increased POAG risk with later (>13 years) compared with earlier (≤12 years) age of menarche. Nurses’ Health Study (NHS) investigators found that OC use of greater than 5 years was associated with a 25% increased risk of POAG. The Mayo Clinic Cohort Study of Oophorectomy and Aging found that women who underwent bilateral oophorectomy before age 43 had an increased risk of glaucoma. The Rotterdam Study found that women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma (2.6-fold increased risk) while the NHS showed a reduced risk of POAG among women older than 65 who entered menopause after age ≥ 54 years. Increased estrogen states may confer a reduced risk of glaucoma or glaucoma related traits such as reduced intraocular pressure (IOP). Pregnancy, a hyperestrogenemic state, is associated with decreased IOP during the third trimester. Though the role of post-menopausal hormone (PMH) use in the reduction of IOP is not fully conclusive, PMH use may reduce the risk of POAG. From a genetic epidemiologic perspective, estrogen metabolic pathway single nucleotide polymorphisms (SNPs) were associated with POAG in women and polymorphisms in endothelial nitric oxide synthase, a gene receptive to estrogen regulation, are associated with glaucoma. Conclusions Increasing evidence suggests that lifetime exposure to estrogen may alter the pathogenesis of glaucoma. Estrogen exposure may have a neuroprotective effect on the progression of POAG but further studies need to confirm this finding. The role of sex-specific preventive and therapeutic treatment may be on the horizon. PMID:26959139

Markers of pubertal timing and leisure-time physical activity from ages 36 to 68 years: findings from a British birth cohort.

PubMed

Elhakeem, Ahmed; Cooper, Rachel; Bann, David; Kuh, Diana; Hardy, Rebecca

2017-11-01

We aimed to examine associations between markers of pubertal timing and leisure-time physical activity (LTPA) from ages 36 to 68 years in men and women from the Medical Research Council National Survey of Health and Development. Pubertal timing was ascertained by physicians at age 14-15 years. Boys were grouped, based on their secondary sexual characteristics, as prepubescent, in early-stage puberty, advanced stage puberty or fully mature at age 14-15 years. Girls were grouped as reaching menarche ≤11, 12, 13 or ≥14 years. LTPA was reported at ages 36, 43, 53, 60-64 and 68 years and classified as active or inactive at each age. Associations were examined using standard and mixed-effects logistic regression models. Of 5362 singleton births recruited, 1499 men and 1409 women had at least one measure of LTPA and data on pubertal timing and selected covariates. When compared with men that were fully mature at age 14-15 years, those that were in advanced stage and early-stage puberty, but not the prepubescent stage, had lower likelihood of LTPA at younger but not older adult ages (p=0.06 for pubertal status-by-age at LTPA interaction in mixed-effects model). For example, fully adjusted ORs of LTPA (vs no LTPA) at ages 36 and 68 years, respectively, for advanced puberty versus fully mature were 0.69 (95% CIs 0.50 to 0.96) and 1.03 (0.72 to 1.47). Age at menarche was not associated with LTPA at any age (p interaction with age at LTPA=0.9). For example, OR (from mixed-effects model) of LTPA between 36 and 68 years was 1.23 (0.93, 1.63) for menarche at 13 vs ≤11 years. In a nationally representative study, there was little evidence to suggest that pubertal timing was an important correlate of LTPA between ages 36 and 68 years. Maturity-related variations in adolescents' LTPA may be transitory and lose importance over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of low-dose estrogen replacement during childhood on pubertal development and gonadotropin concentrations in patients with Turner syndrome: results of a randomized, double-blind, placebo-controlled clinical trial.

PubMed

Quigley, Charmian A; Wan, Xiaohai; Garg, Sipi; Kowal, Karen; Cutler, Gordon B; Ross, Judith L

2014-09-01

The optimal approach to estrogen replacement in girls with Turner syndrome has not been determined. The aim of the study was to assess the effects of an individualized regimen of low-dose ethinyl estradiol (EE2) during childhood from as early as age 5, followed by a pubertal induction regimen starting after age 12 and escalating to full replacement over 4 years. This study was a prospective, randomized, double-blind, placebo-controlled clinical trial. The study was conducted at two US pediatric endocrine centers. Girls with Turner syndrome (n = 149), aged 5.0-12.5 years, were enrolled; data from 123 girls were analyzable for pubertal onset. Interventions comprised placebo or recombinant GH injections three times a week, with daily oral placebo or oral EE2 during childhood (25 ng/kg/d, ages 5-8 y; 50 ng/kg/d, ages >8-12 y); after age 12, all patients received escalating EE2 starting at a nominal dosage of 100 ng/kg/d. Placebo/EE2 dosages were reduced by 50% for breast development before age 12 years, vaginal bleeding before age 14 years, or undue advance in bone age. The main outcome measures for this report were median ages at Tanner breast stage ≥2, median age at menarche, and tempo of puberty (Tanner 2 to menarche). Patterns of gonadotropin secretion and impact of childhood EE2 on gonadotropins also were assessed. Compared with recipients of oral placebo (n = 62), girls who received childhood low-dose EE2 (n = 61) had significantly earlier thelarche (median, 11.6 vs 12.6 y, P < 0.001) and slower tempo of puberty (median, 3.3 vs 2.2 y, P = 0.003); both groups had delayed menarche (median, 15.0 y). Among childhood placebo recipients, girls who had spontaneous breast development before estrogen exposure had significantly lower median FSH values than girls who did not. In addition to previously reported effects on cognitive measures and GH-mediated height gain, childhood estrogen replacement significantly normalized the onset and tempo of puberty. Childhood low-dose estrogen replacement should be considered for girls with Turner syndrome.

The effect of fibromyalgia syndrome to gravidity, parity and duration of breastfeeding; A prospective study from Turkey.

PubMed

Tulay, Koca Tuba; Emrullah, Tanrikut; Aydin, Arslan; Ciledag, Ozdemir Filiz

2016-01-01

Fibromyalgia syndrome (FS) is a chronic pain disorder usually affecting women in their fertile period of life. However, the relationship between FS and pregnancy has not been studied in depth. The effect of FS on the course of pregnancy is poorly investigated in the current literature. Here we aimed to investigate the effects of FS to menarche age, gravidity, parity and duration of breastfeeding. One hundred and eighty-seven non-pregnant females attending between March 2015-June 2015, to Malatya State Hospital Physical Medicine and Rehabilitation Outpatient Clinic, were included in this prospective study. One hundred eleven (111) of them were diagnosed with FS according to the American Rheumatology Association (ACR) 2010 criteria and were defined as group 1; group 2 comprised of seventy six (76) non-pregnant healthy volunteers. All participants were asked about their menarche age, marriage age, gravidity, parity, duration of breastfeeding by conducting a basic questionnaire survey. Patients' body mass index (BMI) were recorded. Depression parameters were evaluated by Beck Depression Scale (BDS). The average age of the patients was 39.04±9.21 (FS) and 38.47±9.65 (Control) years; first menarche age was at 13.28±1.38 (FS) and 13.59±1.54 years (Control), and marriage age was 20.1±3.62 (FS) and 20.69±3.90 years (Control), respectively. No statistically significant difference was found (p=0.598) between BMI values (FS, 27.76±4.95; Control 26.90±4.56 kg/m(2)). The results from both groups were similar in terms of gravidity, parity, and breastfeeding duration, with no statistically significant differences (p=0.252, 0.093, 0.075, respectively). The only significant difference was found in the depression parameter. The BDS results were statistically different between the groups, found higher in FS group (p=0.000). FS occurs as a result of symptoms such as mood disorder, anxiety, cognitive and sleep disorders, and also hormonal changes; no exact cause has yet been established. The syndrome usually occurs during fertile period of young female. According to the findings of our study, FS has no negative effect on the outcome of gravidity, parity, and duration of breastfeeding in Turkish women. Further studies about the effects of FS on the course of pregnancy are required.

A cross-sectional study to assess awareness about menstruation in adolescent girls of an urban slum in western Maharashtra.

PubMed

Dudeja, Puja; Sindhu, Apoorva; Shankar, Pooja; Gadekar, Tukaram

2016-10-14

Reproductive health of adolescent girls is crucial as it determines the health of future generations. School girls when experiencing menarche find themselves in a setting without water, toilets or a supportive female teacher to explain the changes happening in their body. An important concern for adolescent girls is to have adequate, correct knowledge along with facilities and the cultural environment to manage menstruation hygienically and with dignity. Hence, the present study was done to assess knowledge and practices about menstruation in adolescent school girls of an urban slum. This was a descriptive cross-sectional study conducted among girls of a Government School located in an urban slum of western Maharashtra. A total of 250 girls participated. Data collection was through a pilot-tested questionnaire. The data thus collected were entered into Microsoft Excel and analyzed using the SPSS 20 software. All girls were educated about menstrual hygiene after the study. The mean age of the students was 14.9±1.75 years. The mean age at menarche was 11.97 (95% CI: 11.94-11.99). It was observed that only half (56.4%) had acquired prior knowledge about attaining menarche. Out of these in a large proportion, the knowledge was imparted to them by their mothers (60.7%), followed by friends (31.8%). There was no significant association between educational status of mother and awareness in respondent about menstruation. Regarding the organ of menstrual blood flow, half (50.7%) knew the correct answer (i.e. uterus); whereas the rest believed that it was stomach/kidney, etc. Most of the school girls (90.5%) used sanitary pads. Almost 90% of the young women faced physical complaints or health problems during menstruation. Most of the participants had some kind of restrictions on them during the menstruation and most of these were religious restrictions (69.7%) followed by physical (41.2%) and social restrictions (22.3%). All of them were unsatisfied with the toilets and hand washing facilities available inside the school premises. Correct knowledge in adolescent young girls regarding menstruation is lacking. Lack of awareness is a roadblock in adopting safe and hygienic menstrual practices. It also hinders them from overcoming traditional beliefs, misconceptions and restrictions regarding menstruation. This will empower them as they transition into womanhood.

Factors Influencing Medication Adherence in Hypertensive Women Ages 35 to 50 Years

DTIC Science & Technology

1991-06-11

the study (sodium intake , use of alcohol, tobacco, and caffeine, family history, age at menarche, and use of contraceptives). Unique to the nuns’ life... fat metabolism, which can result in the deposition of lipids in the vascular walls (Guyton, 1981). Insulin promotes "arterial smooth muscle cell...1988, Archives of Internal Medicine, 14h(5), p. 1024. Copyright 1988 by E. J. Rocella. Reprinted by permission. 18 predisposition, excessive intake of

Interrelationships of Hormones, Diet, Body Size and Breast Cancer among Hispanic Women

DTIC Science & Technology

2008-09-01

susceptible, gain excess weight due to physical inactivity, and consume a high-fat, low-fiber diet during adolescence and adulthood. It is clear...status, and use of oral contraceptives , as well as physical activity levels. In summary, the findings of our study that serum leptin concentrations were...history of breast cancer, age at menarche, menopausal status, age at menopause, parity, age at first live birth, BMI, use of oral contraceptives , use of

The potential value of sibling controls compared with population controls for association studies of lifestyle-related risk factors: an example from the Breast Cancer Family Registry.

PubMed

Milne, Roger L; John, Esther M; Knight, Julia A; Dite, Gillian S; Southey, Melissa C; Giles, Graham G; Apicella, Carmel; West, Dee W; Andrulis, Irene L; Whittemore, Alice S; Hopper, John L

2011-10-01

A previous Australian population-based breast cancer case-control study found indirect evidence that control participation, although high, was not random. We hypothesized that unaffected sisters may provide a more appropriate comparison group than unrelated population controls. Three population-based case-control-family studies of breast cancer in women of white European origin were carried out by the Australian, Ontario and Northern California sites of the Breast Cancer Family Registry. We compared risk factors between 3643 cases, 2444 of their unaffected sisters and 2877 population controls and conducted separate case-control analyses based on population and sister controls using unconditional multivariable logistic regression. Compared with sister controls, population controls were more highly educated, had an earlier age at menarche, fewer births, their first birth at a later age and their last birth more recently. The established breast cancer associations detected using sister controls, but not detected using population controls, were decreasing risk with each of later age at menarche, more births, younger age at first birth and greater time since last birth. Since participation of population controls might be unintentionally related to some risk factors, we hypothesize that sister controls could provide more valid relative risk estimates and be recruited at lower cost. Given declining study participation by population controls, this contention is highly relevant to epidemiologic research.

Depressive Symptoms and Its Associated Factors in 13-Year-Old Urban Adolescents

PubMed Central

Bulhões, Cláudia; Ramos, Elisabete; Lindert, Jutta; Dias, Sónia; Barros, Henrique

2013-01-01

The available estimates reveal that 20–50% of adolescents report depressive symptoms, being one of the most prevalent health problems in adolescence. The aim of this study was to assess the prevalence of depressive symptoms in a community sample of 13-year-old adolescents and identify associated features. Thirteen year-old adolescents attending private and public schools in Porto (n = 1,988, 52.2% females) were evaluated from October 2003 to June 2004 and completed a questionnaire including health behaviors and the Beck Depression Inventory II. A questionnaire on parents’ socio-demographics and clinical characteristics was sent home. Data were analyzed separately by sex. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. The prevalence of depressive symptoms was 18.8% in girls and 7.6% in boys (p < 0.001). Boys with a family history of depression and girls with smoking habits had a significantly increased risk of depressive symptoms (OR = 2.18, 95%CI 1.00–4.71; OR = 2.34, 95%CI 1.46–3.76). Menarche at an early age significantly increased the risk of depressive symptoms. The characteristics most strongly associated with depressive symptoms were family history of depression among boys, tobacco consumption and an early age at menarche among girls. The high prevalence of depressive symptoms early in adolescence calls for the awareness of public health professionals. PMID:24129117

A longitudinal study of serum ferritin in 319 adolescent Danish boys and girls examined in 1986 and 1992.

PubMed

Milman, N; Byg, K E; Backer, V; Ulrik, C; Graudal, N

1999-10-01

This study examined trends in iron status in adolescents. Serum ferritin was measured in 1986 and 1992 in 319 Danes (161 males) stratified into 5 groups: I. median age 9 yr in 1986 vs. 15 yr in 1992; II. 11 vs. 17 yr; III. 13 vs. 19 yr; IV. 15 vs. 21 yr; V. 17 vs. 23 yr. Males in group I demonstrated no change in ferritin or estimated iron stores in mg/kg; groups II-V displayed an increase in iron status parameters. All groups showed an increase in estimated total iron stores. Changes in iron status parameters were inversely correlated with height velocity in group III, and positively correlated with height velocity in group V. Females in age groups I and II demonstrated a fall in ferritin and estimated iron stores in mg/kg in association with menarche; values were unchanged in groups III and IV, and increased in group V. All groups showed an increase in estimated total iron stores. Changes in iron status parameters were inversely correlated with height velocity in groups I and II. In conclusion, ferritin levels in adolescents display great variation during growth spurt and at menarche. Changes in ferritin showed no consistent association with growth velocity. In both genders, estimated total iron stores increased with age.

The association between irregular menstruations and acne with asthma and atopy phenotypes.

PubMed

Galobardes, Bruna; Patel, Sumaiya; Henderson, John; Jeffreys, Mona; Smith, George Davey

2012-10-15

Earlier menarche and irregular periods, among other markers of sex-hormone levels, have been associated with a higher risk of asthma and allergic diseases. This has suggested an etiologic role of sex hormones in the development of these conditions. The authors investigated the association of age at menarche, irregular periods, duration of menstruation, and acne with reported medical history of asthma and/or atopy (hay fever and/or eczema/urticaria) in a historical cohort of students born before the rise in asthma prevalence in the United Kingdom and attending university in 1948-1968. Finding consistent associations in a cohort that has experienced different life-course exposures and has different confounding structure can help to identify causal associations. In the Glasgow Alumni Cohort, irregular periods were associated with atopic asthma (multinomial odds ratio (MOR) = 2.79, 95% confidence interval (CI): 1.33, 5.83) and atopy alone (MOR = 1.40, 95% CI: 1.06, 1.84) but not with nonatopic asthma (MOR = 1.02, 95% CI: 0.45, 2.30), compared with students reporting no asthma and no atopy. The authors found no association with acne, a marker of high testosterone levels, that they hypothesized could point to polycystic ovary syndrome underpinning these associations. In summary, the authors found evidence for a potentially etiologic role of irregular menstruations with some specific asthma phenotypes, namely, atopic asthma and atopy, but not with nonatopic asthma.

A Genome-Wide Linkage Scan for Age at Menarche in Three Populations of European Descent

PubMed Central

Anderson, Carl A.; Zhu, Gu; Falchi, Mario; van den Berg, Stéphanie M.; Treloar, Susan A.; Spector, Timothy D.; Martin, Nicholas G.; Boomsma, Dorret I.; Visscher, Peter M.; Montgomery, Grant W.

2008-01-01

Context: Age at menarche (AAM) is an important trait both biologically and socially, a clearly defined event in female pubertal development, and has been associated with many clinically significant phenotypes. Objective: The objective of the study was to identify genetic loci influencing variation in AAM in large population-based samples from three countries. Design/Participants: Recalled AAM data were collected from 13,697 individuals and 4,899 pseudoindependent sister-pairs from three different populations (Australia, The Netherlands, and the United Kingdom) by mailed questionnaire or interview. Genome-wide variance components linkage analysis was implemented on each sample individually and in combination. Results: The mean, sd, and heritability of AAM across the three samples was 13.1 yr, 1.5 yr, and 0.69, respectively. No loci were detected that reached genome-wide significance in the combined analysis, but a suggestive locus was detected on chromosome 12 (logarithm of the odds = 2.0). Three loci of suggestive significance were seen in the U.K. sample on chromosomes 1, 4, and 18 (logarithm of the odds = 2.4, 2.2 and 3.2, respectively). Conclusions: There was no evidence for common highly penetrant variants influencing AAM. Linkage and association suggest that one trait locus for AAM is located on chromosome 12, but further studies are required to replicate these results. PMID:18647812

DOE Office of Scientific and Technical Information (OSTI.GOV)

Terenziani, Monica; Casalini, Patrizia; Scaperrotta, Gianfranco

Purpose: To assess the occurrence of breast cancer (BC) after exposure to ionizing radiation for pediatric cancer, by means of a multimodal screening program. Patients and Methods: We identified 86 patients who had received chest wall radiation therapy for pediatric cancer. Clinical breast examination (CBE), ultrasound (US), and mammography (MX) were performed yearly. Magnetic resonance imaging (MRI) was added as of October 2007. We calculated the risk of developing BC by radiation therapy dose, patient age, and menarche before or after primary treatment. Results: Eleven women developed a BC from July 2002-February 2010. The sensitivity of the screening methods wasmore » 36% for CBE, 73% for MX, 55% for US, and 100% for MRI; the specificity was 91%, 99%, 95%, and 80% for CBE, MX, US, and MRI, respectively. The annual BC detection rate was 2.9%. The median age at BC diagnosis was 33 years. Although age had no influence, menarche before as opposed to after radiation therapy correlated significantly with BC (P=.027): the annual BC detection rate in the former subgroup was 5.3%. Conclusions: Mammography proved more sensitive and specific in our cohort of young women than CBE or US. Magnetic resonance imaging proved 100% sensitive (but this preliminary finding needs to be confirmed). Our cohort of patients carries a 10-fold BC risk at an age more than 20 years younger than in the general population.« less

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

PubMed

Shabir, Iram; Ganie, Mohd Ashraf; Zargar, Mohd Afzal; Bhat, Dilafroz; Mir, Mohd Muzzafar; Jan, Aleem; Shah, Zaffar Amin; Jan, Vicar; Rasool, Riyaz; Naqati, Andleeb

2014-05-01

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. 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. 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. The presence of MS or related metabolic derangements is high in the family members of women with PCOS.

Diagnostic classification scheme in Iranian breast cancer patients using a decision tree.

PubMed

Malehi, Amal Saki

2014-01-01

The objective of this study was to determine a diagnostic classification scheme using a decision tree based model. The study was conducted as a retrospective case-control study in Imam Khomeini hospital in Tehran during 2001 to 2009. Data, including demographic and clinical-pathological characteristics, were uniformly collected from 624 females, 312 of them were referred with positive diagnosis of breast cancer (cases) and 312 healthy women (controls). The decision tree was implemented to develop a diagnostic classification scheme using CART 6.0 Software. The AUC (area under curve), was measured as the overall performance of diagnostic classification of the decision tree. Five variables as main risk factors of breast cancer and six subgroups as high risk were identified. The results indicated that increasing age, low age at menarche, single and divorced statues, irregular menarche pattern and family history of breast cancer are the important diagnostic factors in Iranian breast cancer patients. The sensitivity and specificity of the analysis were 66% and 86.9% respectively. The high AUC (0.82) also showed an excellent classification and diagnostic performance of the model. Decision tree based model appears to be suitable for identifying risk factors and high or low risk subgroups. It can also assists clinicians in making a decision, since it can identify underlying prognostic relationships and understanding the model is very explicit.

The Relationship Between Breast Cancer and Risk Factors: A Single-Center Study.

PubMed

Ozsoy, Arzu; Barca, Nurdan; Dolek, Betul Akdal; Aktaş, Hafize; Elverici, Eda; Araz, Levent; Ozkaraoğlu, Ozlen

2017-07-01

To determine the relationship between breast cancer and known risk factors in patients who had mammography (MG) for breast cancer screening or ultrasonography and/or MG for diagnostic purposes. In the period of January-December, 2011, a questionnaire composed of 17 questions was applied to 2862 female patients and MG and/or US examination was performed afterwards. Chi-square and Kruskal-Wallis tests were used for statistical analysis. The mean age was 51.05±8.98, age at menarche was 13.0±1.6 and age at menopause was 47±5.2. The first pregnancy was at 20±4.6. Out of 2862 cases, 242 had breast cancer diagnosis and 32 were newly diagnosed. There was no correlation between menarche age, age at menopause or first pregnancy and breast cancer. There was no relationship between breast cancer risk and hormone replacement therapy or oral contraceptive use. In patients with the diagnosis of breast cancer (242 cases), 61 had (25%) a positive family history. There was a significant correlation between the presence of a positive family history and having breast cancer (p=0.003). The presence of breast cancer in the family has the strongest relationship among all risk factors. It is important to have regular followup of these patients and to raise the awareness of patients.

A comparison of pubertal maturity and growth.

PubMed

Gasser, Theo; Molinari, Luciano; Largo, Remo

2013-07-01

Growth and pubertal development have each been studied in detail, but rarely in conjunction. The study aim was to determine what somatic and pubertal development have in common and how they differ and to quantify the association between milestones for growth and for pubertal development (in terms of pubic hair and genitalia/breast, Age of Peak Testes Velocity, APTV and menarche) in relation both to chronological (CA) and bone age (RUS). The data analysed are from the 1st Zurich Longitudinal Growth Study, with 120 boys and 112 girls with almost complete data from birth to adulthood. Variability of pubertal milestones was somewhat reduced in terms of RUS, in particular in later phases. Pubic hair phase PH2 appeared ∼1 year after the onset of the pubertal spurt. Around the age of maximal deceleration (T9) an adult-like appearance of pubic hair, genitalia and breasts was reached in most cases. APTV occurred close to T8. Correlations were large between milestones for growth and PH stages and also with menarche or APTV. A successful modelling of testis growth led to a new pubertal milestone, APTV. The high correlations between the phenomenologically different domains "linear growth" and "pubertal development", and the high correlations between RUS and linear growth previously established allow the conclusion that these different domains develop along similar biological mechanisms, which are steered mainly by genetic factors.

Dysfunctional uterine bleeding as an early sign of polycystic ovary syndrome during adolescence.

PubMed

Deligeoroglou, E K; Creatsas, G K

2015-08-01

Excessive uterine bleeding during the early years after menarche can be worrisome to the girl and her parents. The most prevalent diagnosis set is Dysfunctional uterine bleeding (DUB), after thorough examination and exclusion of other causes of abnormal uterine bleeding. The aim of this article was to review our knowledge and share our experience as tertiary reference center of pediatric-adolescent gynecology in Greece. We conducted a review of current literature using Pubmed and MedLine as our primary databases, as well as providing commentary considering work up, treatment and follow-up of our DUB patients. Insufficient progesterone production and subsequent abnormal shedding of the endometrium appears to orchestrate the pathophysiology of DUB in adolescence. Hypothalamic-pituitary-ovarian (HPO) axis immaturity right after menarche, is usually the most plausible cause. Nevertheless, it is necessary to exclude other, possibly even life-threatening causes. Complete work up including physical examination, laboratory and imaging studies (complete blood count, b-HCG, hormonal levels and ultrasonography) is needed, and appropriate treatment with combined oral contraceptives is administered accordingly. Although menstrual disorders are very common in early adolescence, a severe episode of DUB should always be thoroughly attended by any physician. Follow-up should be offered in all young patients due to high incidence of recurrence or subsequent development of endocrine disorders such as Polycystic Ovary Syndrome (PCOS).

SHOX haploinsufficiency and Leri-Weill dyschondrosteosis: prevalence and growth failure in relation to mutation, sex, and degree of wrist deformity.

PubMed

Binder, Gerhard; Renz, Alexandra; Martinez, Alicia; Keselman, Ana; Hesse, Volker; Riedl, Stefan W; Häusler, Gabriele; Fricke-Otto, Susanne; Frisch, Herwig; Heinrich, Juan Jorge; Ranke, Michael B

2004-09-01

SHOX mutations causing haploinsufficiency were reported in Leri-Weill dyschondrosteosis (LWD), which is characterized by mesomelic short stature and Madelung deformity of the wrists. The aim of this study was to determine the prevalence of SHOX mutations in LWD and to investigate the degree of growth failure in relation to mutation, sex, age of menarche, and wrist deformity. We studied 20 families with 24 affected children (18 females) and nine affected parents (seven females). All patients presented with bilateral Madelung deformity and shortening of the limbs. Height, sitting height, parental height, birth length, age of menarche, and presence of minor abnormalities were recorded. The degree of Madelung deformity was estimated by analysis of left hand radiographs. Microsatellite typing of the SHOX locus was used for detection of SHOX deletions and PCR direct sequencing for the detection of SHOX point mutations. In 14 of 20 families (70%), SHOX mutations were detected, with seven deletions (four de novo) and seven point mutations (one de novo). The latter included five missense mutations of the SHOX homeodomain, one nonsense mutation (E102X) truncating the whole homeodomain, and one point mutation (X293R) causing a C-terminal elongation of SHOX. Median age of the affected children was 13.4 yr (range, 6.1-18.3), mean height sd score (SDS) (sd in parentheses) was -2.85 (1.04), and mean sitting height/height ratio SDS was +3.06 (1.09). Mean birth length SDS was -0.59 (1.26). Growth failure occurred before school age. Height change during a median follow-up of 7.4 yr (range, 2.3-11.3) was insignificant with a mean change in height SDS of -0.10 (0.52). Mean height SDS of affected parents was -2.70 (0.85) vs. -0.91 (1.10) in unaffected parents. Height loss due to LWD was estimated calculating delta height defined by actual height SDS minus target height SDS of the unaffected parent(s). In the children, mean delta height SDS was -2.16 (1.06), the loss being greater in girls at -2.30 (1.02) than in boys at -1.72 (1.09) (P = 0.32). In patients with SHOX deletions, it was -2.14 (1.15) vs. -1.67 (0.73) for the SHOX point mutation group (P = 0.38). Mean delta height SDS was -2.26 (0.68) for the girls with early menarche (<12 yr) vs. -2.08 (0.91) for the other postmenarcheal girls (P = 0.72). Height loss in patients with radiologically severe wrist deformities in comparison with those having milder radiological signs was -2.81 (1.01) vs. -1.70 (1.04) (P = 0.03). GH treatment in five children during a median duration of 3.4 yr (range, 1.5-9.8 yr) with a median dosage of 0.23 mg/kg.wk (range, 0.14-0.25) resulted in a mean height SDS gain of +0.82 (0.34). In conclusion, SHOX defects were the main cause of LWD. Growth failure occurred during the first years of life with a mean height loss of 2.16 SDS whereas pubertal growth may only be mildly or not affected. Children with a severe degree of wrist deformity were significantly shorter than those with mild deformities. No statistically significant effects of type of mutation, age of menarche, or sex on height were observed. The effect of GH therapy varied between individuals and needs to be examined in controlled studies.

[Menstrual cycle disorders in adolescence].

PubMed

Escobar, María E; Pipman, Viviana; Arcari, Andrea; Boulgourdjian, Elisabeth; Keselman, Ana; Pasqualini, Titania; Alonso, Guillermo; Blanco, Miguel

2010-08-01

The high prevalence of menstrual disorders during the first years after menarche is well recognized. This is usually a cause of concern for parents and patients, and a common reason for visiting the pediatrician. The immaturity of the hypothalamic-pituitary-ovarian axis is the major cause of these disorders, but there are also some general organic or emotional conditions that may alter the menstrual cycle, which is a sensitive indicator of health. Physiology of the menstrual cycle, its alterations, etiology, assessment, diagnosis and treatment are reviewed in this article.

Design, Utility, and History of the Colorado Adoption Project: Examples Involving Adjustment Interactions1

PubMed Central

Rhea, Sally Ann; Bricker, Josh B.; Corley, Robin P.; DeFries, John C.; Wadsworth, Sally J.

2013-01-01

This paper describes the Colorado Adoption Project (CAP), a longitudinal study in behavioral development, and discusses how adoption studies may be used to assess genetic and environmental etiologies of individual differences for important developmental outcomes. Previous CAP research on adjustment outcomes in childhood and adolescence which found significant interactions, including gene-environment interactions, is reviewed. New research suggests mediating effects of menarche and religiosity on age at first sex in this predominantly middle-class, Caucasian sample. PMID:23833552

Growth in Alcohol Use as a Developmental Predictor of Adolescent Girls’ Sexual Risk-Taking

PubMed Central

Stepp, Stephanie; Chung, Tammy; Durand, Vanessa; Keenan, Kate

2012-01-01

Adolescent sexual risk-taking is common and often occurs under the influence of alcohol. Although alcohol use emerges in early adolescence, there is little empirical research examining whether growth in alcohol use during this developmental period predicts later risky sexual behavior. Such information could provide a critical opportunity for the prevention of sexually transmitted infections and unwanted teenage pregnancies. The current study examined alcohol use as a developmental mediator of the relationship between conduct problems, impulsivity, poverty, race and menarche assessed at age 11, and sexual risk-taking among girls at age 16. The sample comprised 499 participants of the Pittsburgh Girls Study (57.7% African American and 42.3% European American) interviewed annually for 6 years between age 11 and 16. The results of the conditioned latent growth curve model showed that the rate of increase in alcohol use, and African American race, predicted higher rates of sexual risk-taking at age 16. However, European American race predicted the intercept and slope of alcohol use. When mediation was tested, the results showed that age 12 use and an increase in propensity for alcohol use between 12 and 15 explained the relationship between European American race and later risky sex, but this was not the case for African American girls. Use of alcohol at age 12 also mediated the association between early menarche and subsequent sexual risk-taking. The implications of the findings for sexual risk prevention are discussed. PMID:22183826

Bone Status of Adolescent Girls in Pune (India) Compared to Age Matched South Asian & White Caucasian UK Girls

PubMed Central

Khadilkar, A; Crabtree, N J; Ward, K A; Khadilkar, V; Shaw, N J; Mughal, M Z

2014-01-01

Purpose To determine whether adolescent girls from a low socioeconomic group in Pune, India, who had low dietary calcium intake (449 mg/day; range 356-538) and hypovitaminosis D (median serum 25-hydroxyvitamin D 23.4 nmol/l; range 13.5-31.9), would have lower lumbar spine (LS) bone mineral apparent density (BMAD), and total body (TB) bone mineral content (BMC) adjusted for lean body mass (LBM). Methods Dual energy X-ray absorptiometry was used to measure TB and LS BMC, bone area (BA) and TBLBM in 50 post menarcheal girls from Pune. These variables were compared with data from 34 South Asian and 82 White Caucasian age matched girls from the UK. Results Pune girls were shorter, lighter and had less LBM for height, compared to both UK groups; they had later age of menarche than UK Asians. The mean (SE) BA adjusted TB BMC and LSBMAD were reduced for Pune girls [1778g (17); 0.335g/cm3(0.006)], compared to the UK South Asians [1864g (18); 0.332 g/cm3 (0.005)] and UK White Caucasians [1864g (13); 0.345 g/cm3 (0.004)]. In contrast both LS and TBBMC adjusted for TBLBM were not significantly different between the groups. Conclusions Pune girls had low bone mass for projected bone area relative to UK South Asian & White Caucasian girls but had the appropriate amount of BMC for their LBM. PMID:19727907

Early puberty, negative peer influence, and problem behaviors in adolescent girls.

PubMed

Mrug, Sylvie; Elliott, Marc N; Davies, Susan; Tortolero, Susan R; Cuccaro, Paula; Schuster, Mark A

2014-01-01

To determine how early puberty and peer deviance relate to trajectories of aggressive and delinquent behavior in early adolescence and whether these relationships differ by race/ethnicity. In this longitudinal study, 2607 girls from 3 metropolitan areas and their parents were interviewed at ages 11, 13, and 16 years. Girls reported on their age of onset of menarche, best friend's deviant behavior, delinquency, and physical, relational, and nonphysical aggression. Parents provided information on family sociodemographic characteristics and girls' race/ethnicity. Sixteen percent of girls were classified as early maturers (defined by onset of menarche before age 11 years). Overall, relational and nonphysical aggression increased from age 11 to age 16, whereas delinquency and physical aggression remained stable. Early puberty was associated with elevated delinquency and physical aggression at age 11. The relationship with early puberty diminished over time for physical aggression but not for delinquency. Best friend's deviant behavior was linked with higher levels of all problem behaviors, but the effect lessened over time for most outcomes. Early puberty was associated with a stronger link between best friend's deviance and delinquency, suggesting increased vulnerability to negative peer influences among early-maturing girls. A similar vulnerability was observed for relational and nonphysical aggression among girls in the "other" racial/ethnic minority group only. Early puberty and friends' deviance may increase the risk of problem behavior in young adolescent girls. Although many of these associations dissipate over time, early-maturing girls are at risk of persistently higher delinquency and stronger negative peer influences.

Lifetime cumulative number of menstrual cycles and serum sex hormone levels in postmenopausal women.

PubMed

Chavez-MacGregor, Mariana; van Gils, Carla H; van der Schouw, Yvonne T; Monninkhof, Evelyn; van Noord, Paulus A H; Peeters, Petra H M

2008-03-01

Lifetime cumulative number of menstrual cycles is related to breast cancer risk. The aim of this study is to investigate the relation between this index and serum sex hormone levels in postmenopausal women. Cross-sectional study including 860 naturally postmenopausal Dutch participants of the European Prospective Investigation into Cancer and Nutrition. Lifetime cumulative number of menstrual cycles was computed using questionnaire data on ages at menarche and menopause, number of pregnancies, breastfeeding, oral contraceptive use (OC) and regularity pattern. Measurements of hormones included estrone (E1), estradiol (E2), andostrenedione, testosterone, sex-hormone binding globulin (SHBG) and dehydroepiandrostenedione sulfate (DHEAS). The relation between the lifetime cumulative number of menstrual cycles and hormone levels was assessed using analysis of covariance. Relations between reproductive characteristics and hormone levels were also studied. Adjustments for characteristics at blood collection included age, years since menopause, BMI, hormone replacement therapy use, OC use, smoking habits, alcohol intake and physical activity were done. Lifetime cumulative number of cycles was related with SHBG; participants in the lowest category had higher SHBG levels. For the separate characteristics, DHEAS and androstenedione increased significantly with increasing age at menarche, while androstenedione and testosterone decreased with increasing age at menopause. For the parity characteristics, SHBG levels increased according to the number of live births. Lifetime cumulative number menstrual cycles was related only to SHBG. Therefore, free levels of estrogens or androgens may be related to this number of menstrual cycles estimate, reflecting lifetime exposure to ovarian hormones.

Reproductive windows, genetic loci, and breast cancer risk.

PubMed

Warren Andersen, Shaneda; Trentham-Dietz, Amy; Gangnon, Ronald E; Hampton, John M; Figueroa, Jonine D; Skinner, Halcyon G; Engelman, Corinne D; Klein, Barbara E; Titus, Linda J; Egan, Kathleen M; Newcomb, Polly A

2014-05-01

The reproductive windows between age at menarche and age at first birth (standardized age at first birth) and from menarche to menopause (reproductive lifespan) may interact with genetic variants in association with breast cancer risk. We assessed this hypothesis in 6131 breast cancer cases and 7274 controls who participated in the population-based Collaborative Breast Cancer Study. Risk factor information was collected through telephone interviews, and DNA samples were collected on a subsample (N= 1484 cases, 1307 controls) to genotype for 13 genome-wide association study-identified loci. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, and P values for the interaction between reproductive windows and genotypes were obtained by adding cross-product terms to statistical models. For standardized age at first birth, the OR was 1.52 (CI, 1.36-1.71) comparing the highest quintile with the lowest quintile. Carrier status for rs10941679 (5p12) and rs10483813 (RAD51B) appeared to modify this relationship (P = .04 and P = .02, respectively). For reproductive lifespan, the OR comparing the highest quintile with the lowest quintiles was 1.62 (CI, 1.35-1.95). No interactions were detected between genotype and reproductive lifespan (all P > .05). All results were similar regardless of ductal versus lobular breast cancer subtype. Our results suggest that the reproductive windows are associated with breast cancer risk and that associations may vary by genetic variants. Copyright © 2014 Elsevier Inc. All rights reserved.

Gynecologic issues of adolescents with Down syndrome, autism, and cerebral palsy.

PubMed

Burke, Lori M; Kalpakjian, Claire Z; Smith, Yolanda R; Quint, Elisabeth H

2010-02-01

The gynecologic issues of adolescents with disabilities are understudied. The purpose of this study was to identify and compare the presenting complaints, treatments, and follow-up of adolescent girls with Down syndrome (DS), autism, and cerebral palsy (CP) presenting to a specialized gynecologic clinic for women with developmental disabilities. Outpatient gynecology clinic. Forty four adolescents (<21 y); 13 with DS, 14 with autism, and 17 with CP who presented to the clinic from 1999 to 2006. None. A retrospective review of the electronic medical records to collect data on age at presentation to clinic, ethnicity, menstrual history, chief complaint, treatment, and follow-up. Mean age at presentation to clinic was 15+/-3.5 years, and age of menarche was 12.5+/-2 years; age at menarche did not significantly differ between groups. The most frequent complaints were irregular bleeding (n=10) and mood/behavioral changes (n=6). Girls with autism were significantly (chi(2)=8.89, P=.012) more likely to present with behavioral issues than the other 2 groups. Initial management for the behavior issues in the autism group included nonsteroidal anti-inflammatory drugs (NSAID), oral contraceptives, and education. The most common gynecologic complaints of adolescent girls with DS, autism, and CP centered on menstruation and mood disorders. Patients with autism were more likely to present with behavioral issues related to the onset of periods. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Age at first marriage in Nepal: differentials and determinants.

PubMed

Aryal, Tika Ram

2007-09-01

The aim of this paper is to investigate the differentials and determinants of female age at first marriage in rural Nepal. The life table technique was employed to calculate median age at marriage. The proportional hazard model was used to study the effect of various socioeconomic variables, and to identify the magnitude and significance of their effects on the timing of first marriage. The data were taken from a sample survey of Palpa and Rupandehi districts in rural Nepal. Both married and unmarried females of marriageable age were included in the survey. Median age at marriage was about 17 years for data from only married females, whereas it was about 18 years for data from married as well as unmarried females of marriageable age. Median age at marriage was about 16 years for uneducated females and 19 years for females educated up to intermediate or higher level. The analysis underestimates the median age at marriage for married females, probably due to right censoring. The risk of getting married early decreased gradually with increasing year-of-birth cohort. The risk of early marriage was higher among females of high socioeconomic status compared with those of low socioeconomic status. Females engaged in service married earlier than those engaged in household work. High socioeconomic status families are motivated, for religious and prestige reasons, to get their daughters married at an early age, preferably before menarche. Thus, education, occupation and age at menarche are the most powerful factors in deciding the timing of first marriage in Nepal.

Gynecological care in young women: a high-risk period of life.

PubMed

Bitzer, Johannes; Sultan, Charles; Creatsas, George; Palacios, Santiago

2014-08-01

Adolescence has been described as period of life when emotions are heightened and regulatory controls are reduced, and this can result in an escalation in risk-taking. Importantly for younger females, risk behaviors associated with the onset of sexual activity, and alcohol and substance abuse may coincide with pathologies such as polycystic ovary syndrome (PCOS) and abnormal uterine bleeding, an iron-deficient diet (vegetarian or vegan) and a negative body image leading to eating disorders. Girls transitioning through adolescence face a number of specific emotional and physical issues related to the onset of menarche and regular menstrual cycles. Menstruation combined with these risk behaviors and pathologies, and the rapid growth and development that is taking place, often results in numerous unwanted effects including iron deficiency. A low iron level is the most common cause of anemia in adolescent girls and can be detrimental to mood and cognition as well as physical well-being. In this article we review the impact of menarche, poor nutrition and some of the risk behaviors and pathologies that predispose females to challenges associated with adolescence, including anemia. We also examine factors that need to be taken into consideration during the initial, and follow-up, consultations with young women. Finally, we present some of the latest advice regarding nutrition and oral iron supplementation, particularly extended-release ferrous sulfate with mucoproteose, with a view to minimizing the development and risks of anemia in this vulnerable population.

Predictors of severity of acne vulgaris in young adolescent girls: results of a five-year longitudinal study.

PubMed

Lucky, A W; Biro, F M; Simbartl, L A; Morrison, J A; Sorg, N W

1997-01-01

The objectives of this study were to determine which factors in early pubertal girls might be predictive of later, severe facial acne. The study was a 5-year longitudinal cohort study, with yearly visits from 1987 through 1991, in a volunteer sample of 439 black and 432 white fourth- and fifth-grade girls with consent from their legal guardians. The subjects were recruited from public and parochial schools in Cincinnati, Ohio. The degree of facial acne was classified annually as mild, moderate, or severe. Blood samples were obtained at the first, third, and fifth years of the study. Using the acne status during the fifth year of the study as the outcome variable, we determined the contributions from the prior acne status and the serum levels of dehydroepiandrosterone sulfate (DHEAS), testosterone, free testosterone (FT), estradiol (E2), progesterone, and testosterone-estrogen binding globulin (TEBG) and compared the results at various ages and at times before and after menarche. No racial differences in acne or hormone levels were found. There was a progressive increase in the number of acne lesions with age and maturation. The girls exhibited many more comedonal than inflammatory acne lesions, regardless of age. The girls in whom severe acne developed by the fifth year of the study had significantly more comedones and inflammatory lesions than girls with mild or moderate acne, as early as age 10 years, approximately 2 h years before menarche, a time when their degree of acne was mild. Girls with mild comedonal acne had significantly later onset of menarche (12.5 compared with 12.2 years) than girls with severe comedonal acne. Girls in whom severe comedonal acne developed had significantly higher levels of serum DHEAS and, in a longitudinal analysis, somewhat higher levels of testosterone and FT in comparison with girls who had mild or moderate comedonal acne. Serum E2, testosterone/E2, progesterone, and TEBG values were no different in girls with severe compared with mild or moderate comedonal acne. The early development of comedonal acne may be one of the best predictors of later, more severe disease. The adrenal hormone DHEAS appears to play an important role in the initiation of acne. DHEAS, testosterone, and FT are associated with the perpetuation of severe comedonal acne. Early recognition of young girls at risk of having severe comedonal acne may enable the clinician to intervene and thus prevent unwanted sequelae.

Thumb Ossification Composite Index (TOCI) for Predicting Peripubertal Skeletal Maturity and Peak Height Velocity in Idiopathic Scoliosis

PubMed Central

Hung, Alec L.H.; Chau, W.W.; Shi, B.; Chow, Simon K.; Yu, Fiona Y.P.; Lam, T.P.; Ng, Bobby K.W.; Qiu, Y.; Cheng, Jack C.Y.

2017-01-01

Background: Accurate skeletal maturity assessment is important to guide clinical evaluation of idiopathic scoliosis, but commonly used methods are inadequate or too complex for rapid clinical use. The objective of the study was to propose a new simplified staging method, called the thumb ossification composite index (TOCI), based on the ossification pattern of the 2 thumb epiphyses and the adductor sesamoid bone; to determine its accuracy in predicting skeletal maturation when compared with the Sanders simplified skeletal maturity system (SSMS); and to validate its interrater and intrarater reliability. Methods: Hand radiographs of 125 girls, acquired when they were newly diagnosed with idiopathic scoliosis prior to menarche and during longitudinal follow-up until skeletal maturity (a minimum of 4 years), were scored with the TOCI and SSMS. These scores were compared with digital skeletal age (DSA) and radius, ulna, and small hand bones (RUS) scores; anthropometric data; peak height velocity; and growth-remaining profiles. Correlations were analyzed with the chi-square test, Spearman and Cramer V correlation methods, and receiver operating characteristic curve analysis. Reliability analysis using the intraclass correlation (ICC) was conducted. Results: Six hundred and forty-five hand radiographs (average, 5 of each girl) were scored. The TOCI staging system was highly correlated with the DSA and RUS scores (r = 0.93 and 0.92, p < 0.01). The mean peak height velocity (and standard deviation) was 7.43 ± 1.45 cm/yr and occurred at a mean age of 11.9 ± 0.86 years, with 70.1% and 51.4% of the subjects attaining their peak height velocity at TOCI stage 5 and SSMS stage 3, respectively. The 2 systems predicted peak height velocity with comparable accuracy, with a strong Cramer V association (0.526 and 0.466, respectively; p < 0.01) and similar sensitivity and specificity on receiver operating characteristic curve analysis. The mean age at menarche was 12.57 ± 1.12 years, with menarche occurring over several stages in both the TOCI and the SSMS. The growth remaining predicted by TOCI stage 8 matched well with that predicted by SSMS stage 7, with a mean of <2 cm/yr of growth potential over a mean of <1.7 years at these stages. The TOCI also demonstrated excellent reliability, with an overall ICC of >0.97. Conclusions: The new proposed TOCI could provide a simplified staging system for the assessment of skeletal maturity of subjects with idiopathic scoliosis. The index needs to be subjected to further multicenter validation in different ethnic groups. PMID:28872525

Age related changes in pelvis size among adolescent and adult females with reference to parturition from Naraingarh, Haryana (India).

PubMed

Sharma, Krishan; Gupta, Puneet; Shandilya, Shailza

2016-08-01

This research examines the ontogenic patterns of changes in growth during adolescence, pelvis variations and growth during twenties and thirties of age, structural remodeling of pelvis related to childbirth and relationship of pelvis area with physique based on the cross-sectional data on 391 females from the state of Haryana. Peak growth velocity for body height and breadths of skeletal traits occurred between 11 and 12 years, much before mean age of menarche at 13.5 years; while for body weight and body mass index (BMI) occurred between 14 and 15 years, after the mean age of menarche. Untill the age 11 years, 11.87% of growth in stature was remaining, 19.37% for bi-cristal breadth, 25.96% for bi-ischial breadth and 35.82% for pelvic area. The hypothesis of critical value of pelvic width of 240mm at iliocristale for menarche to occur has been only a statistical association. Higher prevalence of malnutrition during pubertal phase than pre- and post-pubertal phases was due to greater nutritional needs during puberty. Among adult females, BMI was very poorly correlated with stature but very strongly correlated with body breadths, body breadth-stature indices and body weight. The body mass and pelvis size continued to change during 20s and first half of 30s. The continued increase of BMI was due to increase in body fat and muscle mass in females 18 years and older. To tease apart age and parturition effects on pelvis variations, the analysis showed that pelvic bones remodeling took place after the first child was born and not after the subsequent births, and it was a sign of childbirth phenotypic plasticity rather than age. Pelvis area was strongly associated with stature, BMI and age. Mean pelvic area of tall females was greater than those of medium and short stature. Females with broad shoulders had significantly greater mean pelvis area than those with narrow shoulders and medium shoulders. Females having thin/lean physique had the smallest mean pelvis area compared to those having medium and obese types of physiques. The stepwise multiple regression analysis revealed that BMI was the major determinant factor (multiple r=0.37) of pelvis area; addition of stature component increased the value of multiple r to 0.50, while addition of age marginally increased multiple r to 0.53. Copyright © 2016 Elsevier GmbH. All rights reserved.

Increase of Reproductive Life Span Delays Age of Onset of Parkinson’s Disease

PubMed Central

Frentzel, Dominik; Judanin, Grigorij; Borozdina, Olga; Klucken, Jochen; Winkler, Jürgen; Schlachetzki, Johannes C. M.

2017-01-01

One striking observation in Parkinson’s disease (PD) is the remarkable gender difference in incidence and prevalence of the disease. Data on gender differences with regard to disease onset, motor and non-motor symptoms, and dopaminergic medication are limited. Furthermore, whether estrogen status affects disease onset and progression of PD is controversially discussed. In this retrospective single center study, we extracted clinical data of 226 ambulatory PD patients and compared age of disease onset, disease stage, motor impairment, non-motor symptoms, and dopaminergic medication between genders. We applied a matched-pairs design to adjust for age and disease duration. To determine the effect of estrogen-related reproductive factors including number of children, age at menarche, and menopause on the age of onset, we applied a standardized questionnaire and performed a regression analysis. The male to female ratio in the present PD cohort was 1.9:1 (147 men vs. 79 women). Male patients showed increased motor impairment than female patients. The levodopa equivalent daily dose was increased by 18.9% in male patients compared to female patients. Matched-pairs analysis confirmed the increased dose of dopaminergic medication in male patients. No differences were observed in age of onset, type of medication, and non-motor symptoms between both groups. Female reproductive factors including number of children, age at menarche, and age at menopause were positively associated with a delay of disease onset up to 30 months. The disease-modifying role of estrogen-related outcome measures warrants further clinical and experimental studies targeting gender differences, specifically hormone-dependent pathways in PD. PMID:28871235

The value of different Risser grading systems in determining growth maturity of girls with adolescent idiopathic scoliosis.

PubMed

Wang, Weijun; Zhen, Xin; Sun, Xu; Zhu, Zezhang; Zhu, Feng; Lam, T P; Cheng, Jack C Y; Qiu, Yong

2012-01-01

A grading system for ossification of the iliac apophysis (Risser sign) was developed for skeletal maturity assessment in the United States (US) then adopted with modifications in France (Fr) and other countries. Despite the same name, these systems have important differences. With the aim to analyzing the difference between US and Fr Risser grading systems in determining the growth maturity of girls with adolescent idiopathic scoliosis (AIS), Fifty-three AIS girls undergoing posterior spinal correction with autogenous bone graft were recruited. The Risser grades were recorded for the non-dominant side iliac crest apophysis according to the US and Fr grading systems. Growth activity was determined by standard histologic grades (HGs) on iliac crest cartilage. As a result, Kappa statistics showed poor agreement between two grading systems. The US system showed higher correlation with HGs compared to Fr system by Spearman correlation analysis. It was also found that growth cessation could be determined by Risser grade 5 of US system or Risser grade 4 of Fr system. Furthermore, by employing Receiver Operating Characteristic (ROC) curve analysis, it was found that the Risser grade 4-5 of US system with two years after menarche could be used in determining growth cessation with the highest sensitivity, specificity and accuracy. Hence it was concluded that the US Risser grading system was better in determining maturity of girls with AIS than Fr Risser grading system. By combining years since menarche, the accuracy of Risser grades in determining growth cessation could be enhanced, and the time of weaning from a brace could be advanced.

Increased functional connectivity with puberty in the mentalising network involved in social emotion processing

PubMed Central

Klapwijk, Eduard T.; Goddings, Anne-Lise; Heyes, Stephanie Burnett; Bird, Geoffrey; Viner, Russell M.; Blakemore, Sarah-Jayne

2015-01-01

There is increasing evidence that puberty plays an important role in the structural and functional brain development seen in adolescence, but little is known of the pubertal influence on changes in functional connectivity. We explored how pubertal indicators (salivary concentrations of testosterone, oestradiol and DHEA; pubertal stage; menarcheal status) relate to functional connectivity between components of a mentalising network identified to be engaged in social emotion processing by our prior work, using psychophysiological interaction (PPI) analysis. Female adolescents aged 11 to 13 years were scanned whilst silently reading scenarios designed to evoke either social emotions (guilt and embarrassment) or basic emotions (disgust and fear), of which only social compared to basic emotions require the representation of another person’s mental states. Pubertal stage and menarcheal status were used to assign participants to pre/early or mid/late puberty groups. We found increased functional connectivity between the dorsomedial prefrontal cortex (DMPFC) and the right posterior superior temporal sulcus (pSTS) and right temporo-parietal junction (TPJ) during social relative to basic emotion processing. Moreover, increasing oestradiol concentrations were associated with increased functional connectivity between the DMPFC and the right TPJ during social relative to basic emotion processing, independent of age. Our analysis of the PPI data by phenotypic pubertal status showed that more advanced puberty stage was associated with enhanced functional connectivity between the DMPFC and the left anterior temporal cortex (ATC) during social relative to basic emotion processing, also independent of age. Our results suggest increased functional maturation of the social brain network with the advancement of puberty in girls. PMID:23998674

Women-specific risk factors for heart failure: A genetic approach.

PubMed

van der Kemp, Jet; van der Schouw, Yvonne T; Asselbergs, Folkert W; Onland-Moret, N Charlotte

2018-03-01

Heart failure is a complex disease, which is presented differently by men and women. Several studies have shown that reproductive factors, such as age at natural menopause, parity and polycystic ovarian syndrome (PCOS), may play a role in the development of heart failure. Shared genetics may provide clues to underlying mechanisms; however, this has never been examined. Therefore, the aim of the current study was to explore whether any reproductive factor is potentially related to heart failure in women, based on genetic similarities. Conducting a systematic literature review, single nucleotide polymorphisms (SNPs) associated with reproductive factors, heart failure and its risk factors were extracted from recent genome-wide association studies. We tested whether there was any overlap between the SNPs and their proxies of reproductive risk factors with those known for heart failure or its risk factors. In total, 520 genetic variants were found that are associated with reproductive factors, namely age at menarche, age at natural menopause, menstrual cycle length, PCOS, preeclampsia, preterm delivery and spontaneous dizygotic twinning. For heart failure and associated phenotypes, 25 variants were found. Genetic variants for reproductive factors did not overlap with those for heart failure. However, age at menarche, gestational diabetes and PCOS were found to be genetically linked to risk factors for heart failure, such as atrial fibrillation, diabetes and smoking. Corresponding implicated genes, such as TNNI3K, ErbB3, MKL2, MTNR1B and PRKD1, may explain the associations between reproductive factors and heart failure. Exact effector mechanisms of these genes remain to be investigated further. Copyright © 2017. Published by Elsevier B.V.

Well-being changes in response to 30 years of regional integration in Maya populations from Yucatan, Mexico.

PubMed

Gurri, F D; Pereira, G B; Moran, E F

2001-01-01

Infant mortality rate (IMR), overall frequency of linear enamel hypoplasia (LEH), sexual dimorphism in LEH, age of onset of LEH, and age at menarche were used as indicators to test the hypothesis that the origin and development of the tourist industry and increased state participation on Maya subsistence agriculturists in the early 1970s had improved the well-being of the Maya. Two historical moments where inferred from the data. The first was derived from cheap and effective immunization and sanitation campaigns that reduced IMR from 143.4/1,000 live births in the early 1960s to 97.4 in the early 1970s. State participation broke the undernutrition-disease cycle enough to reduce LEH frequencies significantly (from 71.9% in individuals born before 1971 to 51.5% in those born in 1971 or after, chi(2) = 55.72; 1 df; alpha = 0.00001) and to eliminate the sex difference in LEH expression (from a 14.8% LEH difference between men and women before 1971 [Male/Female Odds Radio = 0.45, alpha significant at 0.05] to a nonsignificant 2% difference). Improvement in overall living conditions reflected in a "modern stage" infant mortality regime and an almost disappearance of LEHs, resulted from gradual improvements in living conditions that did not become apparent until the 1980s. Trends in the age at menarche are not statistically significant, probably due to methodological limitations. However, if overall living conditions continue to improve or stay as they are today, accelerations in maturation should become noticeable.

Mechanical Loading during Growth Is Associated with Plane-specific Differences in Vertebral Geometry: A Cross-sectional Analysis Comparing Artistic Gymnasts vs. Non-gymnasts

PubMed Central

Dowthwaite, Jodi N.; Rosenbaum, Paula F.; Scerpella, Tamara A.

2011-01-01

Lumbar spine geometry, density and indices of bone strength were assessed relative to menarche status, using artistic gymnastics exposure during growth as a model of mechanical loading. Paired posteroanterior (PA) and supine lateral (LAT) DXA scans of L3 for 114 females (60 ex/gymnasts and 54 non-gymnasts) yielded output for comparison of paired (PALAT) versus standard PA and LAT outcomes. BMC, areal BMD, vertebral body dimensions, bone mineral apparent density (BMAD), axial compressive strength (IBS) and a fracture risk index were evaluated, modeling vertebral body geometry as an ellipsoid cylinder. Two-factor ANCOVA tested statistical effects of gymnastic exposure, menarche status and their interaction, adjusting for age and height as appropriate. Compared to non-gymnasts, ex/gymnasts exhibited greater PABMD, PABMC, PAWIDTH, PA CROSS-SECTIONAL AREA (CSA), PAVOLUME, LATBMD, LATBMAD, PALATCSA and PALATIBS (p<0.05). Non-gymnasts exhibited greater LATDEPTH/PAWIDTH, LATBMC/PABMC, LATVHEIGHT, LATAREA and Fracture Risk Index. Using ellipsoid vertebral geometric models, no significant differences were detected for PA or PALAT BMAD. In contrast, cuboid model results (Carter 1992) suggested erroneous ex/gymnast PABMAD advantages, resulting from invalid assumptions of proportional variation in linear skeletal dimensions. Gymnastic exposure was associated with shorter, wider vertebral bodies, yielding greater axial compressive strength and lower fracture risk, despite no BMAD advantage. Our results suggest the importance of plane-specific vertebral geometric adaptation to mechanical loading during growth. Paired scan output provides a more accurate assessment of this adaptation than PA or LAT plane scans alone. PMID:21839871

CYP17 genetic polymorphism, breast cancer, and breast cancer risk factors.

PubMed

Ambrosone, Christine B; Moysich, Kirsten B; Furberg, Helena; Freudenheim, Jo L; Bowman, Elise D; Ahmed, Sabrina; Graham, Saxon; Vena, John E; Shields, Peter G

2003-01-01

Findings from previous studies regarding the association between the CYP17 genotype and breast cancer are inconsistent. We investigated the role of the MspAI genetic polymorphism in the 5' region of CYP17 on risk of breast cancer and as a modifier of reproductive risk factors. Questionnaire and genotyping data were obtained from a population-based, case-control study of premenopausal (n = 182) and postmenopausal (n = 214) European-American Caucasian women in western New York. Cases and controls were frequency matched by age and by county of residence. Odds ratios and 95% confidence intervals were used to estimate relative risks. The CYP17 genotype was not associated with breast cancer risk; however, controls with the A2/A2 genotype (associated with higher estrogens) had earlier menarche and earlier first full-term pregnancy. Premenopausal women with A1/A1 genotypes, but not with A2 alleles, were at significantly decreased risk with late age at menarche (odds ratio = 0.37, 95% confidence interval = 0.14-0.99), and at increased risk with late age at first full-term pregnancy (odds ratio = 4.30, 95% confidence interval = 1.46-12.67) and with use of oral contraceptives (odds ratio = 3.24, 95% confidence interval = 1.08-9.73). Associations were weaker among postmenopausal women. These results suggest that the effects of factors that may alter breast cancer risk through a hormonal mechanism may be less important among premenopausal women with putative higher lifetime exposures to circulating estrogens related to the CYP17 A2 allele.

Cigarette smoking and postmenopausal breast cancer risk in a prospective cohort

PubMed Central

Nyante, S J; Gierach, G L; Dallal, C M; Freedman, N D; Park, Y; Danforth, K N; Hollenbeck, A R; Brinton, L A

2014-01-01

Background: The relationship between cigarette smoking and breast cancer risk has been inconsistent, potentially due to modification by other factors or confounding. Methods: We examined smoking and breast cancer risk in a prospective cohort of 186 150 female AARP (formerly American Association of Retired Persons) members, ages 50–71 years, who joined the study in 1995–96 by responding to a questionnaire. Through 2006, 7481 breast cancers were diagnosed. Multivariable-adjusted hazard ratios (HRs) were estimated, overall and stratified by breast cancer risk factors, using Cox proportional hazards regression. Multiplicative interactions were evaluated using the likelihood ratio test. Results: Increased breast cancer risk was associated with current (HR 1.19, 95% confidence interval (CI) 1.10–1.28) and former (HR 1.07, CI 1.01–1.13) smoking. The current smoking association was stronger among women without (HR 1.24, CI 1.15–1.35) as compared to those with a family history of breast cancer (HR 0.94, CI 0.78–1.13) (P-interaction=0.03). The current smoking association was also stronger among those with later (⩾15 years: HR 1.52, CI 1.20–1.94) as compared with earlier (⩽12 years: HR 1.14, CI 1.03–1.27; 13–14 years: HR 1.18, CI 1.05–1.32) ages at menarche (P-interaction=0.03). Conclusions: Risk was elevated in smokers, particularly in those without a family history or late menarche. Research into smoking's effects on the genome and breast development may clarify these relationships. PMID:24642621

Early Puberty, Negative Peer Influence, and Problem Behaviors in Adolescent Girls

PubMed Central

Elliott, Marc N.; Davies, Susan; Tortolero, Susan R.; Cuccaro, Paula; Schuster, Mark A.

2014-01-01

OBJECTIVE: To determine how early puberty and peer deviance relate to trajectories of aggressive and delinquent behavior in early adolescence and whether these relationships differ by race/ethnicity. METHODS: In this longitudinal study, 2607 girls from 3 metropolitan areas and their parents were interviewed at ages 11, 13, and 16 years. Girls reported on their age of onset of menarche, best friend’s deviant behavior, delinquency, and physical, relational, and nonphysical aggression. Parents provided information on family sociodemographic characteristics and girls’ race/ethnicity. RESULTS: Sixteen percent of girls were classified as early maturers (defined by onset of menarche before age 11 years). Overall, relational and nonphysical aggression increased from age 11 to age 16, whereas delinquency and physical aggression remained stable. Early puberty was associated with elevated delinquency and physical aggression at age 11. The relationship with early puberty diminished over time for physical aggression but not for delinquency. Best friend’s deviant behavior was linked with higher levels of all problem behaviors, but the effect lessened over time for most outcomes. Early puberty was associated with a stronger link between best friend’s deviance and delinquency, suggesting increased vulnerability to negative peer influences among early-maturing girls. A similar vulnerability was observed for relational and nonphysical aggression among girls in the “other” racial/ethnic minority group only. CONCLUSIONS: Early puberty and friends’ deviance may increase the risk of problem behavior in young adolescent girls. Although many of these associations dissipate over time, early-maturing girls are at risk of persistently higher delinquency and stronger negative peer influences. PMID:24324002

Reproductive effects on skeletal health in Shuar women of Amazonian Ecuador: a life history perspective.

PubMed

Madimenos, Felicia C; Snodgrass, J Josh; Liebert, Melissa A; Cepon, Tara J; Sugiyama, Lawrence S

2012-01-01

Clinical and epidemiological research suggest that bone mineral density (BMD) in women is shaped by various reproductive factors such as parity and lactation patterns. However, the extent of these effects on BMD remains unclear because of contradictory findings and a focus on industrialized populations. Because fertility patterns in these groups are vastly different than those of women from non-Western, subsistence populations, our current understanding of the reproductive effects on skeletal health is incomplete. Using a life history perspective, this study examines the relationship between reproductive factors and bone density among women from the Indigenous Shuar population, an Amazonian Ecuadorian forager-horticulturalist group. This preliminary, cross-sectional study included 130 premenopausal and postmenopausal women (14-86 years old) from the Morona-Santiago region of Ecuador. Anthropometrics were recorded, as was estimated BMD using a calcaneal ultrasonometer. A reproductive history questionnaire was administered that included questions regarding menarche, parity, lactation patterns, and menopause. Among postmenopausal women, early menarche and greater stature were significantly associated with higher bone density values. Among premenopausal women, few significant relationships between bone values and reproductive variables were documented; effects of lactation appeared to be transient and restored following weaning. Although preliminary and not based on longitudinal data, these findings suggest that the effects of reproduction are transient as the system of calcium homeostasis in premenopausal women efficiently restores the bone loss that results from metabolically active reproductive states. Further, this research suggests that the timing of early life history events may canalize bone density phenotype. Copyright © 2012 Wiley Periodicals, Inc.

Determinants of age at menopause in women attending menopause clinics in Italy.

PubMed

Parazzini, Fabio

2007-03-20

We analysed the mean age at menopause and its determinants in 31,000 women attending menopause clinics in Italy. Between 1997 and 2003 we conducted a large cross-sectional study on the characteristics of peri- and post-menopausal women attending a network of first-level outpatient menopause clinics in Italy for general counseling or treatment of menopausal symptoms. Spontaneous menopause was defined as natural cessation of menses for 12 or more months. A total of 31,834 women with spontaneous menopause entered the study. The mean age at spontaneous menopause was 51.2. The age at menopause did not markedly changed with cohort of birth. Higher education was associated with lower age at menopause (51.1 in women with low education versus 51.3 for women with high school or university degree, p<0.05). A higher body mass index (BMI) was associated with later age at menopause. Smokers reported a lower age at menopause (51.2 in nonsmokers versus 51.1 in smokers, p<0.05). A later age at menarche was associated with a later age at menopause. Likewise, lifelong irregular menstrual cycles and higher parity were related with later age at menopause. No association emerged between ever oral contraceptive use and age at menopause. Low educational level, lower BMI, smoking, early menarche, nulliparity and regular cycles are independently associated with lower age at natural menopause in a large sample of women attending menopause clinics in Italy. However, in absolute terms the effect of these factors in our sample is very small.

The impact of menstruation in adolescents with disabilities related to cerebral palsy.

PubMed

Zacharin, Margaret; Savasi, Ingrid; Grover, Sonia

2010-07-01

Information regarding menstrual difficulties for adolescents with developmental disabilities and their families is limited. To assess the impact of menstruation on adolescents with developmental disabilities and their families, and to compare this to previously reported experiences of age-matched normal girls. Families of girls aged 12-18 years with known disabilities, attending the Royal Children's Hospital, Melbourne, were recruited into a questionnaire based study evaluating issues of menstruation and associated problems, together with the consequent psychological, social and emotional impact on their families and carers. Information was sought regarding menstrual management strategies, outcome satisfaction and specific areas of family concern. 103 questionnaires were completed. The average age of participating girls was 15.11 years, mean menarchal age 12.3 years. 79 girls were postmenarchal. The severity of menstrual problems was similar to a normal population. 59 (76%) were happy with the impact of menses on their social activities. More than 50% sought menstrual advice before menarche. Advice seeking strongly correlated with disability severity (p=0.01) and impact of menses on social activities (p=0.01), which in turn were highly predictive of seeking assistance (p=0.005). Carer satisfaction with current management inversely correlated with treatment seeking behaviour (p=0.034). Menstrual characteristics in this population are similar to those without disabilities. There is a high level of parental anxiety regarding the impact of menses, particularly when disability is severe. Medical therapies may be required but information for families is lacking. Clinicians should play a proactive and educational role with families and adolescents with disabilities.

Social status of the rural girl child in Tamil Nadu.

PubMed

Ananthakrishnan, Shanthi; Nalini, P

2002-07-01

The social status of the girl child in school age was assessed in a village in Tamil Nadu applying both qualitative and quantitative methods. The home milieu was taken as the social context for the study purpose since home is the first societal unit a child comes into contact with. The various issues considered to study the social status were (1) Gender preference in having children (2) Nutrition and health care given to them (3) Importance given to their education (4) Activity pattern in daily life (5) Attitude of the community towards (a) girl child after menarche and (b) marriage. In the study village, although there was desire to have sons, a girl child is not ignored. The value of having a girl in the family was appreciated. There was no gender discrimination in giving nutrition and health care. However the workload in girls was found to be marginally higher than in boys. The educational status of girls was lower than that of boys in terms of school enrollment and attendance. But menarche, was not an important cause of the lower educational status of girls. In the sociocultural context of the study village the priority in a girl's life during school going age was marriage. Soon after attaining puberty in a girl's life during school going age was marriage, not education and this perhaps reveals the lesser importance given to a girl's education by the community. The need of the hour is to improve her educational status by changing the attitude of the community so that a girl child's priority in her school age is not marriage but education.

Menarche stories: reminiscences of college students from Lithuania, Malaysia, Sudan, and the United States.

PubMed

Chrisler, J C; Zittel, C B

1998-01-01

Women college students in four countries were invited to write the story of their first menstruation in as much detail as memory allowed. Stories were received from 26 Lithuanians, 27 Americans, 20 Malaysians, and 23 Sudanese. The stories were read and their contents analyzed for the presence or absence of information on such topics as emotional reaction, preparedness, sources of information about menstruation, changes in body image, and celebrations of this rite of passage. Similarities and differences among the groups are discussed, and passages from particularly interesting stories are quoted.

Abnormal skeletal growth patterns in adolescent idiopathic scoliosis--a longitudinal study until skeletal maturity.

PubMed

Yim, Annie P Y; Yeung, Hiu-Yan; Hung, Vivian W Y; Lee, Kwong-Man; Lam, Tsz-Ping; Ng, Bobby K W; Qiu, Yong; Cheng, Jack C Y

2012-08-15

A cross-sectional and prospective longitudinal study on the anthropometric parameters and growth pattern of girls with adolescent idiopathic scoliosis (AIS). To investigate the growth pattern of girls with AIS with different severities, using cross-sectional and prospective longitudinal data set in comparison with age-matched healthy controls. AIS occurs in children during their pubertal growth spurt. Although there is no clear consensus on the difference in body height between girls with AIS and healthy controls, it is generally thought that the development and curve progression in girls with AIS is closely associated with their growth rate. There is no concrete prospective longitudinal study to document clearly the growth pattern and growth rate of subjects with AIS . A total of 611 girls with AIS and 296 healthy age-matched controls were included in the study and among them, 194 girls with AIS and 116 healthy controls were followed up until skeletal maturity. The girls with AIS were grouped into moderate (AIS20) and severe curve (AIS40) groups on the basis of maximum curve magnitude at skeletal maturity. Clinical data and detailed anthropometric parameters were recorded. In the cross-sectional analysis, the groups of subjects were compared within different age groups (from the age of 12-16 yr). In the longitudinal study, linear mixed modeling with respect to age or years since menarche was employed to formulate the growth trajectory of different anthropometric parameters. In the cross-sectional analysis, the girls with AIS were generally taller, with longer arm span and lower body mass index than the healthy controls. The girls with AIS40 were found to be significantly shorter in height (P = 0.006) and arm span (P = 0.025) at the age of 12 years but caught up and overtook the control group at the age of 14 to 16 years. In the longitudinal study, the average growth rate of arm span in girls with AIS40 was significantly higher than that in girls with AIS20 (> 30%) (P = 0.004) and controls (> 70%) (P = 0.0004). The age of menarche of girls with AIS40 was significantly delayed by 5.9 months and 3.8 months when compared with the control group and girls with AIS20, respectively (P < 0.05). The growth patterns of girls with AIS with confirmed curve severities were significantly different from healthy age-matched controls. Girls with severe AIS had delayed menarche with faster skeletal growth rate during the age of 12 to 16 years. Monitoring the rate of change of arm span of girls with AIS could be an important additional clinical parameter in helping predict curve severity in girls with AIS.

Scoliosis detection, patient characteristics, referral patterns and treatment in the absence of a screening program in Norway

PubMed Central

2012-01-01

Background Early diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed. Objectives To describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003–2011, when there was no screening and to compare treatment modalities to the period 1976–1988 when screening was performed. Methods Patient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003–2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976–1988. Results We registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003–2011. There were 644 (86%) girls and 108 (14%) boys. Mean age at detection was 14.6 (7–19) years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38° (10°-95°). About 40% had a major curve >40°. Seventy-one percent were detected by patients, close relatives, and friends. Orthopaedic surgeons referred 61% of the patients. The mean duration from detection to the first consultation was 20(0–27) months. The proportion of the average number of patients braced each year was 68% during the period with screening compared to 38% in the period without screening, while the proportion for those operated was 32% and 62%, respectively ( p=0.002, OR 3.5, (95%CI 1.6 to 7.5). Conclusion In the absence of scoliosis screening, lay persons most often detect scoliosis. Many patients presented with a mean Cobb angle approaching the upper limit for brace treatment indications. The frequency of brace treatment has been reduced and surgery is increased during the recent period without screening compared with the period in the past when screening was still conducted. PMID:23098059

Thumb Ossification Composite Index (TOCI) for Predicting Peripubertal Skeletal Maturity and Peak Height Velocity in Idiopathic Scoliosis: A Validation Study of Premenarchal Girls with Adolescent Idiopathic Scoliosis Followed Longitudinally Until Skeletal Maturity.

PubMed

Hung, Alec L H; Chau, W W; Shi, B; Chow, Simon K; Yu, Fiona Y P; Lam, T P; Ng, Bobby K W; Qiu, Y; Cheng, Jack C Y

2017-09-06

Accurate skeletal maturity assessment is important to guide clinical evaluation of idiopathic scoliosis, but commonly used methods are inadequate or too complex for rapid clinical use. The objective of the study was to propose a new simplified staging method, called the thumb ossification composite index (TOCI), based on the ossification pattern of the 2 thumb epiphyses and the adductor sesamoid bone; to determine its accuracy in predicting skeletal maturation when compared with the Sanders simplified skeletal maturity system (SSMS); and to validate its interrater and intrarater reliability. Hand radiographs of 125 girls, acquired when they were newly diagnosed with idiopathic scoliosis prior to menarche and during longitudinal follow-up until skeletal maturity (a minimum of 4 years), were scored with the TOCI and SSMS. These scores were compared with digital skeletal age (DSA) and radius, ulna, and small hand bones (RUS) scores; anthropometric data; peak height velocity; and growth-remaining profiles. Correlations were analyzed with the chi-square test, Spearman and Cramer V correlation methods, and receiver operating characteristic curve analysis. Reliability analysis using the intraclass correlation (ICC) was conducted. Six hundred and forty-five hand radiographs (average, 5 of each girl) were scored. The TOCI staging system was highly correlated with the DSA and RUS scores (r = 0.93 and 0.92, p < 0.01). The mean peak height velocity (and standard deviation) was 7.43 ± 1.45 cm/yr and occurred at a mean age of 11.9 ± 0.86 years, with 70.1% and 51.4% of the subjects attaining their peak height velocity at TOCI stage 5 and SSMS stage 3, respectively. The 2 systems predicted peak height velocity with comparable accuracy, with a strong Cramer V association (0.526 and 0.466, respectively; p < 0.01) and similar sensitivity and specificity on receiver operating characteristic curve analysis. The mean age at menarche was 12.57 ± 1.12 years, with menarche occurring over several stages in both the TOCI and the SSMS. The growth remaining predicted by TOCI stage 8 matched well with that predicted by SSMS stage 7, with a mean of <2 cm/yr of growth potential over a mean of <1.7 years at these stages. The TOCI also demonstrated excellent reliability, with an overall ICC of >0.97. The new proposed TOCI could provide a simplified staging system for the assessment of skeletal maturity of subjects with idiopathic scoliosis. The index needs to be subjected to further multicenter validation in different ethnic groups.

Breast cancer among young U.S. women in relation to oral contraceptive use.

PubMed

White, E; Malone, K E; Weiss, N S; Daling, J R

1994-04-06

While most studies have found no association between oral contraceptive use and breast cancer, several studies of younger women have reported an association with long-term oral contraceptive use. PURPOSE. We studied the relationship of patterns of oral contraceptive use to breast cancer risk among younger women. These women have had oral contraceptives available their entire reproductive lives and are now entering the breast cancer-prone years. A population-based, case-control study of breast cancer was conducted in three counties in western Washington State among women born in 1945 or later, ages 21-45. Case patients were 747 women with breast cancer diagnosed in 1983-1990 and identified through the Seattle-Puget Sound Surveillance, Epidemiology, and End Results cancer registry. Control subjects were 961 women identified by random-digit telephone dialing. Subjects were interviewed in person, using pictures of brands of oral contraceptives and calendars of life events as recall aids. There was no increased incidence of breast cancer associated with ever having used oral contraceptives. Because only 8% of this cohort had never used oral contraceptives, short-term users (< 1 year) were combined with never users as the reference group for further analyses. A small increased risk of breast cancer was associated with long duration of oral contraceptive use (odds ratio for > or = 10 years = 1.3; 95% confidence interval [CI] = 0.9-1.9; P for trend = .03), particularly among women aged 35 years or younger (odds ratio for > or = 10 years = 1.7; 95% CI = 0.9-3.1). Breast cancer was also modestly related to oral contraceptive use early in reproductive life (odds ratio for use within 5 years of menarche = 1.3; 95% CI = 1.0-1.8; P for trend = .04) and to use of high-progestin-potency oral contraceptives for at least 1 year (odds ratio = 1.5; 95% CI = 1.1-2.1). These associations were adjusted for age, age at menarche, term pregnancy, induced abortion, and family history of breast cancer. The associations were not further confounded by case-control differences in education, religion, breast feeding of offspring, or infertility; in oral contraceptive contraindications, indications, or complications; or in measures of breast cancer detection such as mammography or breast biopsy. Long-term oral contraceptive use among young women or use beginning near menarche may be associated with a small excess breast cancer risk, possibly due to susceptibility to genetic damage in breast epithelial cells at ages of high breast cell proliferative activity. Future studies should investigate whether the patterns of risk we reported are present as this cohort ages.

Muscle function in Turner syndrome: normal force but decreased power.

PubMed

Soucek, Ondrej; Lebl, Jan; Matyskova, Jana; Snajderova, Marta; Kolouskova, Stanislava; Pruhova, Stepanka; Hlavka, Zdenek; Sumnik, Zdenek

2015-02-01

Although hypogonadism and SHOX gene haploinsufficiency likely cause the decreased bone mineral density and increased fracture rate associated with Turner syndrome (TS), the exact mechanism remains unclear. We tested the hypothesis that muscle dysfunction in patients with TS contributes to increased fracture risk. The secondary aim was to determine whether menarche, hormone therapy duration, positive fracture history and genotype influence muscle function parameters in patients with TS. A cross-sectional study was conducted in a single university hospital referral centre between March 2012 and October 2013. Sixty patients with TS (mean age of 13·7 ± 4·5 years) were compared to the control group of 432 healthy girls. A Leonardo Mechanograph(®) Ground Reaction Force Platform was used to assess muscle force (Fmax ) by the multiple one-legged hopping test and muscle power (Pmax ) by the single two-legged jump test. While the Fmax was normal (mean weight-specific Z-score of 0·11 ± 0·77, P = 0·27), the Pmax was decreased in patients with TS (Z-score of -0·93 ± 1·5, P < 0·001) compared with healthy controls. The muscle function parameters were not significantly influenced by menarcheal stage, hormone therapy duration, fracture history or genotype (linear regression adjusted for age, weight and height; P > 0·05 for all). Fmax , a principal determinant of bone strength, is normal in patients with TS. Previously described changes in bone quality and structure in TS are thus not likely related to inadequate mechanical loading but rather represent a primary bone deficit. A decreased Pmax indicates impaired muscle coordination in patients with TS. © 2014 John Wiley & Sons Ltd.

Coming of age in Roman Britain: Osteological evidence for pubertal timing.

PubMed

Arthur, Nichola A; Gowland, Rebecca L; Redfern, Rebecca C

2016-04-01

Puberty is a key transitional phase of the human life course, with important biological and social connotations. Novel methods for the identification of the pubertal growth spurt and menarche in skeletal remains have recently been proposed (Shapland and Lewis, 2013, 2014). In this study we applied the methods to two Romano-British cemetery samples (1st-early 5th centuries AD) in order to investigate the timing of puberty during this period and further assess the veracity of the methods. Shapland and Lewis' methods (2013, 2014) were applied to 38 adolescents (aged 8-20 years) from the British cemetery sites of Roman London (1st-early 5th centuries AD) and Queenford Farm, Oxfordshire (4th-early 5th centuries AD). Overall, the Romano-British males and females experienced the onset of puberty at similar ages to modern European adolescents, but subsequently experienced a longer period of pubertal development. Menarche occurred between the ages of 15 and 17 years for these Romano-British females, around 2 to 4 years later than for present-day European females. The observed Romano-British pattern of pubertal timing has various possible explanations, including exposure to environmental stressors in early urban environments. The pattern of pubertal timing is largely congruent with social age transitions alluded to in ancient texts and funerary evidence for this period. While there are limitations to the application of these techniques to archaeological samples, they were successfully applied in this study, and may have important implications for understandings of past life courses, as well as providing a long-term perspective on pubertal timing and biocultural interactions. © 2016 Wiley Periodicals, Inc.

Long-term auxological and pubertal outcome of patients with hereditary insulin-like growth factor-I deficiency (Laron and growth hormone-gene deletion syndrome) treated with recombinant human insulin-like growth factor-I.

PubMed

Messina, M F; Arrigo, T; Valenzise, M; Ghizzoni, L; Caruso-Nicoletti, M; Zucchini, S; Chiabotto, P; Crisafulli, G; Zirilli, G; De Luca, F

2011-04-01

GH-IGF-I axis is mainly involved in the complex process of somatic growth but emerging evidence suggests that it also influences hypothalamic-pituitary-gonadal (HPG) function. We report some data regarding long-term auxological and pubertal outcome of five female patients with hereditary forms of GH-IGF-I deficiency (Laron and GH-gene deletion syndrome) and a mean age of 23.4±5.3 yr (range 19-32). All the patients received recombinant human IGF-I (rhIGF-I, Pharmacia and Upjohn, Stockholm, Sweden, and rhIGF-I, Genentech, San Francisco, CA, USA) from a mean age of 8.6 yr (range 3.2-14.2) up to the final height. Final height was very disappointing (≤ -5.0 SD scores) and lower than target height in all the patients. Pubertal onset was delayed in most of them but menarche occurred spontaneously in all the patients. Median age at menarche was 15.1 yr. Menstrual cycles were regular for several years. Median duration of gynecological follow- up was 8.3 yr with the longest span of 17.2 yr. We can assert that GH-IGF-I axis has an essential role in promoting linear growth in humans and its physiological action cannot be replaced by pharmacological treatment in most patients with hereditary forms of IGF-I insufficiency as demonstrated by their subnormal final height. Our clinical observations can also support an essential role of IGF-I in genitalia growth but not in the function of HPG axis as demonstrated by the maintenance of regular menstrual cycles in the presence of subnormal levels of IGF-I after treatment discontinuation.

Peripubertal female athletes in high-impact sports show improved bone mass acquisition and bone geometry.

PubMed

Maïmoun, Laurent; Coste, Olivier; Philibert, Pascal; Briot, Karine; Mura, Thibault; Galtier, Florence; Mariano-Goulart, Denis; Paris, Françoise; Sultan, Charles

2013-08-01

Intensive physical training may have a sport-dependent effect on bone mass acquisition. This cross-sectional study evaluated bone mass acquisition in girls practicing sports that put different mechanical loads on bone. Eighty girls from 10.7 to 18.0 years old (mean 13.83 ± 1.97) were recruited: 20 artistic gymnasts (AG; high-impact activity), 20 rhythmic gymnasts (RG; medium-impact activity), 20 swimmers (SW, no-impact activity), and 20 age-matched controls (CON; leisure physical activity <3h/wk). Areal bone mineral density (aBMD) was determined using DEXA. Hip structural analysis applied at the femur evaluated cross-sectional area (CSA, cm(2)), section modulus (Z, cm(3)), and buckling ratio. Bone turnover markers and OPG/RANKL levels were analyzed. AG had higher aBMD than SW and CON at all bone sites and higher values than RG in the lumbar spine and radius. RG had higher aBMD than SW and CON only in the femoral region. CSA and mean cortical thickness were significantly higher and the buckling ratio was significantly lower in both gymnast groups compared with SW and CON. In RG only, endocortical diameter and width were reduced, while Z was only increased in AG compared with SW and CON. Reduced bone remodeling was observed in RG compared with AG only when groups were subdivided according to menarcheal status. All groups showed similar OPG concentrations, while RANKL concentrations increased with age and were decreased in SW. High-impact activity clearly had a favorable effect on aBMD and bone geometry during the growth period, although the bone health benefits seem to be more marked after menarche. Copyright © 2013 Elsevier Inc. All rights reserved.

Activity, inactivity, and screen time in relation to weight and fatness over adolescence in girls.

PubMed

Must, Aviva; Bandini, Linda G; Tybor, David J; Phillips, Sarah M; Naumova, Elena N; Dietz, William H

2007-07-01

The impact of activity and inactivity on relative weight and fatness change are best evaluated longitudinally. We examined the longitudinal relationship of physical activity, inactivity, and screen time with relative weight status and percentage body fat (%BF) and explored how it differed by parental overweight status. Non-obese pre-menarcheal girls (173), 8 to 12 years old, were followed until 4 years post-menarche. %BF, BMI z-score, and time spent sleeping, sitting, standing, walking, and in vigorous activity were assessed annually. We developed a physical activity index to reflect time and intensity of activity. Inactivity was defined as the sum of time spent sleeping, sitting, and standing. Screen time was defined as time spent viewing television, videotapes, or playing video games. Parental overweight was defined as at least one parent with BMI>25. In separate linear mixed effects models, activity, inactivity, and screen time were unrelated to BMI z-score longitudinally, with and without accounting for parental overweight. After controlling for parental overweight, activity was inversely related (p<0.001), and inactivity was directly related (p<0.035) to increased %BF longitudinally. Screen time was unrelated to %BF change. With stratification for parental overweight, effects of activity and inactivity on %BF were observed only among girls with at least one overweight parent. In this cohort of initially non-overweight girls, activity and inactivity were related to accrual of BF over adolescence, particularly among children with at least one overweight parent. These results suggest that girls with a family history of overweight represent a target population of high priority for interventions around physical activity and inactivity.

Menstrual Characteristics and Related Problems in 9- to 18-Year-Old Turkish School Girls.

PubMed

Yücel, Gül; Kendirci, Mustafa; Gül, Ülkü

2018-03-14

To determine the cross-sectional characteristics of menstruating girls, dysmenorrhea, and the frequencies of related problems. Descriptive, cross-sectional study. Randomly selected primary, junior, and high schools in the city center of Kayseri. Two thousand female adolescents of ages between 9 and 18 years. We used a questionnaire addressing the epidemiological characteristics of menstruation, such as age at menarche, duration of menstrual intervals, average days of bleeding, and any menstrual problems and their frequencies. This study consists of a sufficient number of participants from all age groups. Of the participant (n = 2000) girls, 63.7% (n = 1274) had started menstruating. The mean age at menarche was 12.74 (±1.03) years. With a prevalence of 84.8% (n = 1080), dysmenorrhea was the most prevalent menstrual problem and the average pain score was 5.87 (±2.45). Of the menstruating girls, 34% (n = 439) used painkillers, the most commonly used was acetaminophen; during their period the prevalence of nonmedical methods to relieve pain was 35.2%; the rate of seeking medical help for dysmenorrhea was 9.3% (n = 119). In menstruating participants, 90.8% discussed their menstrual problems with their mothers. The rate of school absenteeism in menstruating girls was 15.9% in general and 18% in those with dysmenorrhea. Problems related to menstruation are common in adolescents and these problems affect their social life. In adolescent girls, the most common menstrual problem is dysmenorrhea and it affects school performance and attendance. Girls with menstrual problems showed a low rate of seeking medical help. Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Contributions of Function-Altering Variants in Genes Implicated in Pubertal Timing and Body Mass for Self-Limited Delayed Puberty.

PubMed

Howard, Sasha R; Guasti, Leonardo; Poliandri, Ariel; David, Alessia; Cabrera, Claudia P; Barnes, Michael R; Wehkalampi, Karoliina; O'Rahilly, Stephen; Aiken, Catherine E; Coll, Anthony P; Ma, Marcella; Rimmington, Debra; Yeo, Giles S H; Dunkel, Leo

2018-02-01

Self-limited delayed puberty (DP) is often associated with a delay in physical maturation, but although highly heritable the causal genetic factors remain elusive. Genome-wide association studies of the timing of puberty have identified multiple loci for age at menarche in females and voice break in males, particularly in pathways controlling energy balance. We sought to assess the contribution of rare variants in such genes to the phenotype of familial DP. We performed whole-exome sequencing in 67 pedigrees (125 individuals with DP and 35 unaffected controls) from our unique cohort of familial self-limited DP. Using a whole-exome sequencing filtering pipeline one candidate gene [fat mass and obesity-associated gene (FTO)] was identified. In silico, in vitro, and mouse model studies were performed to investigate the pathogenicity of FTO variants and timing of puberty in FTO+/- mice. We identified potentially pathogenic, rare variants in genes in linkage disequilibrium with genome-wide association studies of age at menarche loci in 283 genes. Of these, five genes were implicated in the control of body mass. After filtering for segregation with trait, one candidate, FTO, was retained. Two FTO variants, found in 14 affected individuals from three families, were also associated with leanness in these patients with DP. One variant (p.Leu44Val) demonstrated altered demethylation activity of the mutant protein in vitro. Fto+/- mice displayed a significantly delayed timing of pubertal onset (P < 0.05). Mutations in genes implicated in body mass and timing of puberty in the general population may contribute to the pathogenesis of self-limited DP. Copyright © 2017 Endocrine Society

Developmental Timing of Trauma Exposure Relative to Puberty and the Nature of Psychopathology Among Adolescent Girls.

PubMed

Marshall, Amy D

2016-01-01

Increased neuroplasticity and neural development during puberty provide a context for which stress and trauma can have dramatic and long-lasting effects on psychological systems; therefore, this study was designed to determine whether exposure to potentially traumatic events during puberty uniquely predicts adolescent girls' psychopathology. Because neural substrates associated with different forms of psychopathology seemingly develop at different rates, the possibility that the developmental timing of trauma relative to puberty predicts the nature of psychopathology (posttraumatic stress disorder [PTSD], depressive, and anxiety disorders) was examined. A subset of 2,899 adolescent girls from the National Comorbidity Survey Replication-Adolescent Supplement who completed the study 2+ years postmenarche was selected. Past-year psychiatric disorders and reports of age of trauma exposure were assessed using the Composite International Diagnostic Interview. Developmental stages were defined as the 2 years after the year of menarche ("postpuberty"), 3 years before and year of menarche ("puberty"), 2 to 6 years before the puberty period ("grade school"), and 4 to 5 years after birth ("infancy-preschool"). Compared to other developmental periods, trauma during puberty conferred significantly more risk (50.47% of model R(2)) for girls' past-year anxiety disorder diagnoses (primarily social phobia), whereas trauma during the grade school period conferred significantly more risk (47.24% of model R(2)) for past-year depressive disorder diagnoses. Recency of trauma best predicted past-year PTSD diagnoses. Supporting rodent models, puberty may be a sensitive period for the impact of trauma on girls' development of an anxiety disorder. Trauma prepuberty or postpuberty distinctly predicts depression or PTSD, suggesting differential etiological processes. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Nature and Prevalence of Menstrual Disorders among Teenage Female Students at Zagazig University, Zagazig, Egypt.

PubMed

Nooh, Ahmed M; Abdul-Hady, Atiea; El-Attar, Nadia

2016-04-01

To determine the nature and prevalence of menstrual disorders among teenage girls. An observational descriptive cross-sectional study. Zagazig University Students' Hospital, Zagazig, Egypt. A representative sample of female students who attended the university pre-enrollment medical examination. Self-administered questionnaire covering items on the adolescents' demographic data and menstruation characteristics. Information about menarche, body mass index, physical exercise, cycle length and regularity, duration of menses, menstrual blood loss, dysmenorrhea, and premenstrual syndrome. A total of 285 questionnaires were analyzed. Mean age at menarche was 12.3 ± 1.5 years. Oligomenorrhea was reported by 18 participants (6.3%) and 5 others (1.8%) mentioned having polymenorrhea. Hypomenorrhea was noted in 25 students (8.8%), and hypermenorrhea was reported by 12 (4.2%). Irregular periods were mentioned by 24 students (8.4%). Dysmenorrhea was reported in 188 students (66.0%). Of these, 81 (28.4%) graded their pain as mild, 69 (24.2%) as moderate, and 38 (13.3%) as severe. Premenstrual syndrome was mentioned by 160 girls (56.1%). Consulting somebody regarding their menstrual problems was reported by 36 students (12.6%). Our results are not greatly different from those in other parts of the world. Data on nature and prevalence of menstrual disorders and their effect on young women's health status, quality of life, and social integration suggest that management of these disorders should be given more attention within the available reproductive health care programs. Further research into prevalence of and risk factors for menstrual disorders and their morbidity is warranted and anxiously awaited. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Polycystic ovary syndrome in Iranian adolescents.

PubMed

Esmaeilzadeh, Seddigheh; Delavar, Mouloud Agajani; Amiri, Mania; Khafri, Soraya; Pasha, Nargess Gholizadeh

2014-01-01

Polycystic ovary syndrome (PCOS) is linked with metabolic syndrome, which includes obesity, insulin resistance, dyslipidemia, and endocrine function in patients with PCOS. The aim of this study was to determine the prevalence of adolescent PCOS and characteristics associated with PCOS in adolescents in Babol, Iran. A cross-sectional study was conducted on 1549 girl high school students aged 16-20 years who were living in Iran. After overnight fasting, blood samples were collected to determine hormones and lipid levels in PCOS patients between the first and fifth days of their menstrual period or withdrawal bleeding. The overall prevalence of adolescent PCOS was 129 (8.3%) (95% CI; 4.0, 12.0). Irregular menstruation was observed in 24.1% of adolescents. A total of 68% of PCOS adolescents had insulin resistance. Compared with non-PCOS adolescents, the OR of adolescent PCOS for family history of hirsutism was 1.53 (95% CI, 1.06-2.20; p=0.024), family history of irregular menstrual cycle was 2.27 (95% CI, 1.56-3.30; p<0.001), menarche age <13 years was 1.95 (95% CI, 1.36-2.81; p<0.001), hirsutism was 1.14 (CI 95%, 1.10-1.17; p<0.001), acne was 5.10 (CI 95%, 3.52-7.40; p<0.001), and wrist circumference was 1.28 (CI 95%, 1.07-1.54; p=0.007). The presenting findings showed the high prevalence of PCOS among Iranian adolescents. Emphasis should be placed on clinical screening in adolescents with high-risk factors, including irregular menstrual, menarche <13 years, hirsutism, acne, high wrist circumference, and paternal obesity to help reduce the risk of developing metabolic disturbance and to find ways to improve long-term health.

Risk factors for stress fracture among young female cross-country runners.

PubMed

Kelsey, Jennifer L; Bachrach, Laura K; Procter-Gray, Elizabeth; Nieves, Jeri; Greendale, Gail A; Sowers, Maryfran; Brown, Byron W; Matheson, Kim A; Crawford, Sybil L; Cobb, Kristin L

2007-09-01

To identify risk factors for stress fracture among young female distance runners. Participants were 127 competitive female distance runners, aged 18-26, who provided at least some follow-up data in a randomized trial among 150 runners of the effects of oral contraceptives on bone health. After completing a baseline questionnaire and undergoing bone densitometry, they were followed an average of 1.85 yr. Eighteen participants had at least one stress fracture during follow-up. Baseline characteristics associated (P<0.10) in multivariate analysis with stress fracture occurrence were one or more previous stress fractures (rate ratio [RR] [95% confidence interval]=6.42 (1.80-22.87), lower whole-body bone mineral content (RR=2.70 [1.26-5.88] per 1-SD [293.2 g] decrease), younger chronologic age (RR=1.42 [1.05-1.92] per 1-yr decrease), lower dietary calcium intake (RR=1.11 [0.98-1.25] per 100-mg decrease), and younger age at menarche (RR=1.92 [1.15-3.23] per 1-yr decrease). Although not statistically significant, a history of irregular menstrual periods was also associated with increased risk (RR=3.41 [0.69-16.91]). Training-related factors did not affect risk. The results of this and other studies indicate that risk factors for stress fracture among young female runners include previous stress fractures, lower bone mass, and, although not statistically significant in this study, menstrual irregularity. More study is needed of the associations between stress fracture and age, calcium intake, and age at menarche. Given the importance of stress fractures to runners, identifying preventive measures is of high priority.

The Diagnostic Value of Anti-Müllerian Hormone in Early Post Menarche Adolescent Girls with Polycystic Ovarian Syndrome.

PubMed

Kocaay, Pınar; Siklar, Zeynep; Buyukfirat, Sema; Berberoglu, Merih

2018-02-17

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism and chronic anovulation, which affects 5%-10% of reproductive-age women. Diagnosis of adult patients with PCOS is made easily with clinical and laboratory methods and the anti-Müllerian hormone (AMH) level are accepted as a good indicator. However, there is still no complete consensus on the diagnosis of PCOS in adolescents. Prospective cohort study, December 2013 to November 2014. The study was conducted on adolescent girls with oligomenorrhea, with at least 2 years since menarche. The study group consisted of adolescent girls with complete PCOS and incomplete PCOS. A control group was formed of healthy adolescent girls. Complete PCOS was diagnosed according to the Rotterdam criteria, as the presence of all the following characteristics: oligomenorrhea, hyperandrogenism, and polycystic ovarian morphology on ultrasound image. Incomplete PCOS was accepted as "oligomenorrhea and polycystic ovarian morphology," or "oligomenorrhea and hyperandrogenism." All patients underwent a physical examination and the anthropometric assessments, insulin resistance, and acanthosis nigricans were recorded. It was also noted whether or not the patient had an acne score. The Ferriman-Gallwey score was applied to evaluate hirsutism. The results of this study showed that no statistically significant difference was found between the PCOS and incomplete PCOS groups and the control group with respect to AMH levels. The use of adult-specific diagnostic methods in adolescence might result in an incomplete diagnosis and inadequate treatment plan. Although the serum AMH level clearly facilitates the diagnosis of PCOS, the use of the AMH level in adolescence in PCOS diagnosis is still controversial and further studies are needed. Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Menstrual Abnormalities in School Going Girls – Are They Related to Dietary and Exercise Pattern?

PubMed Central

Vani K., Rupa; K.S., Veena; L., Subitha; Kumar V.R., Hemanth; A., Bupathy

2013-01-01

Context: Adolescence is the transitional phase of physical and mental development between childhood and adulthood and is characterized by immense hormonal changes.75% of girls experience some problems associated with menstruation. Aim: We tried to find out the prevalence of menstrual abnormalities in school going girls in Pondicherry and their association with dietary and exercise habits. Setting and Design: A cross-sectional questionnaire based study was conducted in adolescent girls who attained menarche in four secondary schools of Pondicherry, India. Material and Methods: All students who attained menarche and willing to participate in the study were invited to answer the questionnaire, which dealt with anthropometric data, socioeconomic data, menstrual history, and diet and exercise pattern. Statistical Analysis: Chi-square test and Fisher’s exact test was used to compare the dietary and exercise patterns among students having menstrual abnormalities and those who do not have menstrual abnormalities. Results: A total of 853 students participated in the study. Dysmenorrhea and premenstrual symptoms were the most frequent problems encountered. Premenstrual symptoms were significantly more common among girls who were overweight, in girls who were eating junk food regularly, in girls who were eating less food (dieting) in order to lose weight and in those who were not doing regular physical activity. Dysmenorrhea was significantly more common in the girls who were dieting to lose weight. Passage of clots was also significantly high in the girls who were dieting. Conclusion: Lifestyle modifications like regular physical activity, decreasing the intake of junk food and promoting healthy eating habits should be emphasised in school health education programs to improve their menstrual health. PMID:24392394

Excess adiposity, inflammation, and iron-deficiency in female adolescents.

PubMed

Tussing-Humphreys, Lisa M; Liang, Huifang; Nemeth, Elizabeta; Freels, Sally; Braunschweig, Carol A

2009-02-01

Iron deficiency is more prevalent in overweight children and adolescents but the mechanisms that underlie this condition remain unclear. The purpose of this cross-sectional study was to assess the relationship between iron status and excess adiposity, inflammation, menarche, diet, physical activity, and poverty status in female adolescents included in the National Health and Nutrition Examination Survey 2003-2004 dataset. Descriptive and simple comparative statistics (t test, chi(2)) were used to assess differences between normal-weight (5th < or = body mass index [BMI] percentile <85th) and heavier-weight girls (< or = 85th percentile for BMI) for demographic, biochemical, dietary, and physical activity variables. In addition, logistic regression analyses predicting iron deficiency and linear regression predicting serum iron levels were performed. Heavier-weight girls had an increased prevalence of iron deficiency compared to those with normal weight. Dietary iron, age of and time since first menarche, poverty status, and physical activity were similar between the two groups and were not independent predictors of iron deficiency or log serum iron levels. Logistic modeling predicting iron deficiency revealed having a BMI > or = 85th percentile and for each 1 mg/dL increase in C-reactive protein the odds ratio for iron deficiency more than doubled. The best-fit linear model to predict serum iron levels included both serum transferrin receptor and C-reactive protein following log-transformation for normalization of these variables. Findings indicate that heavier-weight female adolescents are at greater risk for iron deficiency and that inflammation stemming from excess adipose tissue contributes to this phenomenon. Food and nutrition professionals should consider elevated BMI as an additional risk factor for iron deficiency in female adolescents.

Higher premenarcheal bone mass in elite gymnasts is maintained into young adulthood after long-term retirement from sport: a 14-year follow-up.

PubMed

Erlandson, Marta C; Kontulainen, Saija A; Chilibeck, Phil D; Arnold, Cathy M; Faulkner, Robert A; Baxter-Jones, Adam D G

2012-01-01

Sports that impact-load the skeleton during childhood and adolescence increase determinants of bone strength such as bone mineral content and density; however, it is unclear if this benefit is maintained after retirement from the sport. The purpose of this study was to assess whether the previously reported higher bone mass in a group of premenarcheal gymnasts was still apparent 10 years after the cessation of participation and withdrawal of the gymnastics loading stimulus. In 1995, 30 gymnasts 8 to 15 years of age were measured and compared with 30 age-matched nongymnasts. Twenty-five former gymnasts and 22 nongymnasts were measured again 14 years later (2009 to 2010). Gymnasts had been retired from gymnastics training and competition for an average of 10 years. Total body (TB), lumbar spine (LS), and femoral neck (FN) bone mineral content (BMC) was assessed at both measurement occasions by dual-energy X-ray absorptiometry (DXA). Multivariate analysis of covariance (MANCOVA) was used to compare former gymnasts' and nongymnasts' BMC while controlling for differences in body size and maturation (covariates: age, height, weight, and years from menarche [1995] or age at menarche [2009 to 2010]). Premenarcheal gymnasts (measured in 1995) had significantly greater size-adjusted TB, LS, and FN BMC (p < 0.05) (15%, 17%, and 12%, respectively) than nongymnasts. Ten years after retirement, gymnasts had maintained similar size-adjusted TB, LS, and FN BMC differences (p < 0.05) (13%, 19%, and 13%, respectively) when compared with nongymnasts. Bone mass benefits in premenarcheal gymnasts were still apparent even after long-term (10 years) removal of the gymnastics loading stimulus. Copyright © 2012 American Society for Bone and Mineral Research.

[Caffeine consumption by pregnant women selected from a Health Care Center in the municipality of Rio de Janeiro, Brazil].

PubMed

Pacheco, Alice Helena de Resende Nóra; Araujo, Daniele Marano Rocha; Lacerda, Elisa Maria de Aquino; Kac, Gilberto

2008-05-01

to determine caffeine consumption in pregnant women and to evaluate its association with demographic, socioeconomic, reproductive, lifestyle and maternal nutritional status. it is a cross-sectional study performed between 2005 and 2007. The present analysis refers to the period among the 8th and 13th gestational week and included 255 pregnant women from 18 to 40 years, clients of a municipal health center in Rio de Janeiro. The outcome variable was caffeine consumption, quantified by a semi-quantitative food frequency questionnaire, which count with a list containing 81 items and eight options of consumption frequencies; besides it being previously validated in a sample of employees of the State University of Rio de Janeiro. The caffeine intake was quantified starting from the consumption of: powdered chocolate, chocolate bar or chocolate, soft drink, coffee and mate tea. The statistical analysis was performed by means of fitting a multivariate linear regression. the median and the mean caffeine consumption were, respectively, 97.5 and 121.1 mg (standard deviation, sd = 128.4). The high caffeine consumption (> 300 mg/day) was observed in 8.3% of pregnant women. It was observed in the multivariate model that women with earlier menarche (beta = -0.15), with more household partners (b = 0.17) and who didn't make use of medicines (beta = -0.24) presented larger tendency to high caffeine consumption association that was statistically significant (p <0.05). the caffeine consumption for most of the pregnant women was inferior to the limit of 300 mg/day as committed in other studies. Tendency was observed toward higher consumption of caffeine in pregnant women with earlier menarche, with more household partners and who didn't make use of medicines.

Injuries in Female Dancers Aged 8 to 16 Years

PubMed Central

Steinberg, Nili; Siev-Ner, Itzhak; Peleg, Smadar; Dar, Gali; Masharawi, Youssef; Zeev, Aviva; Hershkovitz, Israel

2013-01-01

Context Most studies of injured dancers have been carried out on professional adult dancers; data on young, nonprofessional injured dancers are sparse. Objective To identify the types of injuries sustained by recreational dancers and to examine their association with age, joint range of motion, body structure, age at menarche, presence of anatomic anomalies, and physical burden (ie, practice hours en pointe). Design Descriptive epidemiology study. Setting The Israel Performing Arts Medicine Center, Tel Aviv. Patients or Other Participants A total of 569 injured female dancers, aged 8 to 16 years. Main Outcome Measure(s) Dependent variables were 61 types of current injuries that were later classified into 4 major categories: knee injuries, foot and ankle tendinopathy, back injuries, and other injuries. Independent variables were age, joint range of motion, body size and shape, age at menarche, anatomic anomalies, and dance discipline (eg, hours of practice per week en pointe). Results At least 1 previous injury had been sustained by 42.4% of the dancers. The most common injuries involved the knee (40.4%), followed by other injuries (23.4%). The relative frequency of back injuries and tendinopathy decreased with age, whereas knee injuries increased. Types of injuries were significantly associated with ankle plantar flexion, hip external rotation, hip abduction, and knee flexion. Multinomial regression analysis revealed only 3 predictive variables (with other as baseline), all for back injury: scoliosis, age, and hip external rotation. Conclusions Joint range of motion and scoliosis may signal the potential for future injury. Young dancers (less than 10 years of age) should not be exposed to overload (especially of the back) or extensive stretching exercises. PMID:23672333

'Le moment de la lune'. an auto-ethnographic tale of practice about menarche in a children's hospital.

PubMed

Denshire, Sally

2011-08-01

Auto-ethnographic accounts can highlight unsaid moments of professional practice. In this case, my auto-ethnographic tale 'Le moment de la lune' re-inscribes subjugated knowledge about menstruation and occupational therapy practice in the era before adolescent wards. This fictional tale is written in direct dialogue with an article that was published in this journal at a particular point in my own career as an occupational therapist. In the tale I am 'writing in' what was not written about in my article and in occupational therapy generally. This 'writing-in'/re-inscribing is the research method. My previous article 'Normal spaces' published in this journal in 1985, was organised around principles and generalities of youth-specific practice. The original article had little locating the personal or evoking the body and a heavy reliance on the literature. Issues of gender and culture were largely absent, or, perhaps, 'written out'. The corresponding tale of embodied sexuality, 'Le moment de la lune', articulates something of local complex practice and the particularity of individual therapeutic work to do with menstruation in self-care. Points of tension in 'Normal spaces' are elaborated and I explain how 'Le moment de la lune' problematises supporting menarche in a children's hospital. Now practice has moved on with dedicated adolescent wards in all major children's hospitals. Nevertheless, occupational therapy practice around issues of menstrual self-management is still under-documented. Writing about unspoken moments of practice can have ethical implications for expanding the ways occupational therapy practice can be written and understood. © 2011 The Author. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

Assessment of Risk Factors of Obesity and Diet on Breast Cancer in Ankara, Turkey.

PubMed

Alim, Nural Erzurum; Kiziltan, Gul

2016-01-01

To determine the risk factors of obesity and diet on breast cancer in Ankara, Turkey. A case-controlled study was carried out on newly diagnosed 40 breast cancer patients [patient group (PC)] and 40 volunteer individuals [control group (CG)] with no diagnosis of cancer and history of cancer in the family with similar characteristics to the age and gender-matched patient group between March and July 2016. All the individuals were administered a questionnaire by face-to-face interview method. The mean menarche age, age at first birth and menopause age were 13.0±1.17, 22.6±3.78 and 44.33±2.39 years in PG and 12.3±0.95, 21.6±2.99, 46.71±2.41 years in CG, respectively. The mean BMI values were determined as 28.1±6.75 kg/m 2 in PG and 30.1±6.18 kg/m 2 in CG (p>0.05). It was determined that intake of vitamin C and fiber decreases the risk of breast cancer. Also, eating quickly and smoking were risk factors for breast cancer (p<0.05). This study indicated that there are relationships between menarche age, menopause age, and age at first birth, eating quickly, smoking and breast cancer. Conversely, there are significant negative relationships between dietary fiber, vitamin C intake and breast cancer. As a result, it can be said that there is a link between breast cancer and lifestyle factors and a reduction in the risk of developing breast cancer can be achieved through changes in diet, one of the lifestyle factors.

Assessment of Risk Factors of Obesity and Diet on Breast Cancer in Ankara, Turkey

PubMed Central

Alim, Nural Erzurum; Kiziltan, Gul

2016-01-01

Objective: To determine the risk factors of obesity and diet on breast cancer in Ankara, Turkey. Methods: A case-controlled study was carried out on newly diagnosed 40 breast cancer patients [patient group (PC)] and 40 volunteer individuals [control group (CG)] with no diagnosis of cancer and history of cancer in the family with similar characteristics to the age and gender-matched patient group between March and July 2016. All the individuals were administered a questionnaire by face-to-face interview method. Results: The mean menarche age, age at first birth and menopause age were 13.0±1.17, 22.6±3.78 and 44.33±2.39 years in PG and 12.3±0.95, 21.6±2.99, 46.71±2.41 years in CG, respectively. The mean BMI values were determined as 28.1±6.75 kg/m2 in PG and 30.1±6.18 kg/m2 in CG (p>0.05). It was determined that intake of vitamin C and fiber decreases the risk of breast cancer. Also, eating quickly and smoking were risk factors for breast cancer (p<0.05). Conclusion: This study indicated that there are relationships between menarche age, menopause age, and age at first birth, eating quickly, smoking and breast cancer. Conversely, there are significant negative relationships between dietary fiber, vitamin C intake and breast cancer. As a result, it can be said that there is a link between breast cancer and lifestyle factors and a reduction in the risk of developing breast cancer can be achieved through changes in diet, one of the lifestyle factors. PMID:28083060

Disordered Eating Attitudes and Their Correlates among Iranian High School Girls

PubMed Central

Pourghassem Gargari, Bahram; Kooshavar, Deniz; Seyed Sajadi, Neda; Safoura, Safoura; Hamed Behzad, Mahdiyeh; Shahrokhi, Hassan

2011-01-01

Background: Disordered eating attitudes are contributing factors to the development of eating disorders. Adolescent girls are at high risk for eating diseases. In Iran, there is few data on the subject, especially in Azarian adolescent girls, so we did this study for assessing disordered eating attitudes and their correlates among Iranian Azarbaijani high school girls. Methods: In a cross-sectional study, 1887 high school girls were selected. Eating Attitude Test-26 (EAT-26) and socio economical questionnaires were used. The EAT-26 score of 20 or higher defined as disordered eating attitudes. Data were analyzed using the Statistical Program for Social Sciences, by using from descriptive and analytical statistics. Results: Reliability and validity of the translated EAT-26 were 0.80, 0.76, respectively. In studied subjects, mean (SD) of EAT-26 was 11.71(8.48). Totally, 16.7% (C.I with 95%: 15.1- 18.3%) of students had disordered eating attitudes. About half of the participants were unhappy with their body weight and considered themselves as obese. Mean of EAT-26 was higher in this group. Groups, who intent to weight loss, were smoker, and who had age of menarche less than 11 years, also had higher EAT-26 scores. Parent’s literacy or job, birth order, family size or income and house ownership had not any significant effect on EAT-26 score. Conclusions: Persian version of EAT-26 has good reliability and validity for assessing disordered eating attitudes in Azarian girl adolescents. Prevalence of disordered eating attitudes among Azarian adolescent girls are in the range of some studies, but are less than Arabian countries, and some European ones. In adolescent girls, body weight dissatisfaction, smoking and early menarche has important role in eating attitudes. PMID:24688898

Prevalence of dysmenorrhea and its correlating lifestyle factors in Japanese female junior high school students.

PubMed

Kazama, Mie; Maruyama, Keiko; Nakamura, Kazutoshi

2015-06-01

Dysmenorrhea is a common menstrual disorder experienced by adolescents, and its major symptoms, including pain, adversely affect daily life and school performance. However, little epidemiologic evidence on dysmenorrhea in Japanese adolescents exists. This cross-sectional study aimed to determine the prevalence of and identify factors associated with dysmenorrhea in Japanese female junior high school students. Among 1,167 girls aged between 12 and 15 years, 1,018 participants completed a questionnaire that solicited information on age at menarche, menstruation, and lifestyle, as well as demographic characteristics. Dysmenorrhea was defined based on menstrual pain using a Visual Analog Scale (VAS), with moderate or severe (moderate-severe) dysmenorrhea, which adversely affects daily life, defined as VAS ≥ 4, and severe dysmenorrhea defined as VAS ≥ 7. The prevalence of moderate-severe dysmenorrhea was 476/1,018 (46.8%), and that of severe dysmenorrhea was 180/1,018 (17.7%). Higher chronological and gynecological ages (years after menarche) were significantly associated with a higher prevalence of dysmenorrhea regardless of severity (P for trend < 0.001). In addition, short sleeping hours (< 6/day) were associated with moderate-severe dysmenorrhea (OR = 3.05, 95%CI: 1.06-8.77), and sports activity levels were associated with severe dysmenorrhea (P for trend = 0.045). Our findings suggest that dysmenorrhea that adversely affects daily activities is highly prevalent, and may be associated with certain lifestyle factors in junior high school students. Health education teachers should be made aware of these facts, and appropriately care for those suffering from dysmenorrhea symptoms, absentees, and those experiencing difficulties in school life due to dysmenorrhea symptoms.

Testosterone concentrations in female athletes and ballet dancers with menstrual disorders.

PubMed

Łagowska, Karolina; Kapczuk, Karina

2016-01-01

Menstrual disorders are common among female athletes and ballet dancers. Endocrine changes, such as high testosterone (HT) levels and high luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratios, may suggest functional ovarian hyperandrogenism which may induce such dysfunction. The aim of this study was therefore to evaluate endocrine status in female athletes and ballet dancers with menstrual disorders. Their nutritional status and dietary habits were analysed in relation to the testosterone levels. In a cross-sectional approach, 31 female athletes (18.1 ± 2.6 years) and 21 ballerinas (17.1 ± 0.9) with menstrual disorders participated in the study. The levels of serum LH, FSH, progesterone (P), estradiol (E2), prolactin (PRL), thyroid-stimulating hormone, testosterone (T) and sex hormone-binding globulinwere measured to assess hormonal status. In addition, the free androgen index (FAI) was calculated. Nutritional status, total daily energy expenditure and nutritional habits were evaluated. Girls were assigned to one of the following groups: low testosterone (LT) level, normal testosterone level or HT level. There were significant differences between ballerinas and other female athletes in terms of testosterone levels, FAI, age at the beginning of training, length of training period and age at menarche. The PRL level was lowest in the LT group while the FAI index was highest in the HT group. Daily energy and carbohydrate intakes were significantly lower in the HT group. T levels in the study subjects were found to be associated with nutritional factors, energy availability, age at the beginning of training and frequency of training. This is the first report of HT levels being associated with the status of a female ballet dancer, the age of menarche and the length of the training history. Further research is necessary to confirm the results in a larger study group.

[Reproductive variables and gynaecological service use in delusional disorder outpatients].

PubMed

González-Rodríguez, Alexandre; Molina-Andreu, Oriol; Penadés Rubio, Rafael; Catalán Campos, Rosa; Bernardo Arroyo, Miguel

2015-01-01

Oestrogens have been hypothesized to have a protective effect in psychotic disorders. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD). We aimed to evaluate gynaecological variables and psychopathology, and rates of gynaecological service use in female DD outpatients. Fourty-six outpatients with DD (DSM-IV-TR) were attended at the Hospital Clinic of Barcelona, from 2008 to 2013. Demographic and clinical variables, as well as gynaecological features were recorded in twenty-five women with DD. Hamilton Rating Scale for Depression-17 for depression, Positive and Negative Syndrome Scale for psychopathology, Personal and Social Performance for functionality, and Columbia Suicide Severity Rating Scale were assessed. Mean age of menarche (SD) was 12.83(1.54) years, mean age of menopause 48.73(2.69), mean age at onset of DD was 48.70(13.03). 48% of the sample did not receive gynaecological attention in the last 2-3 years. No statistically significant correlations were found between age at menopause and age at onset of DD. Age at menopause showed a tendency to be negatively correlated with Personal and Social Performance total scores (r = -0.431; P = .074), and was positively associated with suicidal ideation intensity (r = 0.541; P = .038). However, after controlling for social support variables, this relationship was no longer significant. Although a small sample size, this is the first study to specifically examine gynaecological variables in DD. Low compliance rates in gynaecological service use were found. No correlations between age at menopause and clinical variables were statistically significant. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

Endometriosis in Adolescent and Young Girls: Report on a Series of 55 Cases.

PubMed

Matalliotakis, Michail; Goulielmos, George N; Matalliotaki, Charoula; Trivli, Alexandra; Matalliotakis, Ioannis; Arici, Aydin

2017-10-01

The aim of this retrospective study was to evaluate endometriosis in adolescent and young girls and further to review the menstrual, reproductive characteristics, and risk factors. We reviewed the medical records of adolescent and young girls with endometriosis from 2 different countries. Data were collected and analyzed from charts of 900 patients with endometriosis. Fifty-five female adolescents aged between 13 and 21 years (mean age 18.3 years) participated in our series. This study was conducted in the Obstetric and Gynecology Department of Venizeleio General Hospital of Crete and involved all patients diagnosed with endometriosis between 1996 and 2016. Statistical methods included χ 2 and Mann-Whitney U test. Of 900 patients with endometriosis we found 55 female adolescents (6.1%). The mean age was 18.3 ± 2.3 years, significantly younger compared with the advanced endometriosis patients (32.7 ± 7.2; P < .001). Regarding the menstrual reproductive and others characteristics, we observed several differences in adolescent young girls compared with the advanced age endometriosis group. The factors associated with an increased risk for young women include age at menarche, dysmenorrhea, history of asthma, and a positive family history of endometriosis. Additionally, we report on 16 of 55 (32%) adolescent women with endometriosis and congenital malformations (P < .01) and 5 patients who were diagnosed with dry eye syndrome. There is an association between endometriosis in adolescent and young women and risk factors including early menarche, early onset of dysmenorrhea, history of asthma, previous surgical procedures, obstructive genital anomalies, and family history of endometriosis. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

The role of menstruation in women's objectification: a questionnaire study.

PubMed

Sveinsdóttir, Herdís

2017-06-01

The aim of this study was to investigate the concepts of objectification and self-objectification among young women in the context of attitudes towards menstruation, menstrual suppression, menstrual and menarche experiences, disorder eating and exercise habits and to detect predictors of objectification and self-objectification. The negative effects of objectification are well founded. Considering the central role menstruation plays in female biology, it comes as quite a surprise that so little attention is given to the subject in the research on objectification. Cross-sectional explorative survey design. A questionnaire that included the Self-Objectification Questionnaire, the Objectified Body Consciousness Scale, the Belief and Attitudes Towards Menstruation Questionnaire and the Suppress Menstruation subscale of the Attitudes Towards Menstrual Suppression Questionnaire was administered at the end of 2013 to 319 Icelandic women who represented the population by age. A stepwise multiple linear regression model was employed to calculate significant predictors of objectification and self-objectification. Four models of objectification are presented: the self-objectification model, the body surveillance model, the body shame model and the control belief model. Taken together, the strongest predictors of these models were related to eating habits. However, the findings also support the proposition that menstrual-related experiences influence women's objectification, particularly in terms of age at menarche, of belief in the prescriptive role of menstruation and of use of pain medication for menstrual pain. Healthcare providers in general and nurses in particular could and should assist girls and women in developing a positive view of their body and its reproductive functions by discussing the body and menstruation based on women's concerns. © 2016 John Wiley & Sons Ltd.

Menstrual characteristics amongst south-eastern Nigerian adolescent school girls.

PubMed

Adinma, E D; Adinma, J I B

2009-03-01

Information on pattern of menstruation and its implications is lacking amongst adolescents in Nigeria. To examine the characteristics of menstruation amongst adolescent Igbo school girls with respect to the biosocial characteristics, the pattern of menstruation, associated complications, and the source of information on menstruation. A descriptive cross-sectional study of 550 students recruited from a multi-sampling of 50 secondary schools in Onitsha, Anambra State, Nigeria, using pre-tested, semistructured, and interviewer administered questionnaires. Four hundred and sixteen (75.6%) respondents were aged 15-17 years; 338 (61.4%) of whom were Catholics. Menarcheal age range of respondents was 11-16 years, with a mean age of 13.40 +/- 1.15 years. Menstruation was regular in 410 (74.5%), and irregular in 124 (22.5%) of respondents. Duration of menstrual flow ranged between two and eight days, although a four-day flow occurred most commonly, 268 (53.6%). Abdominal pain, (66.2%), and waist pain, (38.5%), constituted the major problems associated with menstruation, followed by depression, (24.4%); vomiting, (6.9%); school absenteeism, (4.5%); anorexia, (1.8%); weakness, (1.5%); and increased appetite, (1.1%). The commonest source of information on menstruation (prior to menarche) amongst respondents was from the mother, 48.4%, followed by elder sister, and friends --14.2%, and 8.7% respectively, while the teacher constituted the least source, 1.1%. The characteristics of menstruation in this study do not differ considerably from what obtains amongst other adolescent girls. Associated complications may have profound psychosocial impact on the growing adolescent girl, requiring address, best achieved through the empowerment of mothers and teachers under a comprehensive family life education scheme.

Demographic, lifestyle, and other factors in relation to antimüllerian hormone levels in mostly late premenopausal women.

PubMed

Jung, Seungyoun; Allen, Naomi; Arslan, Alan A; Baglietto, Laura; Brinton, Louise A; Egleston, Brian L; Falk, Roni; Fortner, Renée T; Helzlsouer, Kathy J; Idahl, Annika; Kaaks, Rudolph; Lundin, Eva; Merritt, Melissa; Onland-Moret, Charlotte; Rinaldi, Sabina; Sánchez, María-José; Sieri, Sabina; Schock, Helena; Shu, Xiao-Ou; Sluss, Patrick M; Staats, Paul N; Travis, Ruth C; Tjønneland, Anne; Trichopoulou, Antonia; Tworoger, Shelley; Visvanathan, Kala; Krogh, Vittorio; Weiderpass, Elisabete; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Dorgan, Joanne F

2017-04-01

To identify reproductive, lifestyle, hormonal, and other correlates of circulating antimüllerian hormone (AMH) concentrations in mostly late premenopausal women. Cross-sectional study. Not applicable. A total of 671 premenopausal women not known to have cancer. None. Concentrations of AMH were measured in a single laboratory using the picoAMH ELISA. Multivariable-adjusted median (and interquartile range) AMH concentrations were calculated using quantile regression for several potential correlates. Older women had significantly lower AMH concentrations (≥40 [n = 444] vs. <35 years [n = 64], multivariable-adjusted median 0.73 ng/mL vs. 2.52 ng/mL). Concentrations of AMH were also significantly lower among women with earlier age at menarche (<12 [n = 96] vs. ≥14 years [n = 200]: 0.90 ng/mL vs. 1.12 ng/mL) and among current users of oral contraceptives (n = 27) compared with never or former users (n = 468) (0.36 ng/mL vs. 1.15 ng/mL). Race, body mass index, education, height, smoking status, parity, and menstrual cycle phase were not significantly associated with AMH concentrations. There were no significant associations between AMH concentrations and androgen or sex hormone-binding globulin concentrations or with factors related to blood collection (e.g., sample type, time, season, and year of blood collection). Among premenopausal women, lower AMH concentrations are associated with older age, a younger age at menarche, and currently using oral contraceptives, suggesting these factors are related to a lower number or decreased secretory activity of ovarian follicles. Copyright © 2017 American Society for Reproductive Medicine. All rights reserved.

Demographic, lifestyle, and other factors in relation to anti-Müllerian hormone levels in mostly late premenopausal women

PubMed Central

Jung, Seungyoun; Allen, Naomi; Arslan, Alan A.; Baglietto, Laura; Brinton, Louise A.; Egleston, Brian L.; Falk, Roni; Fortner, Renée T.; Helzlsouer, Kathy J.; Idahl, Annika; Kaaks, Rudolph; Lundin, Eva; Merritt, Melissa; Onland-Moret, Charlotte; Rinaldi, Sabina; Sánchez, María-José; Sieri, Sabina; Schock, Helena; Shu, Xiao-Ou; Sluss, Patrick M.; Staats, Paul N.; Travis, Ruth C.; Tjønneland, Anne; Trichopoulou, Antonia; Tworoger, Shelley; Visvanathan, Kala; Krogh, Vittorio; Weiderpass, Elisabete; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Dorgan, Joanne F.

2017-01-01

Objective To identify reproductive, lifestyle, hormonal and other correlates of circulating anti-Müllerian Hormone (AMH) concentrations in mostly late premenopausal women Design Cross-sectional study Setting Nine cohorts that participated in the Prospective Study of AMH and Gynecologic Cancer Risk Patient(s) 671 premenopausal women not known to have cancer. Intervention(s) None Main Outcome Measure(s) AMH concentrations were measured in a single laboratory using the picoAMH enzyme-linked immunosorbent assay. Multivariable-adjusted median (and interquartile range) AMH concentrations were calculated using quantile regression for several potential correlates. Results Older women had significantly lower AMH concentrations (≥40, n=444 vs. <35 years, n=64, multivariable-adjusted median: 0.73 ng/mL vs. 2.52 ng/mL). AMH concentrations were also significantly lower among women with earlier age at menarche (<12, n=96 vs. ≥14 years, n=200: 0.90 ng/mL vs. 1.12 ng/mL) and among current users of oral contraceptives (n=27), compared to never or former users (n=468) (0.36 ng/mL vs. 1.15 ng/mL). Race, body mass index, education, height, smoking status, parity and menstrual cycle phase were not significantly associated with AMH concentrations. There were no significant associations between AMH concentrations and androgen or sex hormone-binding globulin concentrations or with factors related to blood collection (e.g., sample type, time, season, and year of blood collection). Conclusions Among premenopausal women, lower AMH concentrations are associated with older age, a younger age at menarche and currently using oral contraceptives, suggesting these factors are related to a lower number or decreased secretory activity of ovarian follicles. PMID:28366409

A comparative study of nutritional status and foodstuffs in adolescent girls in iran.

PubMed

Talaie-Zanjani, A; Faraji, F; Rafie, M; Mohammadbeigi, A

2014-01-01

The prevalence of obesity and overweight in children and adolescents is increasing world-wide. Obesity in children and adolescents is a major risk factor for diabetes, heart diseases, hypertension, and cancer in adulthood. The aim of the study was to compare the nutritional status and food-stuffs among high-school girls in Arak, Iran, in matter of body mass index (BMI) and associated factors. A cross-sectional survey of a representative sample of 278 adolescents was conducted in six randomly chosen high-schools. Height and weight of students were collected using standard methods and the BMI calculated and BMI percentiles of these girls are compared with the Center of Disease Control and Prevention (CDC) reference data. The 5(th), 8(th), and 95(th) percentiles of the CDC were adopted as cut-off points for underweight, overweight and obese girls, respectively. Data were analyzed using SPSS by analysis of variance and Chi-square tests. On the basis of CDC, the overall prevalence rates of underweight, overweight, and obesity were estimated 10.1% (28/278), 12.9% (36/278), and 1.4% (4/278), respectively. There was no significant difference between nutritional knowledge scores and the rate of physical activities in various groups. The mean age at menarche was significantly higher among the obese girls (P = 0.02). Consumption of ice-cream and chocolate was significantly higher in the obese girls group (P = 0.03). According to the present study, the prevalence of overweight and obesity in high-school girls of Arak is lower than that of many other parts of Iran and some neighboring countries, which are at the high-risk of overweight and obesity. This study warrants the necessity of paying attention to promote healthy life-style and weight control. The earlier age of menarche is alarming.

Complete androgen insensitivity syndrome associated with male gender identity or female precocious puberty in the same family.

PubMed

Bermúdez de la Vega, José A; Fernández-Cancio, Mónica; Bernal, Susana; Audí, Laura

2015-01-01

In 4 complete androgen insensitivity syndrome (CAIS) members of one family, 2 presented extreme and unusual clinical features: male gender identity disorder (case 1) and female precocious central puberty (case 2). The AR gene carried the mutation c.1752C>G, p.Phe584Leu. Gender dysphoria in CAIS may be considered as a true transgender and has been described in 3 other cases. Central precocious puberty has only been described in 1 case; Müllerian ducts in case 2 permitted menarche. Despite the common CAIS phenotype, there was a familial disparity for gender identity adequacy and timing and type of puberty.

Salivary sex hormones in adolescent females with trichotillomania.

PubMed

Grant, Jon E; Chamberlain, Samuel R

2018-05-05

Trichotillomania is several times more common in women and has peak onset around puberty. The role of sex hormones, however, has received little research. 11 adolescent girls with trichotillomania, post-menarche and not taking birth control, were examined on a variety of clinical measures. Participants provided saliva samples for analysis of estradiol, progesterone, and testosterone levels. Lower progesterone was associated with more severe symptoms and lower levels of all hormones were associated with worse overall functioning. Adolescents with trichotillomania exhibit a range of hormone levels but that lower levels of certain hormones may have important clinical associations. Copyright © 2018 Elsevier B.V. All rights reserved.

[Catamenial pneumothorax secondary to thoracic endometriosis].

PubMed

Mendoza Calderón, Fernando; Valladares, Virgilio; Ballesteros, Alberto; Ayala, María de la Merced

2007-11-01

It is a 27 years old patient, childbirths three, menarche 13 years, regular cycles, with dismenorrea incapacitante twice a year, referring light dispareunia, which was refered a our hospital. She had been hospitalized three days ago presenting left neumotorax, it was the third time she have had the same clinical square in the last four months, she had a neumotorax of 40%, Ca 125 de 102 U/ml, the pelvic ultrasound reported like positive anecoica image of five for four centimeters, through a toracoscopy in which reported two focuses endometriosicos of aproximately 0.5 centimeters, from which a biopsy was obtained and reported tissue endometrium in lung parenchyma.

Menstrual socialization, beliefs, and attitudes concerning menstruation in rural and urban Mexican women.

PubMed

Marvan, Maria Luisa; Trujillo, Paulina

2010-01-01

Women living in rural and urban areas of Mexico answered a questionnaire about what they were told at home about menstruation before their menarche (first menstruation), and answered the Beliefs About and Attitudes Toward Menstruation Questionnaire. Around half of both urban and rural women were told that they were going to experience negative perimenstrual changes. There were fewer urban than rural women who were advised to do or not to do certain activities while menstruating. Menstrual socialization affected the beliefs and attitudes concerning menstruation held by women as adults. These findings are discussed in light of the sociocultural background of the participants.

Hypogonadism and Sex Steroid Replacement Therapy in Girls with Turner Syndrome.

PubMed

Gawlik, Aneta; Hankus, Magdalena; Such, Kamila; Drosdzol-Cop, Agnieszka; Madej, Paweł; Borkowska, Marzena; Zachurzok, Agnieszka; Malecka-Tendera, Ewa

2016-12-01

Turner syndrome is the most common example of hypergonadotropic hypogonadism resulting from gonadal dysgenesis. Most patients present delayed, or even absent, puberty. Premature ovarian failure can be expected even if spontaneous menarche occurs. Laboratory markers of gonadal dysgenesis are well known. The choice of optimal hormone replacement therapy in children and adolescents remains controversial, particularly regarding the age at which therapy should be initiated, and the dose and route of estrogen administration. On the basis of a review of the literature, we present the most acceptable schedule of sex steroid replacement therapy in younger patients with Turner syndrome. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Premenarchal, recurrent vaginal discharge associated with an incomplete obstructing longitudinal vaginal septum.

PubMed

Hansen, Keith A; DeWitt, Jason

2005-12-01

To describe an unusual, premenarchal presentation of an obstructive vaginal anomaly. Case Report. University Medical Center. Premenarchal subject Vaginogram, vaginal septum resection. Vaginal septum resection with resolution of vaginal discharge. This case demonstrates some of the typical features of uterus didelphys bicollis with incomplete obstructing hemivagina, but had a unique presentation with premenarchal, recurrent vaginal discharge. Typically, patients with an obstructing mullerian anomaly present after menarche with pelvic pain and a mass. The vaginogram assists in the preoperative definition of abnormal anatomy which allows the surgeon to develop the most appropriate surgical approach. Resection of this incompletely obstructing vaginal septum resulted in resolution of the recurrent vaginal discharge.

Menstruation in adolescents: what do we know? And what do we do with the information?

PubMed

Adams Hillard, Paula J

2014-12-01

The menstrual cycle has been recognized as a vital sign that gives information about the overall health of an adolescent or young adult female. Significant deviations from monthly cycles can signal disease or dysfunction. This review highlights the evidence based parameters for normal puberty, menarche, cyclicity, and amount of bleeding. The review addresses sources of information available online, noting inaccuracies that appear in web sites, even and especially those targeting adolescents. The review includes a call to action to provide accurate information about the menstrual cycle as a VITAL SIGN. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Knowledge, Practices, and Restrictions Related to Menstruation among Young Women from Low Socioeconomic Community in Mumbai, India

PubMed Central

Thakur, Harshad; Aronsson, Annette; Bansode, Seema; Stalsby Lundborg, Cecilia; Dalvie, Suchitra; Faxelid, Elisabeth

2014-01-01

The main objective was to assess knowledge, practices, and restrictions faced by young women regarding their menstrual hygiene. The views of adult women having young daughters were also included and both views were compared. In addition, the factors influencing the menstrual hygiene practices were also studied. The study was carried out during 2008 in Mumbai, India. The mixed methods approach was followed for the data collection. Both qualitative and quantitative methods were used to collect the data. For quantitative survey, totally 192 respondents (96 adult and 96 younger women) were selected. While young women were asked about questions related to their menstruation, adult women were asked questions to find out how much they know about menstrual history of their daughters. The qualitative data helped to supplement the findings from the quantitative survey and to study the factors affecting menstrual practices in young women. The mean age at menarche reported was 13.4 years and 30–40% of young girls did not receive any information about menstruation before menarche. It is thus seen that very few young girls between the age group 15 and 24 years did receive any information before the onset of menstruation. Among those who received some information, it was not adequate enough. The source of information was also not authentic. Both young and adult women agreed on this. Due to the inadequate knowledge, there were certain unhygienic practices followed by the young girls resulting in poor menstrual hygiene. It also leads to many unnecessary restrictions on young girls and they faced many health problems and complaints, which were either ignored or managed inappropriately. The role of health sector was almost negligible from giving information to the management of health problems of these young girls. This paper reemphasizes the important, urgent, and neglected need of providing correct knowledge to the community including adolescent girls. PMID:25072044

[Breast cancer and heredity: results of a population case-control study in Girona].

PubMed

de Sanjosé, S; Viladiu, P; Cordón, F; Vilardell, L; Marcos, R; Izquìerdo, A

1998-03-21

To characterise the relationship between breast cancer and different aspects of the reproductive life, use of drugs and alcohol by family history of breast cancer. From the cancer registry of Girona, Spain, 330 women were identified with histologically confirmed breast cancer during 1986-1989. For each case, a control woman was selected from a random sample of the population living in the matched area to the case by age (+/- 5 yr.). The information was collected by a personal interview and included: family history of breast cancer, reproductive history, presence of acne during the teenage years, use of oral contraceptives and drugs for sleep and anxiety disorders, and alcohol consumption. 18.5% of breast cancer cases and 8.9% of all controls had a family history of breast cancer. Family history on a first degree relative (mother or sister) was present in 10.6% of the cases and 2.8% of controls, which represented an odds ratio for breast cancer of 3.7 (95% CI, 1.8-7.8) higher than the general population. Women with a first degree family history of breast cancer were at higher risk for breast cancer if they had a history of acne during the teenage period (OR = 2.4; 95% CI, 1.1-5.2) and if they referred long menstrual periods in the early years of menarche (OR = 3.1; 95% CI, 1.3-7.0). Women with no family history had a higher breast cancer risk if they had a late menarche, long menstrual periods, late first full term pregnancy, and history of acne during puberty. Alcohol consumption and use of drugs for anxiety and sleep disorders were associated with a decreased risk of breast cancer. First degree family history of breast cancer seems to be the best risk indicator for developing breast cancer. Long menstrual periods and presence of acne during puberty may indicate hormonal imbalance that act independently of the family history in breast cancer development.

Comparison of Reflexology and Connective Tissue Manipulation in Participants with Primary Dysmenorrhea.

PubMed

Demirtürk, Funda; Erkek, Zümrüt Yilar; Alparslan, Özgür; Demirtürk, Fazlı; Demir, Osman; Inanir, Ahmet

2016-01-01

The aim of this interventional correlational study is to compare the effects of foot reflexology (FR) and connective tissue manipulation (CTM) in subjects with primary dysmenorrhea. A total of 30 participants having primary dysmenorrhea completed the study. Data, including demographics (age, body-mass index), menstrual cycle (age at menarche, menstrual cycle duration, time since menarche, bleeding duration), and menstrual pain characteristics (intensity and duration of pain, type and amount of analgesics), were recorded. Effect of dysmenorrhea on participants' concentration in lessons and in sports and social activities was assessed by using the visual analog scale. Participants rated their menstruation-related symptom intensity through the Likert-type scale. FR was applied to 15 participants for 3 days a week and CTM was performed on 15 participants for 5 days a week. Treatments were performed during one cycle, which started at the third or fourth day of menstruation and continued till the onset of next menstruation. Assessments were performed before treatment (first menstruation), then after termination of the treatment because of the next menstruation's onset (second menstruation), and ∼1 month after at the consecutive menstrual period (third menstrual cycle). Time-dependent changes in duration and intensity of pain along with analgesic amount show that both treatments provided significant improvements (p < 0.05) and no superiority existed between the groups (p > 0.05). A similar result was obtained in terms of time-dependent changes in concentration in lessons and difficulty in sports and social activities due to dysmenorrhea. Menstruation-related symptoms were found to be decreased after treatment and in the following cycle with both treatments (p < 0.05) where no difference existed between the groups (p > 0.05). Both FR and CTM can be used in the treatment of primary dysmenorrhea and menstruation-related symptoms as these methods are free from the potentially adverse effects of analgesics, noninvasive, and easy to perform.

Very late nonfatal consequences of fractionated TBI in children undergoing bone marrow transplant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faraci, Maura; Barra, Salvina; Cohen, Amnon

Purpose: To describe long-term late consequences in children who received total body irradiation (TBI) for hematopoietic stem cell transplantation 10 years earlier. Methods and Materials: A cohort of 42 children treated with TBI between 1985 and 1993, still alive at least 10 years after fractionated TBI (FTBI), was evaluated. Twenty-five patients received FTBI at 330 cGy/day for 3 days (total dose 990 cGy), whereas 17 children were administered fractions of 200 cGy twice daily for 3 days (total dose 1200 cGy). Twenty-seven patients received autologous and 16 allogeneic hematopoietic stem cell transplantation. Median age at TBI was 6.3 years, andmore » 18.4 years at most recent follow-up. Results: Cataract was diagnosed in 78% of patients after a median of 5.7 years. Hypothyroidism was detected in 12%, whereas thyroid nodules were observed in 60% of our population after a median interval of 10.2 years. Patients treated with 990 cGy developed thyroid nodules more frequently than those treated with 1200 cGy (p = 0.0002). Thyroid carcinoma was diagnosed in 14% of the total population. Females who received FTBI after menarche more frequently developed temporary ovarian dysfunction than those treated before menarche, but cases of persistent ovarian dysfunction did not differ between the two groups. Indirect signs of germinal testicular dysfunction were detected in 87% of males. Restrictive pulmonary disease was observed in 74% of patients. Osteochondroma was found in 29% of patients after a median interval of 9.2 years. This latter complication appeared more frequently in patients irradiated before the age of 3 years (p < 0.001). Conclusions: This study shows that late effects that are likely permanent, although not fatal, are frequent in survivors 10 years after TBI. However, some of the side effects observed shortly after TBI either disappeared or remained unchanged without signs of evolution. Monitoring is recommended to pursue secondary prevention strategies and counseling on family planning.« less

Low bone density risk is higher in exercising women with multiple triad risk factors.

PubMed

Gibbs, Jenna C; Nattiv, Aurelia; Barrack, Michelle T; Williams, Nancy I; Rauh, Mitchell J; Nichols, Jeanne F; De Souza, Mary Jane

2014-01-01

The cumulative effect of the female athlete triad (Triad) risk factors on the likelihood of low bone mineral density (BMD) in exercising women is unclear. This study aimed to determine the risk of low BMD in exercising women with multiple Triad risk factors. We retrospectively examined cross-sectional data from 437 exercising women (mean ± SD age of 18.0 ± 3.5 yr, weighed 57.5 ± 7.1 kg with 24.5% ± 6.1% body fat) obtained at baseline from 4 prospective cohort studies examining Triad risk factors. Questionnaires were completed to obtain information on demographic characteristics, self-reported eating attitudes/behaviors, menstrual function, sport/activity participation, and medication use. Height and body weight were measured. BMD was measured using dual energy x-ray absorptiometry. Low BMD was defined as z-scores of <-1 and ≤-2. Chi-square tests were performed to determine the percentage of women with low BMD who met the criteria for individual (current oligo/amenorrhea, late menarche, low body mass index (BMI), elevated dietary restraint, lean sport/activity participation) or multiple (2, 3, 4, or 5) Triad risk factors. Late menarche and low BMI were associated with the highest percentage of low BMD (z-score < -1), 55% and 54%, respectively, and low BMD (z-score ≤-2), 14% and 16%, respectively. The percentage of participants with low BMD (z-score < -1 and ≤-2) increased from 10% to 62% and from 2% to 18%, respectively, as women met the criteria for an increasing number of Triad risk factors. A cumulative number of Triad risk factors were associated with an increased risk of low BMD, suggesting a dose-response association between the number of Triad risk factors and BMD in exercising women. Further research should be conducted to develop a user-friendly algorithm integrating these indicators of risk for low BMD in exercising women (particularly factors associated with low BMI/body weight, menstrual dysfunction, lean sport/activity participation, and elevated dietary restraint).

Reproductive history and risk of colorectal cancer in postmenopausal women.

PubMed

Zervoudakis, Alice; Strickler, Howard D; Park, Yikyung; Xue, Xiaonan; Hollenbeck, Albert; Schatzkin, Arthur; Gunter, Marc J

2011-05-18

There are conflicting data regarding the role of sex hormones in colorectal cancer development. Whereas clinical trials data indicate that hormone therapy use reduces the risk of colorectal cancer, data from prospective cohort studies suggest that circulating estrogen levels are positively associated with colorectal cancer risk. A surrogate measure of lifetime estrogen exposure is reproductive history. We investigated the relationship between reproductive factors and the risk of colorectal cancer. Subjects were postmenopausal women enrolled in the National Institutes of Health-American Association of Retired Persons Diet and Health Study, a cohort of 214,162 individuals (aged 50-71 years) that included 2014 incident cases of colorectal cancer that occurred over a mean follow-up of 8.2 years. Questionnaires were used to collect data on reproductive factors, including ages at menarche, birth of first child, and menopause; parity, and use of oral contraceptives. Multivariable Cox proportional hazards models were constructed to examine associations between these reproductive factors and the risk of colorectal cancer, with adjustment for established colorectal cancer risk factors. All statistical tests were two-sided. Age at menopause (≥ 55 vs < 40 years: hazard ratio [HR] = 1.50, 95% confidence interval [CI] = 1.23 to 1.83; P(trend) = .008) and age at birth of first child (≥ 30 vs ≤ 19 years: HR = 1.26, 95% CI = 1.01 to 1.58; P(trend) = .05) were positively associated with the risk of colorectal cancer. Among women with no history of hormone therapy use, age at menarche (≥ 15 vs 11-12 years: HR = 0.73, 95% CI = 0.57 to 0.94; P(trend) = .02) and parity (≥ 5 children vs no children: HR = 0.80, 95% CI = 0.63 to 1.02; P(trend) = .10) were inversely associated with the risk of colorectal cancer. These data support a role for sex hormones in colorectal tumorigenesis and suggest that greater endogenous estrogen exposure may increase the risk of colorectal cancer in postmenopausal women.

Reproductive History and Risk of Colorectal Cancer in Postmenopausal Women

PubMed Central

Zervoudakis, Alice; Strickler, Howard D.; Xue, Xiaonan; Hollenbeck, Albert; Schatzkin, Arthur

2011-01-01

Background There are conflicting data regarding the role of sex hormones in colorectal cancer development. Whereas clinical trials data indicate that hormone therapy use reduces the risk of colorectal cancer, data from prospective cohort studies suggest that circulating estrogen levels are positively associated with colorectal cancer risk. A surrogate measure of lifetime estrogen exposure is reproductive history. We investigated the relationship between reproductive factors and the risk of colorectal cancer. Methods Subjects were postmenopausal women enrolled in the National Institutes of Health–American Association of Retired Persons Diet and Health Study, a cohort of 214 162 individuals (aged 50–71 years) that included 2014 incident cases of colorectal cancer that occurred over a mean follow-up of 8.2 years. Questionnaires were used to collect data on reproductive factors, including ages at menarche, birth of first child, and menopause; parity, and use of oral contraceptives. Multivariable Cox proportional hazards models were constructed to examine associations between these reproductive factors and the risk of colorectal cancer, with adjustment for established colorectal cancer risk factors. All statistical tests were two-sided. Results Age at menopause (≥55 vs <40 years: hazard ratio [HR] = 1.50, 95% confidence interval [CI] = 1.23 to 1.83; Ptrend = .008) and age at birth of first child (≥30 vs ≤19 years: HR = 1.26, 95% CI = 1.01 to 1.58; Ptrend = .05) were positively associated with the risk of colorectal cancer. Among women with no history of hormone therapy use, age at menarche (≥15 vs 11–12 years: HR = 0.73, 95% CI = 0.57 to 0.94; Ptrend = .02) and parity (≥5 children vs no children: HR = 0.80, 95% CI = 0.63 to 1.02; Ptrend = .10) were inversely associated with the risk of colorectal cancer. Conclusion These data support a role for sex hormones in colorectal tumorigenesis and suggest that greater endogenous estrogen exposure may increase the risk of colorectal cancer in postmenopausal women. PMID:21447807

Effects of prenatal alcohol exposure on testosterone and pubertal development

PubMed Central

Carter, R.C.; Jacobson, J.L.; Dodge, N.C.; Granger, D.A.; Jacobson, S.W.

2014-01-01

Background Animal models have demonstrated fetal alcohol-related disruptions in neuroendocrine function in the hypothalamic-pituitary-gonadal (HPG) axis and downstream effects on pubertal development and sexual behavior in males and females, but little is known about these effects in humans. This study examined whether prenatal alcohol exposure is associated with alterations in testosterone during adolescence and whether it affects timing of pubertal development. Methods The sample consisted of 265 African American adolescents from the Detroit Longitudinal Cohort Study for whom testosterone and/or pubertal development data were available. Subjects were offspring of women recruited at their first prenatal clinic visit to over-represent moderate-to-heavy alcohol use, including a 5% random sample of low-level drinkers/abstainers. Mothers were interviewed at every prenatal visit about their alcohol consumption using a timeline follow-back approach and about their smoking and drug use and sociodemographic factors. At age 14 years, adolescents provided salivary samples, which were analyzed for testosterone (pg/mL), self-reported Tanner stages for pubertal development, and age at menarche (females). Results Prenatal alcohol exposure was related to elevated testosterone concentrations for males and females but not to changes in Tanner stages or age at menarche, after controlling for confounders. In regression models stratified by alcohol exposure, the expected relation between testosterone and pubic hair development was seen among males with light-to-no prenatal alcohol exposure but not among those with moderate-to-heavy prenatal alcohol exposure. This interaction between testosterone and prenatal alcohol exposure was confirmed in multivariable models including an alcohol exposure group X testosterone interaction term and potential confounders. Conclusions This study was the first to show a relation between prenatal alcohol exposure and increased testosterone during adolescence and evidence of decreased testosterone responsiveness in tissues related to pubertal development. Further studies examining androgen receptor expression and other hormonal and cellular factors affecting pubertal development may reveal important mechanisms underlying these teratogenic effects of alcohol exposure. PMID:24717169

Very late nonfatal consequences of fractionated TBI in children undergoing bone marrow transplant.

PubMed

Faraci, Maura; Barra, Salvina; Cohen, Amnon; Lanino, Edoardo; Grisolia, Francesca; Miano, Maurizio; Foppiano, Franca; Sacco, Oliviero; Cabria, Manlio; De Marco, Riccardo; Stella, Gilberto; Dallorso, Sandro; Bagnasco, Francesca; Vitale, Vito; Dini, Giorgio; Haupt, Riccardo

2005-12-01

To describe long-term late consequences in children who received total body irradiation (TBI) for hematopoietic stem cell transplantation 10 years earlier. A cohort of 42 children treated with TBI between 1985 and 1993, still alive at least 10 years after fractionated TBI (FTBI), was evaluated. Twenty-five patients received FTBI at 330 cGy/day for 3 days (total dose 990 cGy), whereas 17 children were administered fractions of 200 cGy twice daily for 3 days (total dose 1200 cGy). Twenty-seven patients received autologous and 16 allogeneic hematopoietic stem cell transplantation. Median age at TBI was 6.3 years, and 18.4 years at most recent follow-up. Cataract was diagnosed in 78% of patients after a median of 5.7 years. Hypothyroidism was detected in 12%, whereas thyroid nodules were observed in 60% of our population after a median interval of 10.2 years. Patients treated with 990 cGy developed thyroid nodules more frequently than those treated with 1200 cGy (p = 0.0002). Thyroid carcinoma was diagnosed in 14% of the total population. Females who received FTBI after menarche more frequently developed temporary ovarian dysfunction than those treated before menarche, but cases of persistent ovarian dysfunction did not differ between the two groups. Indirect signs of germinal testicular dysfunction were detected in 87% of males. Restrictive pulmonary disease was observed in 74% of patients. Osteochondroma was found in 29% of patients after a median interval of 9.2 years. This latter complication appeared more frequently in patients irradiated before the age of 3 years (p < 0.001). This study shows that late effects that are likely permanent, although not fatal, are frequent in survivors 10 years after TBI. However, some of the side effects observed shortly after TBI either disappeared or remained unchanged without signs of evolution. Monitoring is recommended to pursue secondary prevention strategies and counseling on family planning.

The maturation rate of girls living in rich and poor rural regions of Poland before and after the transformation of 1989.

PubMed

Laska-Mierzejewska, T; Olszewska, E

2004-01-01

The aim of this study was to find out whether the political and economic system transformation in Poland in 1989 had an influence on the rate of maturation of girls from various categories of the rural population in two regions, differing in wealth. The stratification of the villagers was based on the source of the family income (farmers, farmer-workers and non-farmers), on parents' education, and on the number of children per family. The age at menarche (AM) was used as biological indicator of living conditions. Rural girls aged 9.5-18.5 years were studied in 1987 in Leszno (L), a rich region (n = 2049), and in 1989 in Suwałki (S), a poor region (n = 2077). The study was repeated in 2001 in the same villages, the numbers of subjects amounting to 2440 and 2122, respectively. In the 1980s, AM in regions L and S amounted to 13.18 and 13.88 years, respectively, and was strongly related to social stratification. The earliest AM was found in daughters of non-farmers and the latest in the girls from farmers' families. In 2001, the acceleration in AM amounted to 0.14 years in the rich region and to 0.46 years in the poor region. The percentage of families owning a car, freezer, colour TV and automatic washing machine markedly increased and the education of parents improved. Such results are indicative of an improvement in the living standard of the groups investigated, but the villagers regard themselves as the losers as a result of the system transformation in Poland. Since the Polish population is considered as ethnically homogenous, the great differences in AM within the rural population, as well as the differences between the inhabitants of villages and large cities should be regarded as biological effects of social inequalities. Such differences indicate that Polish rural girls are far below the genetic potential for menarcheal age.

Participation in leanness sports but not training volume is associated with menstrual dysfunction: a national survey of 1276 elite athletes and controls

PubMed Central

Torstveit, M; Sundgot-Borgen, J

2005-01-01

Objective: To examine the prevalence of menstrual dysfunction in the total population of Norwegian elite female athletes and national representative controls in the same age group. Methods: A detailed questionnaire that included questions on training and/or physical activity patterns, menstrual, dietary, and weight history, oral contraceptive use, and eating disorder inventory subtests was administered to all elite female athletes representing the country at the junior or senior level (aged 13–39 years, n = 938) and national representative controls in the same age group (n = 900). After exclusion, a total of 669 athletes (88.3%) and 607 controls (70.2%) completed the questionnaire satisfactorily. Results: Age at menarche was significantly (p<0.001) later in athletes (13.4 (1.4) years) than in controls (13.0 (1.3) years), and differed among sport groups. A higher percentage of athletes (7.3%) than controls (2.0%) reported a history of primary amenorrhoea (p<0.001). A similar percentage of athletes (16.5%) and controls (15.2%) reported present menstrual dysfunction, but a higher percentage of athletes competing in leanness sports reported present menstrual dysfunction (24.8%) than athletes competing in non-leanness sports (13.1%) (p<0.01) and controls (p<0.05). Conclusions: These novel data include virtually all eligible elite athletes, and thus substantially extend previous studies. Age at menarche occurred later and the prevalence of primary amenorrhoea was higher in elite athletes than in controls. A higher percentage of athletes competing in sports that emphasise thinness and/or a specific weight reported present menstrual dysfunction than athletes competing in sports focusing less on such factors and controls. On the basis of a comparison with a previous study, the prevalence of menstrual dysfunction was lower in 2003 than in 1993. PMID:15728691

Assessing Breast Cancer Risk Estimates Based on the Gail Model and Its Predictors in Qatari Women.

PubMed

Bener, Abdulbari; Çatan, Funda; El Ayoubi, Hanadi R; Acar, Ahmet; Ibrahim, Wanis H

2017-07-01

The Gail model is the most widely used breast cancer risk assessment tool. An accurate assessment of individual's breast cancer risk is very important for prevention of the disease and for the health care providers to make decision on taking chemoprevention for high-risk women in clinical practice in Qatar. To assess the breast cancer risk among Arab women population in Qatar using the Gail model and provide a global comparison of risk assessment. In this cross-sectional study of 1488 women (aged 35 years and older), we used the Gail Risk Assessment Tool to assess the risk of developing breast cancer. Sociodemographic features such as age, lifestyle habits, body mass index, breast-feeding duration, consanguinity among parents, and family history of breast cancer were considered as possible risks. The mean age of the study population was 47.8 ± 10.8 years. Qatari women and Arab women constituted 64.7% and 35.3% of the study population, respectively. The mean 5-year and lifetime breast cancer risks were 1.12 ± 0.52 and 10.57 ± 3.1, respectively. Consanguineous marriage among parents was seen in 30.6% of participants. We found a relationship between the 5-year and lifetime risks of breast cancer and variables such as age, age at menarche, gravidity, parity, body mass index, family history of cancer, menopause age, occupation, and level of education. The linear regression analysis identified the predictors for breast cancer in women such as age, age at menarche, age of first birth, family history and age of menopausal were considered the strong predictors and significant contributing risk factors for breast cancer after adjusting for ethnicity, parity and other variables. The current study is the first to evaluate the performance of the Gail model for Arab women population in the Gulf Cooperation Council. Gail model is an appropriate breast cancer risk assessment tool for female population in Qatar.

Early-life nutritional status and metabolic syndrome: gender-specific associations from a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Briskiewicz, Bruna Lucas; Barreto, Sandhi Maria; do Amaral, Joana Ferreira; Diniz, Maria de Fátima Haueisen Sander; Molina, Maria Del Carmen Bisi; Matos, Sheila Maria Alvim; Cardoso, Letícia de Oliveira; Velasquez-Melendez, Gustavo; Schmidt, Maria Inês; Giatti, Luana

2018-06-01

In the present study we investigated gender-specific associations of low birth weight (LBW) and shorter relative leg length with metabolic syndrome (MetS) after adjusting for sociodemographic characteristics and health-related behaviours. We also investigated whether these associations are independent of age at menarche and BMI at 20 years old. Cross-sectional analysis. Baseline data from 12 602 participants (35-74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008-2010. MetS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III guidelines. LBW (<2·5 kg) and age- and sex-standardized relative leg length (high, medium and low) were the explanatory variables studied. The strength of the associations between the explanatory variables and MetS was estimated by Poisson regression with robust variance. MetS prevalence was 34·2 %; it was more prevalent in men (36·8 %) than in women (32·2 %). In multivariate analysis, LBW was associated (prevalence ratio; 95 % CI) with MetS only in women (1·28; 1·24, 1·45). Shorter leg length was associated with MetS in both men (1·21; 1·09, 1·35 and 1·46; 1·29, 1·65 for low and medium lengths, respectively) and women (1·12; 1·00, 1·25 and 1·40; 1·22, 1·59 for low and medium lengths, respectively). Additional adjustments for age at menarche and BMI at 20 years old did not change the associations. Poor nutritional status as estimated by LBW and lower leg length in childhood was associated with a higher prevalence of MetS, although LBW was a significant factor only among women.

Initiation rites at menarche and self-reported dysmenorrhoea among indigenous women of the Colombian Amazon: a cross-sectional study

PubMed Central

Zuluaga, Germán; Andersson, Neil

2013-01-01

Objectives To investigate the association between self-reported dysmenorrhoea and patterns of female initiation rites at menarche among Amazonian indigenous peoples of Vaupés in Colombia. Design A cross-sectional study of all women in seven indigenous communities. Questionnaire administered in local language documented female initiation rites and experience of dysmenorrhoea. Analysis examined 10 initiation components separately, then together, comparing women who underwent all rites, some rites and no rites. Settings Seven indigenous communities belonging to the Tukano language group in the Great Eastern Reservation of Vaupés (Colombia) in 2008. Participants All women over the age of 13 years living in the seven communities in Vaupés, who had experienced at least two menstruations (n=185), aged 13–88 years (mean 32.5; SD 15.6). Primary and secondary outcome measures The analysis rested on pelvic pain to define dysmenorrhoea as the main outcome. Women were also asked about other disorders present during menstruation or the precedent days, and about the interval between two menstruations and duration of each one. Results Only 17.3% (32/185) completed all initiation rites and 52.4% (97/185) reported dysmenorrhoea. Women not completing the rites were more likely to report dysmenorrhoea than those who did so (p=0.01 Fisher exact), taking into account age, education, community, parity and use of family planning. Women who completed less than the full complement of rites had higher risk than those who completed all rites. Those who did not complete all rites reported increased severity of dysmenorrhoea (p=0.00014). Conclusions Our results are compatible with an association between traditional practices and women's health. We could exclude indirect associations with age, education, parity and use of family planning as explanations for the association. The study indicates feasibility, possible utility and limits of intercultural epidemiology in small groups. PMID:23457324

The effects of nutrition, puberty and dancing on bone density in adolescent ballet dancers.

PubMed

Burckhardt, Peter; Wynn, Emma; Krieg, Marc-Antoine; Bagutti, Carlo; Faouzi, Mohamed

2011-06-01

Ballet dancers have on average a low bone mineral content (BMC), with elevated fracture-risk, low body mass index (BMI) for age (body mass index, kg/m2), low energy intake, and delayed puberty. This study aims at a better understanding of the interactions of these factors, especially with regard to nutrition. During a competition for pre-professional dancers we examined 127 female participants (60 Asians, 67 Caucasians). They averaged 16.7 years of age, started dancing at 5.8 years, and danced 22 hours/week. Assessments were made for BMI, BMC (DXA), and bone mineral apparent density (BMAD) at the lumbar spine and femoral neck, pubertal stage (Tanner score), and nutritional status (EAT-40 questionnaire and a qualitative three-day dietary record). BMI for age was found to be normal in only 42.5% of the dancers, while 15.7% had a more or less severe degree of thinness (12.6% Grade2 and 3.1% Grade 3 thinness). Menarche was late (13.9 years, range 11 to 16.8 years). Food intake, evaluated by number of consumed food portions, was below the recommendations for a normally active population in all food groups except animal proteins, where the intake was more than twice the recommended amount. In this population, with low BMI and intense exercise, BMC was low and associated with nutritional factors; dairy products had a positive and non-dairy proteins a negative influence. A positive correlation between BMAD and years since menarche confirmed the importance of exposure to estrogens and the negative impact of delayed puberty. Because of this and the probable negative influence of a high intake of non-dairy proteins, such as meat, fish, and eggs, and the positive association with a high dairy intake, ballet schools should promote balanced diets and normal weight and should recognize and help dancers avoid eating disorders and delayed puberty caused by extensive dancing and inadequate nutrition.

'We keep it secret so no one should know'--a qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural western Kenya.

PubMed

Mason, Linda; Nyothach, Elizabeth; Alexander, Kelly; Odhiambo, Frank O; Eleveld, Alie; Vulule, John; Rheingans, Richard; Laserson, Kayla F; Mohammed, Aisha; Phillips-Howard, Penelope A

2013-01-01

Keeping girls in school offers them protection against early marriage, teen pregnancy, and sexual harms, and enhances social and economic equity. Studies report menstruation exacerbates school-drop out and poor attendance, although evidence is sparse. This study qualitatively examines the menstrual experiences of young adolescent schoolgirls. The study was conducted in Siaya County in rural western Kenya. A sample of 120 girls aged 14-16 years took part in 11 focus group discussions, which were analysed thematically. The data gathered were supplemented by information from six FGDs with parents and community members. Emergent themes were: lack of preparation for menarche; maturation and sexual vulnerability; menstruation as an illness; secrecy, fear and shame of leaking; coping with inadequate alternatives; paying for pads with sex; and problems with menstrual hygiene. Girls were unprepared and demonstrated poor reproductive knowledge, but devised practical methods to cope with menstrual difficulties, often alone. Parental and school support of menstrual needs is limited, and information sparse or inaccurate. Girls' physical changes prompt boys and adults to target and brand girls as ripe for sexual activity including coercion and marriage. Girls admitted 'others' rather than themselves were absent from school during menstruation, due to physical symptoms or inadequate sanitary protection. They described difficulties engaging in class, due to fear of smelling and leakage, and subsequent teasing. Sanitary pads were valued but resource and time constraints result in prolonged use causing chafing. Improvised alternatives, including rags and grass, were prone to leak, caused soreness, and were perceived as harmful. Girls reported 'other girls' but not themselves participated in transactional sex to buy pads, and received pads from boyfriends. In the absence of parental and school support, girls cope, sometimes alone, with menarche in practical and sometimes hazardous ways. Emotional and physical support mechanisms need to be included within a package of measures to enable adolescent girls to reach their potential.

Menstruation-related Headache in Adolescents: Point Prevalence and Associated Factors.

PubMed

Carman, K B; Arslantas, D; Unsal, A; Atay, E; Ocal, E E; Demirtas, Z; Saglan, R; Dinleyici, M; Yarar, C

2018-04-02

To study the prevalence of menstruation-related headache and the impact of associated factors in adolescents. This cross-sectional study was conducted in seven randomly selected high schools, and 3,886 girls attending those schools were invited. After the consent of the school principals, a final total of 2,485 girls (63.9%) were involved in the study. A specific questionnaire was distributed to adolescent girls (14-19 years old). The first part of the survey investigated the features of menstruation (age of first menstruation, duration of period, pad fully soaked per day). The last part of the questionnaire surveyed the presence of headache during the menstruation period. The severity of headache was measured by a visual analogue scale. Lastly, participants were requested to complete the Beck Depression Inventory (BDI). The prevalence of menstruation-related headache and associated factors were studied. The mean age of the study group was 15.89 ± 1.07 (14-19) years old. The age of onset of menarche was younger than 12 years old in 32.4% of girls, and mean age of onset of menarche was 12.96 ± 1.09 years old. The prevalence of menstruation-related headache was calculated to be 25.9% (n = 646). The onset of menstruation before the age of 12 years old, longer duration of menstruation period, dysmenorrhea, daily consumption of coffee and cola and smoking significantly affected the frequency of menstruation-related headache. The mean scores of the BDI were calculated as 21.68 ± 13.65 and a significant relationship was found between headache and BDI scores. Our study indicates that menstruation-related headache is a common problem of adolescent girls. It might be associated with different comorbidities such as depression. Accordingly, a multidisciplinary treatment approach must be considered to improve their life quality. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Menstruation, objectification and health-related quality of life: A questionnaire study.

PubMed

Sveinsdóttir, Herdís

2018-02-01

To explore young women's health-related quality of life (HRQOL) and investigate whether menstrual and menarche experiences and objectification predict mental and physical health components of HRQOL. Menstruation plays a fundamental role in female biology, in women's relationship to their bodies and consequently in women's health and their HRQOL. Cross-sectional explorative survey design. A questionnaire that included the SF-36v2, the Self-objectification Questionnaire (SOQ), the Body Surveillance and Body Shame subscales of the Objectified Body Consciousness Scale, the Belief and Attitudes Towards Menstruation Questionnaire (four subscales), and questions on menarche and menstruation was administered at the end of 2013 to 319 Icelandic women who represented the population by age. The SF-36v2 includes eight dimensions addressing the mental and physical components of HRQOL. Scores are presented as raw data scores and scores based on standardised score of American women and range from 0 to 100 with higher scores indicating better HRQL. A hierarchical multiple linear regression model was employed to calculate significant predictors of mental and physical health components of HRQOL. Mean raw data scores on SF36-v2 dimensions ranged from 54.7 to 91.5. The participants scored below the standardised, mean norm-based score for all dimensions. Secrecy of menstruation, experience of body shame and pain during menstruation predicted worse mental HRQOL. To believe in the proscriptive role and the unpleasantness of menstruation, experience of body shame, medication for menstrual pain and not holding a university education predicted worse physical HRQOL. These two models explained 30% and 22% of the variance of the mental and physical components of SF36-v2, respectively. Young women's mental and physical HRQOL is influenced by the specific context of their lives. Women's health education should take into account the various relationships women may have with their bodies. © 2017 John Wiley & Sons Ltd.

Mothers perception of sexuality education for children.

PubMed

Opara, P I; Eke, G K; Akani, N A

2010-01-01

Sexuality education is the process of acquiring information and forming attitudes and beliefs about sex, sexual identity, relationships and intimacy. It develops young people's skills so that they make informed choices about their behaviour, and feel confident and competent about acting on these choices. It also equips children to face developmental challenges and empowers them against the ills of abuse, exploitation, unwanted pregnancies amongst others. Mothers who are the primary caregivers should be well informed about sexuality issues. The objective of the study is to determine mothers' perception of sexuality education in children, in Port Harcourt. A structured, anonymous and self-administered questionnaire, used as instrument for data collection, was distributed amongst a convenient sample of women attending a Christian women's convention in Port Harcourt. One hundred and fifty eight women participated in the study. Most of them were married (80.4%), and belonged to the 30-49 years age bracket. Seventy one (44.9%) of the respondents had tertiary education. Over 80% agreed that children needed sexuality education but only 15 women (9.5%) had a good knowledge of the concept of sexuality education. One hundred and eleven (70.2%) believed it was the responsibility of both parents to educate their children and over 70% acknowledged that the home was the best place for such education. 64 (40.5%) believed that 6-10 years was the ideal age for starting sex education while 49% thought that the ideal age was 11-15 years. 65% of respondents discussed sexuality issues with their children at least occasionally, the content mostly involved description of body parts and reproductive organs. The average age of menarche amongst respondents was 14.0. One hundred (63%) of the women had prior knowledge of menstruation before menarche. About half of them had received information from their mothers. The study highlights the need for enlightenment of women on sexuality education to enable them empower their against the ills of child abuse.

[Prevalence of tumors in the left breast].

PubMed

Aareleĭd, T P; Khint, E K

1987-01-01

The present investigation was undertaken to study the laterality of breast tumors on the basis of the Estonian Cancer Registry data for the period of 1968-1981 and special breast screening data for 1974-1983. The ratio of the patients with the left- and right-sided disease was 1.12 (p less than 0.001) for breast cancer, 1.75 (p less than 0.001)--for fibroadenomatosis of the mammary gland, and 1.43 (p less than 0.001)--for mastodynia. Left-sided carcinoma was more common in patients with left nipple discharge which was accompanied by "early menarche" more often than discharge from the right nipple (p less than 0.05). There was no significant difference in the patients' survival versus the laterality of breast cancer.

A rare cause of acute abdominal pain: Herlyn-Werner-Wunderlich syndrome.

PubMed

Aydin, Ramazan; Ozdemir, Ayse Zehra; Ozturk, Bahadir; Bilgici, Meltem Ceyhan; Tosun, Migraci

2014-01-01

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare müllerian duct anomaly with uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. Patients with this syndrome generally present after menarche with pelvic pain and mass and, rarely, primary infertility in later years. Strong suspicion and knowledge of this syndrome are mandatory for an accurate diagnosis. A 14-year-old female patient presented with acute retention of urine and abdominopelvic pain. Her condition was diagnosed with the use ultrasonography and magnetic resonance imaging as a case of HWW syndrome. She was treated with vaginal hemiseptal resection. The HWW syndrome should be considered among the differential diagnoses in girls with renal anomalies presenting with pelvic mass, symptoms of acute abdominal pain, and acute urinary retention.

A Twin Study of Objective and Subjective Pubertal Timing and Peer Influence on Risk-Taking.

PubMed

Kretsch, Natalie; Mendle, Jane; Harden, K Paige

2016-03-01

The current study used a behavioral genetic design to test whether three measures of pubertal timing moderated peer influence on risk-taking in a sample of 248 female adolescent twin pairs ( M age =16.0, SD =1.5) from the National Longitudinal Study of Adolescent Health. Peer influence was operationalized as the quasi-causal association between girls' self-reported risk-taking and the risk-taking reported by their friends. Girls with earlier ages at menarche and who perceived themselves as more developed than peers were more susceptible to peer influence on risk-taking. However, age-standardized ratings of body changes did not moderate peer influence. This study highlights distinctions between multiple measures of pubertal timing, using an innovative synthesis of genetically informative data and peer nomination data.

A Twin Study of Objective and Subjective Pubertal Timing and Peer Influence on Risk-Taking

PubMed Central

Kretsch, Natalie; Mendle, Jane; Harden, K. Paige

2014-01-01

The current study used a behavioral genetic design to test whether three measures of pubertal timing moderated peer influence on risk-taking in a sample of 248 female adolescent twin pairs (Mage=16.0, SD=1.5) from the National Longitudinal Study of Adolescent Health. Peer influence was operationalized as the quasi-causal association between girls' self-reported risk-taking and the risk-taking reported by their friends. Girls with earlier ages at menarche and who perceived themselves as more developed than peers were more susceptible to peer influence on risk-taking. However, age-standardized ratings of body changes did not moderate peer influence. This study highlights distinctions between multiple measures of pubertal timing, using an innovative synthesis of genetically informative data and peer nomination data. PMID:27026753

Primary ovarian leiomyoma in a premenarchal adolescent: first reported case.

PubMed

Blue, Nathan R; Felix, Juan C; Jaque, Jenny

2014-08-01

Primary ovarian leiomyoma is a rare benign ovarian tumor with only several reported cases in adolescents. Little is known about the origin or natural history of these rare tumors as they have occurred in a variety of presentations and were removed upon presentation without observation. A 14-year-old, premenarchal female was found to have a 4 cm mass which grew to 6.5 cm over two years. It appeared sonographically most consistent with a teratoma; however, during surgical resection it was found to be solid, and on pathologic evaluation was identified as an ovarian leiomyoma. The growth of this patient's tumor with the onset of puberty supports hormonal responsivity, but its presence prior to menarche suggests an alternate origin, independent of gonadal hormones. Published by Elsevier Inc.

[Growth and development of children in Cuba].

PubMed

Jordán Rodríguez, J; Bebel Agua, A; Rubén, M; Hernández, J

1980-01-01

During the years 1972 to 1974, a great scale study was carried out on development and growth taking at random a stratified sample of multiple stages of 50,311 children from birth to 20 years. Fifteen anthropometric dimensions were considered and evaluation was made of sexual development in both sexes. In girls, the age of menarche was registered. An X-ray of the hand was taken to 10% of the sample. One year later, 30% of the sample was X-rayed again to determine speed of growth. Response of the population was close to 94%. The importance of a national system of growth is recognized, together with the colaboration of the orgaism of masses to achieve these purposes. Information related with some of measurements reported is offered and comments related with these findings are made.

GnRH-dependent precocious puberty manifested at the age of 14 months in a girl with 47,XXX karyotype.

PubMed

Skordis, Nicos; Ferrari, Eleana; Antoniadou, Aria; Phylactou, Leonidas A; Fanis, Pavlos; Neocleous, Vassos

2017-07-01

This case report describes a 47,XXX girl who presented very early, at the age of 14 months, with signs of sexual precocity (breast and pubic hair development, menarche) and was finally diagnosed with GnRH dependent precocious puberty with no evidence of underlying central nervous system pathology. Molecular testing did not identify any genetic defect in any of the genes tested (KISS1, KISS1R, DLK1 and the intronless MKRN3). Though previous studies have shown a link between karyotype 47,XXX and precocious puberty, this is the youngest patient reported so far. Treatment with GnRH analog was commenced and proved to be effective, indicating a successful suppression of the hypothalamic-pituitary-ovarian axis.

Pubertal timing, sexual behaviour and self-reported depression in middle adolescence.

PubMed

Kaltiala-Heino, Riittakerttu; Kosunen, Elise; Rimpelä, Matti

2003-10-01

The associations between pubertal timing, sexual activity and self-reported depression were analysed in a population sample of 17,082 girls and 15,922 boys aged 14-16 as a par of a classroom survey. Pubertal timing was assessed by age at onset of menstruation (menarche) or ejaculations (oigarche). Sexual experiences elicited included kissing, light petting, heavy petting and intercourse. Self-reported depression was measured by the 13-item Beck Depression Inventory. Among girls, self-reported depression was associated with early puberty and intimate sexual relationship. Among boys depression was associated with very early and late puberty and experience of intercourse. Early puberty is a risk factor for self-reported depression. Intimate sexual relationships in middle adolescent are likely to indicate problems in adolescent development rather than successful adolescent passage.

Sex hormones and headache.

PubMed

Silberstein, S D

2000-01-01

The normal female life cycle is associated with a number of hormonal milestones: menarche, pregnancy, contraceptive use, menopause, and the use of replacement sex hormones. Menarche marks the onset of menses and cyclic changes in hormone levels. Pregnancy is associated with rising noncyclic levels of sex hormones, and menopause with declining noncyclic levels. Hormonal contraceptive use during the reproductive years and hormone replacement in menopause are therapeutic hormonal interventions that alter the levels and cycling of sex hormones. These events and interventions may cause a change in the prevalence or intensity of headache. The menstrual cycle is the result of a carefully orchestrated sequence of interactions between the hypothalamus, pituitary, ovary, and endometrium, with the sex hormones acting as modulators and effectors at each level. Estrogen and progestins have potent effects on central serotonergic and opioid neurons, modulating both neuronal activity and receptor density. The primary trigger of Menstrually-related migraine (MM) appears to be the withdrawal of estrogen rather than the maintenance of sustained high or low estrogen levels. However, changes in the sustained estrogen levels with pregnancy (increased) and menopause (decreased) appear to affect headaches. Headaches associated with OC use or menopausal hormonal replacement therapy may be related, in part, to periodic discontinuation of oral sex hormone preparations. The treatment of migraine associated with changes in sex hormone levels is frequently difficult and the patients are often refractory to therapy. Based on what is known of the pathophysiology of migraine, we have attempted to provide a logical approach to the treatment of headaches that are associated with menses, menopause, and OCs using abortive and preventive medications and hormonal manipulations. Considerable evidence suggests a link between estrogen and progesterone, the female sex hormones, and migraine. (Silberstein and Merriam, 1997; Lipton and Stewart, 1993; Epstein et al., 1975; Goldstein and Chen, 1982; Selby and Lance, 1960) Although no gender difference is apparent in prepubertal children, with migraine occurring equally in 4p. 100 of boys and girls, (Goldstein and Chen, 1982, Waters and O'Connor, 1971) migraine occurs more frequently in adult women (18p. 100) than in men (6p. 100). (Lipton and Stewart, 1993) Migraine develops most frequently in the second decade, with the peak incidence occurring with adolescence. (Selby and Lance, 1960; Epstein et al., 1975) Menstrually-related migraine (MM) begins at menarche in 33p. 100 of affected women (Epstein et al. , 1975). MM occurs mainly at the time of menses in many migrainous women, and exclusively with menses (true menstrual migraine [TMM]) in some (Epstein et al., 1975). Menstrual migraine can be associated with other somatic complaints arising before and often persisting into menses, such as nausea, backache, breast tenderness, and cramps and like them appears to be the result of falling sex hormone levels (Silberstein and Merriam, 1997; American Psychiatric Association, 1994). In addition, premenstrual migraine can be associated with premenstrual dysphoric disorder (PDD), also called "premenstrual syndrome" (PMS), which is distinct from the physical symptoms of the perimenstrual period and is probably not directly driven by declining progesterone levels (Mortola, 1998). Migraine occurring during (rather than prior to) menstruation is usually not associated with PMS (Silberstein and Merriam, 1997). Migraine may worsen during the first trimester of pregnancy and, although many women become headache-free during the last two trimesters, 25p. 100 have no change in their migraine (Silberstein, 1997). MM typically improves with pregnancy, perhaps due to sustained high estrogen levels (Silberstein, 1997). Hormonal replacement with estrogens can exacerbate migraine and oral contraceptives (OCs) can change its character and frequency

Social and emotional predictors of the tempo of puberty in female rhesus monkeys

PubMed Central

Wilson, Mark E; Bounar, Shannon; Godfrey, Jodi; Michopoulos, Vasiliki; Higgins, Melinda; Sanchez, Mar

2012-01-01

A cascade of neuroendocrine events regulates the initiation and progression of female puberty. However, the factors that determine the timing of these events across individuals are still uncertain. While the consequences of puberty on subsequent emotional development and adult behavior have received significant attention, what is less understood are the social and environmental factors that actually alter the initiation and progression of puberty. In order to more fully understand what factors influence pubertal timing in females, the present study quantified social and emotional behavior; stress physiology; and growth and activity measures in juvenile female rhesus monkeys to determine what best predicts eventual puberty. Based on previous reports, we hypothesized that increased agonistic behavior resulting from subordinate status in their natal group, in combination with slowed growth, reduced prosocial behavior, and increased emotional reactivity would predict delayed puberty. The analyses were restricted to behavioral and physiological measures obtained prior to the onset of puberty, defined as menarche. Together, our findings indicate that higher rates of aggression but lower rates of submission received from group mates; slower weight gain; and greater emotional reactivity, evidenced by higher anxiety, distress and appeasing behaviors, and lower cortisol responsivity in response to a potentially threatening situation, predicts delayed puberty. Together the combination of these variables accounted for 58% of the variance in the age of menarche, 71% in age at first ovulation, and 45% in the duration of adolescent sterility. While early puberty may be more advantageous for the individual from a fertility standpoint, it presents significant health risks, including increased risk for a number of estrogen dependent cancers and as well as the emergence of mood disorders during adulthood. On the other hand, it is possible that increased emotional reactivity associated with delayed puberty could persist, increasing the risk for emotional dysregulation to socially challenging situations. The data argue for prospective studies that will determine how emotional reactivity shown to be important for pubertal timing is affected by early social experience and temperament, and how these stress-related variables contribute to body weight accumulation, affecting the neuroendocrine regulation of puberty. PMID:22658962

‘We Keep It Secret So No One Should Know’ – A Qualitative Study to Explore Young Schoolgirls Attitudes and Experiences with Menstruation in Rural Western Kenya

PubMed Central

Mason, Linda; Nyothach, Elizabeth; Alexander, Kelly; Odhiambo, Frank O.; Eleveld, Alie; Vulule, John; Rheingans, Richard; Laserson, Kayla F.; Mohammed, Aisha; Phillips-Howard, Penelope A.

2013-01-01

Background Keeping girls in school offers them protection against early marriage, teen pregnancy, and sexual harms, and enhances social and economic equity. Studies report menstruation exacerbates school-drop out and poor attendance, although evidence is sparse. This study qualitatively examines the menstrual experiences of young adolescent schoolgirls. Methods and Findings The study was conducted in Siaya County in rural western Kenya. A sample of 120 girls aged 14–16 years took part in 11 focus group discussions, which were analysed thematically. The data gathered were supplemented by information from six FGDs with parents and community members. Emergent themes were: lack of preparation for menarche; maturation and sexual vulnerability; menstruation as an illness; secrecy, fear and shame of leaking; coping with inadequate alternatives; paying for pads with sex; and problems with menstrual hygiene. Girls were unprepared and demonstrated poor reproductive knowledge, but devised practical methods to cope with menstrual difficulties, often alone. Parental and school support of menstrual needs is limited, and information sparse or inaccurate. Girls’ physical changes prompt boys and adults to target and brand girls as ripe for sexual activity including coercion and marriage. Girls admitted ‘others’ rather than themselves were absent from school during menstruation, due to physical symptoms or inadequate sanitary protection. They described difficulties engaging in class, due to fear of smelling and leakage, and subsequent teasing. Sanitary pads were valued but resource and time constraints result in prolonged use causing chafing. Improvised alternatives, including rags and grass, were prone to leak, caused soreness, and were perceived as harmful. Girls reported ‘other girls’ but not themselves participated in transactional sex to buy pads, and received pads from boyfriends. Conclusions In the absence of parental and school support, girls cope, sometimes alone, with menarche in practical and sometimes hazardous ways. Emotional and physical support mechanisms need to be included within a package of measures to enable adolescent girls to reach their potential. PMID:24244435

Menstrual cycle characteristics and steroid hormone, prolactin, and growth factor levels in premenopausal women.

PubMed

Farland, Leslie V; Mu, Fan; Eliassen, A Heather; Hankinson, Susan E; Tworoger, Shelley S; Barbieri, Robert L; Dowsett, Mitch; Pollak, Michael N; Missmer, Stacey A

2017-12-01

Menstrual cycle characteristics are markers of endocrine milieu. However, associations between age at menarche and adulthood sex steroid hormone levels have been inconsistent, and data on menstrual characteristics and non-sex steroid hormones are sparse. We assessed the relations of menstrual characteristics with premenopausal plasma sex steroid hormones, sex hormone binding globulin (SHBG), prolactin, and growth factors among 2,745 premenopausal women (age 32-52) from the Nurses' Health Study II. Geometric means and tests for trend were calculated using multivariable general linear models. Early age at menarche was associated with higher premenopausal early-follicular free estradiol (percent difference < 12 vs. > 13 years = 11%), early-follicular estrone (7%), luteal estrone (7%), and free testosterone (8%) (all p trend  < 0.05). Short menstrual cycle length at age 18-22 was associated with higher early-follicular total (< 26 vs. > 39 days = 18%) and free estradiol (16%), early-follicular estrone (9%), SHBG (7%), lower luteal free estradiol (- 14%), total (- 6%), and free testosterone (- 15%) (all p trend  < 0.05). Short adult menstrual length was associated with higher early-follicular total estradiol (< 26 vs. > 31 days = 14%), SHBG (10%), lower luteal estrone (- 8%), progesterone (- 9%), total (- 11%) and free testosterone (- 25%), and androstenedione (- 14%) (all p trend  < 0.05). Irregularity of menses at 18-22 was associated with lower early-follicular total (irregular vs. very regular = - 14%) and free estradiol (- 14%), and early-follicular estrone (- 8%) (All p trend  < 0.05). Irregularity of adult menstrual cycle was associated with lower luteal total estradiol (irregular vs. very regular = - 8%), SHBG (- 3%), higher total (8%), and free testosterone (11%) (all p trend  < 0.05). Early-life and adulthood menstrual characteristics are moderately associated with mid-to-late reproductive year's hormone concentrations. These relations of menstrual characteristics with endogenous hormone levels could partially account for associations between menstrual characteristics and reproductive cancers or other chronic diseases.

The relationship of maternal bone density with nutritional rickets in Nigerian children.

PubMed

Hsu, Jennifer; Fischer, Philip R; Pettifor, John M; Thacher, Tom D

2017-04-01

Factors that affect maternal bone mineral density may be related to the risk of nutritional rickets in their offspring. Our aim was to determine the relationship between maternal areal bone mineral density (aBMD) and rickets in Nigerian children. Using a case-control design, we measured forearm aBMD in 56 and 135 mothers of children with and without nutritional rickets, respectively. Active rickets was confirmed or excluded in all children radiographically. Using logistic regression, we assessed the association of maternal aBMD, adjusted for parity, pregnancy and lactation status, duration of most recent completed lactation, age of menarche, height, body mass index, and maternal age with nutritional rickets. The median (range) age of all mothers was 30years (17-47years), and parity was 4 (1-12). A total of 36 (19%) were pregnant and 55 (29%) were currently breast feeding. Mean (±SD) metaphyseal forearm aBMDs were 0.321±0.057 and 0.316±0.053g/cm 2 in mothers of children with and without rickets, respectively (P=0.60). Diaphyseal forearm aBMDs were 0.719±0.071 and 0.715±0.072g/cm 2 , respectively (P=0.69). In an adjusted analysis, maternal forearm aBMD, bone mineral content and bone area at metaphyseal and diaphyseal sites were not associated with rickets in the child. In the adjusted analysis, rickets was associated with shorter duration of most recently completed lactation (aOR 0.91 for each additional month; 95% CI 0.83-0.99), older maternal age (aOR 1.07 for each additional year; 1.00-1.14), and less frequent maternal use of lead-containing eye cosmetics (aOR 0.20; 95% CI 0.05-0.64), without any difference in maternal blood lead levels. Maternal age, parity, age of menarche, height, and body mass index were not associated with having had a child with rickets in multivariate analysis. Nutritional rickets in Nigerian children was not associated with maternal forearm aBMD. Other unidentified maternal characteristics and practices likely contribute to the risk of rickets in Nigerian children. Copyright © 2017 Elsevier Inc. All rights reserved.

Cumulative effect of reproductive factors on ideal cardiovascular health in postmenopausal women: a cross-sectional study in central south China.

PubMed

Cao, Xia; Zhou, Jiansong; Yuan, Hong; Chen, Zhiheng

2015-12-21

The American Heart Association developed the Life's Simple 7 metric for defining cardiovascular health. Little is known, however, whether co-occurring reproductive factors, which affects endogenous oestrogen levels during a woman's life, also influences ideal cardiovascular health in postmenopausal women. Using data on a cross-sectional study with a convenience sample of 1,625 postmenopausal women (median age, 60.0 years) in a medical health checkup program at a general hospital in central south China 2013-2014, we examined the association between cumulative reproductive risk and ideal cardiovascular health in postmenopausal women. A cumulative risk score (range 0 to 4) was created by summing four reproductive risk factors (age at menarche, age at menopause, number of children, and pregnancy losses) present in each individual from binary variables in which 0 stands for favorable and 1 for less-than-favorable level. Ideal levels for each component in Life's Simple 7 (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, and diet) were used to create an ideal Life's Simple 7 score [0-1 (low), 2, 3, 4, 5 and 6-7 (high)]. Participants with earlier age at menarche (odds ratio [OR] =0.42 [95 % CI 0.26-0.48]), earlier age at menopause [0.46 (0.32-0.58)], who have more than three children (0.42 [0.38-0.56]) and have history of pregnancy losses [0.76 (0.66-0.92)] were more likely to attain low (0-1) ideal Life's Simple 7 after adjustment for age. Participants were more likely to attain low (0-1) ideal Life's Simple 7 as exposure to the number of reproductive risk factors increased [OR (95 % CI) of 0.52 (0.42-0.66), 0.22 (0.16-0.26), and 0.16 (0.12-0.22) for cumulative reproductive risk scores of 1, 2, and 3 or 4, respectively, each versus 0]. The postmenopausal Chinese women with an increasing number of reproductive risk factors were progressively less likely to attain ideal levels of cardiovascular health factors.

Changing trends in reproductive/lifestyle factors in UK women: descriptive study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)

PubMed Central

Gentry-Maharaj, Aleksandra; Glazer, Clara; Burnell, Matthew; Ryan, Andy; Berry, Hannah; Kalsi, Jatinderpal; Woolas, Robert; Skates, Steve J; Campbell, Stuart; Jacobs, Ian

2017-01-01

Objective There has been considerable interest in the impact of reproductive factors on health but there are little data on how these have varied over time. We explore trends in reproductive/lifestyle factors of postmenopausal British women by analysing self-reported data from participants of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Design Prospective birth cohort analysis. Setting Population cohort invited between 2001 and 2005 from age-sex registers of 27 Primary Care Trusts in England, Wales and Northern Ireland and recruited through 13 National Health Service Trusts. Participants 202 638 postmenopausal women aged 50–74 years at randomisation to UKCTOCS between April 2001 and October 2005. Interventions Women were stratified into the following six birth cohorts (1925–1929, 1930–1934, 1935–1939, 1940–1944, 1945–1949, 1950–1955) based on year of birth. Self-reported data on reproductive factors provided at recruitment were explored using tabular and graphical summaries to examine for differences between the birth cohorts. Outcome measures Trends in mean age at menarche and menopause, use of oral contraceptives, change in family size, infertility treatments, tubal ligation and hysterectomy rates. Results Women born between 1935 and 1955 made up 86% of the cohort. Median age at menarche decreased from 13.4 for women born between 1925 and 1929 to 12.8 for women born between 1950 and 1955. Increased use of the oral contraceptives, infertility treatments and smaller family size was observed in the younger birth cohorts. Tubal ligation rates increased for those born between 1925 and 1945, but this increase did not persist in subsequent cohorts. Hysterectomy rates (17–20%) did not change over time. Conclusions The trends seen in this large cohort are likely to reflect the reproductive history of the UK female postmenopausal population of similar age. Since these are risk factors for hormone-related cancers, these trends are important in understanding the changing incidence of these cancers. Trial registration number International Standard Randomised Controlled Trial Number: 22488978. PMID:28264823

[The Effects of Exercising in Childhood on Bone Health.

PubMed

Imai, Kazuhiro; Iwamoto, Jun; Torii, Suguru; Masujima, Atsushi

In contemporary Japan, there is a polarizing trend in children who exercise more than 1,800 minutes a week and those who exercise less than 60 minutes a week. Quite a lot of girls in particular hate exercise,and therefore they don't get enough of it. Osteoporosis is a preventable disease from childhood. It is crucial for girls to exercise and to provide appropriate stimulation to bones before menarche, which increases bone mineral content. Exercise and sports in childhood are characterized as the ways to the lifelong prevention strategies against osteoporosis and fractures. It is hoped that all children practice appropriate exercise program based on scientific evidence to promote bone health. In this review article, the effects of exercising in childhood on bone health, and the points to be noted regarding childhood sports are described.

Case Report: A Rare Cause of Complicated Urinary Tract Infection in a Woman with Herlyn-Werner-Wunderlich Syndrome.

PubMed

Tsai, Jun-Li; Tsai, Shang-Feng

2016-11-01

Urinary tract infection is a common disease in the general population. However, in patients with frequent urinary tract infection, it is important to determine any treatable cause to avoid recurrence. Herlyn-Werner-Wunderlich syndrome or OHVIRA syndrome is a very rare congenital anomaly with uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. The earliest presentation of this syndrome is hematocolpos that develops during menstruation and results in dysmenorrhea and a pelvic mass shortly after menarche. Herein, we report a patient with Herlyn-Werner-Wunderlich syndrome manifested with unusual symptoms, delayed onset and without surgery. The unique point of this patient is the partial obstruction of cervico-vaginal junction. Early diagnosis and timely treatment of OHVIRA syndrome can prevent long-term complications, such as recurrent urinary tract infection and infertility. A high index of suspicion is required, even though OHVIRA syndrome is extremely rare and may have an atypical presentation.

Premature ovarian failure 3 years after menarche in a 16-year-old girl following human papillomavirus vaccination.

PubMed

Little, Deirdre Therese; Ward, Harvey Rodrick Grenville

2012-09-30

Premature ovarian failure in a well adolescent is a rare event. Its occurrence raises important questions about causation, which may signal other systemic concerns. This patient presented with amenorrhoea after identifying a change from her regular cycle to irregular and scant periods following vaccinations against human papillomavirus. She declined the oral contraceptives initially prescribed for amenorrhoea. The diagnostic tasks were to determine the reason for her secondary amenorrhoea and then to investigate for possible causes of the premature ovarian failure identified. Although the cause is unknown in 90% of cases, the remaining chief identifiable causes of this condition were excluded. Premature ovarian failure was then notified as a possible adverse event following this vaccination. The young woman was counselled regarding preservation of bone density, reproductive implications and relevant follow-up. This event could hold potential implications for population health and prompts further inquiry.

Are synchronised swimmers at risk of amenorrhoea?

PubMed Central

Ramsay, R; Wolman, R

2001-01-01

Objective—Synchronised swimming is a sport that shares certain characteristics with other aesthetically pleasing sports such as gymnastics and dance. The purpose of this investigation was to ascertain whether the highest ranked synchronised swimmers in the United Kingdom experience menstrual abnormalities, a common medical problem seen in these related activities. Methods—Twenty three members of the Great Britain synchronised swimming squad completed a questionnaire on menstrual history. Body composition and VO2MAX were measured in the laboratory during regular physiological screening. Results—Three of the 23 subjects were oligomenorrhoeic and none were amenorrhoeic. All were postmenarchal. Mean estimated body fat percentage was 23%, and mean VO2MAX was 47.2 ml/kg/min. Conclusions—It appears that synchronised swimmers in the United Kingdom are relatively protected from menstrual disturbances for reasons that cannot be explained in isolation. Key Words: synchronised swimming; amenorrhoea; menarche PMID:11477017

Exercise and reproductive dysfunction.

PubMed

Chen, E C; Brzyski, R G

1999-01-01

To provide an overview of our current understanding of exercise-induced reproductive dysfunction and an approach to its evaluation and management. A MEDLINE search was performed to review all articles with title words related to menstrual dysfunction, amenorrhea, oligomenorrhea, exercise, and athletic activities from 1966 to 1998. The pathophysiology, proposed mechanisms, clinical manifestations, evaluation, and management of exercise-associated reproductive dysfunction were compiled. Exercise-induced menstrual irregularity appears to be multifactorial in origin and remains a diagnosis of exclusion. The underlying mechanisms are mainly speculative. Clinical manifestations range from luteal phase deficiency to anovulation, amenorrhea, and even delayed menarche. Evaluation should include a thorough history and a complete physical plus pelvic examination. Most cases are reversible with dietary and exercise modifications. Hormonal replacement in cases of a prolonged hypoestrogenic state with evidence of increased bone loss is recommended, although the long-term consequences of prolonged hormonal deficiency are ill-defined.

Exploring the Causes of Change in Adolescent Girls' Sexual Behaviour in Begoro, Ghana.

PubMed

Gyan, Sylvia E

2017-06-01

There is a changing trend in adolescent girls' sexual and reproductive behaviour in Ghana. However, contemporary perspectives on adolescent girls' sexual behaviours are largely missing hence this study. Thematic analysis of data collected through in-depth interviews with adolescent girls and community members as well as focus group discussions with adolescent boys identified several factors accounting for the changes in adolescent girls' sexual and reproductive behaviour. These factors include changes in girls' attitudes to traditional practices, diversity in the agents of socialization as well as the age at menarche. This has resulted in a clash of value system between girls' sexual behaviours and that of the elderly. Thus, the social context in which girls are experiencing sexual and reproductive life in Ghana is changing and this must be taken into consideration when designing any intervention to help adolescent girls become resilient in their sexual and reproductive lives.

Evidence for effects of weight on reproduction in women.

PubMed

Davies, Michael J

2006-05-01

Body weight, and its constituent components of fat mass and lean tissue, plays an important role modulating reproductive development and functioning. Body weight influences the timing of menarche and the capacity to achieve a pregnancy. The nature of this relationship appears to be some variant on a 'U' shape. Extremes in body weight are associated with infertility and a range of adverse outcomes for both mother and baby across the course of pregnancy and perinatal period. Whereas underweight is associated with poor fetal growth and elevated pregnancy loss, overweight is more strongly associated with diseases in pregnancy, pregnancy loss and stillbirth and high birth weight. An emerging area of interest is the role of obesity on fertility, and the intergenerational 'tracking' of high maternal body weight into the second and subsequent generations, resulting not only in an increased risk of metabolic disease, but also perturbed reproductive functioning in the offspring.

Nonhuman primate models of polycystic ovary syndrome

PubMed Central

Abbott, David H; Nicol, Lindsey E; Levine, Jon E; Xu, Ning; Goodarzi, Mark O; Dumesic, Daniel A

2013-01-01

With close genomic and phenotypic similarity to humans, nonhuman primate models provide comprehensive epigenetic mimics of polycystic ovary syndrome (PCOS), suggesting early life targeting for prevention. Fetal exposure to testosterone (T), of all nonhuman primate emulations, provides the closest PCOS-like phenotypes, with early-to-mid gestation T-exposed female rhesus monkeys exhibiting adult reproductive, endocrinological and metabolic dysfunctional traits that are co-pathologies of PCOS. Late gestational T exposure, while inducing adult ovarian hyperandrogenism and menstrual abnormalities, has less dysfunctional metabolic accompaniment. Fetal exposures to dihydrotestosterone (DHT) or diethylstilbestrol (DES) suggest androgenic and estrogenic aspects of fetal programming. Neonatal exposure to T produces no PCOS-like outcome, while continuous T treatment of juvenile females causes precocious weight gain and early menarche (high T), or high LH and weight gain (moderate T). Acute T exposure of adult females generates polyfollicular ovaries, while chronic T exposure induces subtle menstrual irregularities without metabolic dysfunction. PMID:23370180

Idiopathic precocious puberty in girls: Psychosexual development.

PubMed

Meyer-Bahlburg, H F; Ehrhardt, A A; Bell, J J; Cohen, S F; Healey, J M; Feldman, J F; Morishima, A; Baker, S W; New, M I

1985-08-01

A promising model syndrome for the examination of the role of physical maturation in the development of female sexuality is idiopathic precocious puberty (IPP). In this first controlled study of psychosexual development in IPP females, 16 females between 13 and 20 years of age with a history of IPP were compared to 16 control subjects with a history of normal puberty pair-matched to the index subjects on the basis of sex, race, age, socioeconomic level, and menarcheal status. The psychosexual history and the current psychosexual status were assessed by a systematic half-structured interview. The IPP females on average passed the psychosexual milestones at an earlier age than their normal maturing peers, with a particularly early onset of masturbation. Those who were sociosexually active tended to report a higher total orgasmic outlet and a higher sex drive. There was no increase in homosexuality among IPP girls. The timing of puberty has a (modest) influence on psychosexual development in females.

Psychosexual characteristics of female university students in Brazil.

PubMed

Leite, R M; Buoncompagno, E M; Leite, A C; Mergulhao, E A; Battistoni, M M

1994-01-01

Freshmen women (N = 240) at the State University of Campinas (UNICAMP) in the state of Sao Paulo, Brazil responded to a questionnaire concerning several aspects of their sexuality from the beginning of adolescence. Topics such as body changes during puberty, menarche, menstruation, masturbation, sexual identity, virginity, sexual relations, maternity, contraceptives, abortion, and attitudes toward AIDS were investigated, as well as the level and sources of information about sex and the quality of the subjects' relationships with their parents. The majority of the subjects revealed satisfactory development in most of the aspects surveyed, as well as in their relationships with their parents except where sexual issues were concerned. Nevertheless, most of the students reported menstrual disturbances, and a significant number of the sexually active reported inappropriate behavior in relation to contraception and AIDS prevention. The results of the research are analyzed using psychodynamic theories of sexual development.

Cardiometabolic Risk in PCOS: More than a Reproductive Disorder

PubMed Central

Torchen, Laura C.

2018-01-01

Purpose of Review Polycystic ovary syndrome (PCOS) is diagnosed by its characteristic reproductive features. However, PCOS is also associated with metabolic abnormalities, including insulin resistance and β-cell dysfunction. The severity of these abnormalities varies according to the reproductive phenotype, with the so-called NIH or classic phenotype conferring the greatest metabolic risk. The increased risk for type 2 diabetes (T2D) is well-established among affected women with the NIH phenotype, but whether PCOS also confers an increased risk for cardiovascular events remains unknown. Recent Findings Recent studies in daughters of affected women have found evidence for pancreatic β-cell dysfunction prior to menarche. Further, genetic analyses have provided evidence that metabolic abnormalities such as obesity and insulin resistance contribute to the pathogenesis of PCOS. Summary PCOS increases the risk for T2D. However, the risk for cardiovascular disease has not been quantified, and prospective, longitudinal studies are still critically needed. PMID:29128916

Cardiometabolic Risk in PCOS: More than a Reproductive Disorder.

PubMed

Torchen, Laura C

2017-11-11

Polycystic ovary syndrome (PCOS) is diagnosed by its characteristic reproductive features. However, PCOS is also associated with metabolic abnormalities, including insulin resistance and β-cell dysfunction. The severity of these abnormalities varies according to the reproductive phenotype, with the so-called NIH or classic phenotype conferring the greatest metabolic risk. The increased risk for type 2 diabetes (T2D) is well established among affected women with the NIH phenotype, but whether PCOS also confers an increased risk for cardiovascular events remains unknown. Recent studies in daughters of affected women have found evidence for pancreatic β-cell dysfunction prior to menarche. Further, genetic analyses have provided evidence that metabolic abnormalities such as obesity and insulin resistance contribute to the pathogenesis of PCOS. PCOS increases the risk for T2D. However, the risk for cardiovascular disease has not been quantified, and prospective, longitudinal studies are still critically needed.

A Case of Distal Vaginal Agenesis Presenting with Recurrent Urinary Tract Infection and Pyuria in a Prepubertal Girl.

PubMed

Dural, Ozlem; Ugurlucan, Funda Gungor; Yasa, Cenk; Bastu, Ercan; Eren, Hulya; Yuksel, Bahar; Celik, Serdal; Akhan, Suleyman Engin

2017-02-01

Isolated distal vaginal agenesis is a rare anomaly and mostly becomes symptomatic after menarche. We describe an unusual presentation of this anomaly in a prepubertal girl. An 11-year-old prepubertal girl presented with recurrent urinary tract infection, pyuria, and right-sided renal agenesis. The findings of perineal inspection, ultrasonography, and magnetic resonance imaging were consistent with a distal vaginal agenesis with pyometrocolpos. Discharging pyometrocolpos with dissection of the atretic portion and a pull-through vaginoplasty were performed. A cystoscopy showed no sign of a vesicovaginal or uterine fistula. This rare presentation of distal vaginal agenesis reminds us that congenital malformations of the female genital tract should be considered in patients with congenital anomalies of the urinary system and/or recurrent urinary tract infection, even during the prepubertal period. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Bone mineral content and bone mineral density in adolescent girls with anorexia nervosa--a longitudinal study.

PubMed

Jagielska, G; Wolańczyk, T; Komender, J; Tomaszewicz-Libudzic, C; Przedlacki, J; Ostrowski, K

2001-08-01

Total body and lumbar spine bone mineral density (BMD-TB, BMD-L) and total body bone mineral content (BMC-TB) were measured to establish the course of bone demineralization in anorexia nervosa and the clinical factors influencing BMC-TB and BMD changes during treatment. Forty-two girls with DSM III-R anorexia nervosa, age 14.7+/-2.4 years. BMC-TB, BMD-TB and BMD-L were measured in approximately 7-month intervals for 27.8+/-4.1 months using DXA. Despite nutritional improvement, there was an initial decrease of BMD-L, and no change in BMC-TB and BMD-TB. an increase in BMC-TB and BMD was observed after approx. 21 months from the beginning of the study. The improvement in BMC-TB and BMD was related to changes in nutritional status and was significantly marked in younger patients, with earlier anorexia onset and before menarche.

Metabolic Syndrome and Breast Cancer Risk.

PubMed

Wani, Burhan; Aziz, Shiekh Aejaz; Ganaie, Mohammad Ashraf; Mir, Mohammad Hussain

2017-01-01

The study was meant to estimate the prevalence of metabolic syndrome in patients with breast cancer and to establish its role as an independent risk factor on occurrence of breast cancer. Fifty women aged between 40 and 80 years with breast cancer and fifty controls of similar age were assessed for metabolic syndrome prevalence and breast cancer risk factors, including age at menarche, reproductive status, live births, breastfeeding, and family history of breast cancer, age at diagnosis of breast cancer, body mass index, and metabolic syndrome parameters. Metabolic syndrome prevalence was found in 40.0% of breast cancer patients, and 18.0% of those in control group ( P = 0.02). An independent and positive association was seen between metabolic syndrome and breast cancer risk (odds ratio = 3.037; 95% confidence interval 1.214-7.597). Metabolic syndrome is more prevalent in breast cancer patients and is an independent risk factor for breast cancer.

Puberty and the Education of Girls*

PubMed Central

CAVANAGH, SHANNON E.; RIEGLE-CRUMB, CATHERINE; CROSNOE, ROBERT

2010-01-01

This study extends previous research on the social psychological implications of pubertal timing to education by applying a life course framework to data from the National Longitudinal Study of Adolescent Health and from the Adolescent Health and Academic Achievement Study. Early pubertal timing, which has previously been associated with major social psychological changes in girls' lives during middle school, predicted girls' grade point average and probability of course failure at the start of high school. Because of this initial failure during the high school transition, it also predicted their probability of dropping out of high school, and, among those who graduated, their grade point average at the end of high school. Such research demonstrates one way in which the immediate social psychological risk of early pubertal timing, measured as the age at menarche, translates into long-term disadvantage for girls, thereby opening up new avenues of research for social psychologists interested in youth development, health, and education. PMID:20216926

Follicle-stimulating hormone levels in female workers exposed to urban pollutants.

PubMed

Ciarrocca, Manuela; Caciari, Tiziana; Ponticiello, Barnaba Giuseppina; Gioffrè, Pier Agostino; Tomei, Gianfranco; Sancini, Angela; Schifano, Maria Pia; Palermo, Paola; Nardone, Nadia; Scimitto, Lara; Fiaschetti, Maria; Tomei, Francesco

2011-12-01

The aim of this study was to evaluate if there were alterations in FSH plasma levels in female outdoor workers (traffic policewomen and drivers) exposed to chemical urban stressors vs. control group. After excluding subjects with main confounding factors, traffic policewomen, drivers and indoor workers were matched by age, working life, socioeconomic status, marital status, menstrual cycle day, age of menarche, habitual consumption of Italian coffee and soy. A total of 129 female subjects were included in the study: some 63 workers studied during proliferative phase and 66 during secretory phase of menstrual cycle. Proliferative phase of menstrual cycle: FSH mean values were significantly higher in traffic policewomen compared to controls (p < 0.05). Results suggest that in outdoor workers exposed to urban chemical stressors there are alterations in FSH levels; therefore FSH may be used as an early biological marker, valuable for the group, used in occupational set.

Metabolic syndrome and asthma.

PubMed

Garmendia, Jenny V; Moreno, Dolores; Garcia, Alexis H; De Sanctis, Juan B

2014-01-01

Metabolic syndrome (MetS) is a syndrome that involves at least three disorders dyslipidemia, insulin resistance, obesity and/or hypertension. MetS has been associated with several chronic diseases in the adulthood; however, in the recent years, the syndrome was redefined in children. Girls with early menarche and asthma, and children with MetS and asthma that reach adulthood appear to have higher risk to develop severe or difficult to control asthma and a higher probability to suffer cardiovascular diseases. It has been proposed that patients with MetS and endocrinological disorders should be considered a different entity in which pharmacologic treatment should be adjusted according to the individual. Recent patents on the field have addressed new issues on how endocrine control should be managed along with asthma therapeutics. In the near future, new approaches should decrease the high morbidity and mortality associated to these types of patients.

Risk factors of breast cancer among women in eastern India: a tertiary hospital based case control study.

PubMed

Das, Soumen; Sen, Santanu; Mukherjee, Anindya; Chakraborty, Debadatta; Mondal, Pankaj Kumar

2012-01-01

Breast cancer is one of the most common cancers of women in India with high fatality rate. Over a 1 year study period 105 consecutive biopsy or fine needle aspiration cytology confirmed breast cancer patients were interviewed by direct questionnaire method regarding risk factors attending Surgery and Radiotherapy OPD of Medical College Kolkata, West Bengal while taking other 105 patients attending Surgery Department for some other disease as controls. The data were compiled in MS Excel 2007 and analyzed by Epi info 3.5.1 software. Among the cases, rural residence, illiteracy and low socio-economic status was significantly higher than controls. Late onset of menarche, late onset of menopause, ever OCP usage, breast feeding for 1-2 years and age of 1st childbirth between 20-30 years were found to be significant protective factors. People should be made aware regarding the modifiable risk factors to prevent breast cancer.

Menstruation: symptoms, management and attitude of female nursing students in Ibadan, Nigeria.

PubMed

Moronkola, O A; Uzuegbu, V U

2006-12-01

This study surveyed 120 student nurses from two schools of nursing in Ibadan, Nigeria to assess the symptoms experienced during menstruation, attitude towards and management of menstruation. The student nurses overall mean age at menarche was 14 years, average duration of menstrual period was five days and mean of menstrual cycle was 28 days. Out of the 120 study participants, 93% were having menstruation regularly. More participants experienced symptoms during premenstrual periods than menstrual periods. Majority (70%) used sanitary pad to manage their menstruation, 93% had positive attitude towards menstruation while only 20% consulted medical doctors whenever they experienced menstrual symptoms. Paracetamol was the drug of choice for many of the participants whenever they experienced menstrual symptoms It was recommended that authorities in schools of nursing should not overlook reproductive health needs of students. Also teaching of reproductive health education early in primary and secondary schools should be encouraged.

Menstruation and menstrual hygiene amongst adolescent school girls in Kano, Northwestern Nigeria.

PubMed

Lawan, U M; Yusuf, Nafisa Wali; Musa, Aisha Bala

2010-09-01

This study examined the knowledge and practices of adolescent school girls in Kano, Nigeria around menstruation and menstrual hygiene. Data was collected quantitatively and analyzed using Epi info version 3.2.05. The mean age of the students was 14.4 +/- 1.2 years; majority was in their mid adolescence. The students attained menarche at 12.9 +/- 0.8 years. Majority had fair knowledge of menstruation, although deficient in specific knowledge areas. Most of them used sanitary pads as absorbent during their last menses; changed menstrual dressings about 1-5 times per day; and three-quarter increased the frequency of bathing. Institutionalizing sexuality education in Nigerian schools; developing and disseminating sensitive adolescent reproductive health massages targeted at both parents and their adolescent children; and improving access of the adolescents to youth friendly services are veritable means of meeting the adolescent reproductive health needs in Nigeria.

Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis

PubMed Central

van Eijk, Anna Maria; Sivakami, M; Thakkar, Mamita Bora; Bauman, Ashley; Laserson, Kayla F; Coates, Susanne; Phillips-Howard, Penelope A

2016-01-01

Objectives To assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs. Design Systematic review and meta-analysis. We searched PubMed, The Global Health Database, Google Scholar and references for studies published from 2000 to September 2015 on girls’ MHM. Setting India. Participants Adolescent girls. Outcome measures Information on menarche awareness, type of absorbent used, disposal, hygiene, restrictions and school absenteeism was extracted from eligible materials; a quality score was applied. Meta-analysis was used to estimate pooled prevalence (PP), and meta-regression to examine the effect of setting, region and time. Results Data from 138 studies involving 193 subpopulations and 97 070 girls were extracted. In 88 studies, half of the girls reported being informed prior to menarche (PP 48%, 95% CI 43% to 53%, I2 98.6%). Commercial pad use was more common among urban (PP 67%, 57% to 76%, I2 99.3%, n=38) than rural girls (PP 32%, 25% to 38%, I2 98.6%, n=56, p<0.0001), with use increasing over time (p<0.0001). Inappropriate disposal was common (PP 23%, 16% to 31%, I2 99.0%, n=34). Menstruating girls experienced many restrictions, especially for religious activities (PP 0.77, 0.71 to 0.83, I2 99.1%, n=67). A quarter (PP 24%, 19% to 30%, I2 98.5%, n=64) reported missing school during periods. A lower prevalence of absenteeism was associated with higher commercial pad use in univariate (p=0.023) but not in multivariate analysis when adjusted for region (p=0.232, n=53). Approximately a third of girls changed their absorbents in school facilities (PP 37%, 29% to 46%, I2 97.8%, n=17). Half of the girls’ homes had a toilet (PP 51%, 36% to 67%, I2 99.4%, n=21). The quality of studies imposed limitations on analyses and the interpretation of results (mean score 3 on a scale of 0–7). Conclusions Strengthening of MHM programmes in India is needed. Education on awareness, access to hygienic absorbents and disposal of MHM items need to be addressed. Trial registration number CRD42015019197. PMID:26936906

Body size and pubertal development explain ethnic differences in structural geometry at the femur in Asian, Hispanic, and white early adolescent girls living in the U.S.

PubMed Central

Osborne, D.L.; Weaver, C.M.; McCabe, L.D.; McCabe, G.M.; Novotny, R.; Van Loan, M.D.; Going, S.; Matkovic, V.; Boushey, C.J.; Savaiano, D.A.

2012-01-01

Variation in structural geometry is present in adulthood, but when this variation arises and what influences this variation prior to adulthood remains poorly understood. Ethnicity is commonly the focus of research of skeletal integrity and appears to explain some of the variation in quantification of bone tissue. However, why ethnicity explains variation in skeletal integrity is unclear. Methods Here we examine predictors of bone cross sectional area (CSA) and section modulus (Z), measured using dual-energy X-ray absorptiometry (DXA) and the Advanced Hip Analysis (AHA) program at the narrow neck of the femur in adolescent (9–14 yr) girls (n=479) living in the United States who were classified as Asian, Hispanic, or white if the subject was 75% of a given group based on parental reported ethnicity. Protocols for measuring height and weight follow standardized procedures. Total body lean mass (LM) and total body fat mass (FM) were quantified in kilograms using DXA. Total dietary and total dairy calcium intakes from the previous month were estimated by the use of an electronic semi-quantitative food frequency questionnaire (eFFQ). Physical activity was estimated for the previous year by a validated self-administered modifiable activity questionnaire for adolescents with energy expenditure calculated from the metabolic equivalent (MET) values from the Compendium of Physical Activities. Multiple regression models were developed to predict CSA and Z. Results Age, time from menarche, total body lean mass (LM), total body fat mass (FM), height, total calcium, and total dairy calcium all shared a significant (p<0.05), positive relationship with CSA. Age, time from menarche, LM, FM, and height shared significant (p<0.05), positive relationships with Z. For both CSA and Z, LM was the most important covariate. Physical activity was not a significant predictor of geometry at the femoral neck (p≥0.339), even after removing LM as a covariate. After adjusting for covariates, ethnicity was not a significant predictor in regression models for CSA and Z. Conclusion Variability in bone geometry at the narrow neck of the femur is best explained by body size and pubertal maturation. After controlling for these covariates there were no differences in bone geometry between ethnic groups. PMID:22944607

Increased long-term recreational physical activity is associated with older age at natural menopause among heavy smokers: the California Teachers Study

PubMed Central

Emaus, Aina; Dieli-Conwright, Christina; Xu, Xinxin; Lacey, James V.; Ingles, Sue A.; Reynolds, Peggy; Bernstein, Leslie; Henderson, Katherine D.

2012-01-01

Objective Although physical activity modulates the hypothalamic-ovarian-pituitary axis, the few studies investigating whether physical activity is associated with age at natural menopause have had mixed results. We set out to determine whether physical activity is associated with the timing of natural menopause in a large cohort of California women, overall, and by smoking history. Methods We investigated the association between long-term physical activity (hours/week/year) and age at natural menopause among 97,945 women in the California Teachers Study. Multivariable Cox proportional hazards regression methods were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). The impact of cigarette smoking (never smoker, former-light smoker, former-heavy smoker, current-light smoker, current-heavy smoker) as an effect modifier was evaluated. Results In a multivariable model adjusting for body mass index at age 18, age at menarche, race/ethnicity, and age at first full-term pregnancy, increased physical activity was statistically significantly associated with older age at natural menopause (ptrend=0.005). Higher body mass index at age 18 (ptrend=0.0003) and older age at menarche (ptrend=0.0003) were also associated with older age at natural menopause. Hispanic ethnicity (vs. non-Hispanic whites, HR 1.17, 95% CI 1.09–1.26), current smokers (vs. never smokers, HR 1.68, 95% CI 1.60–1.75 for current-light smokers; HR 1.38, 95% CI 1.33–1.44 for current-heavy smokers) and older age at first full-term pregnancy (HR≥29, 2+ full-term pregnancies vs. <29, 2+ full-term pregnancies 1.10, 95% CI 1.06–1.14) were associated with earlier age at natural menopause. Upon stratification by smoking history, increased physical activity was statistically significantly associated with older natural menopause among heavy smokers only (HRHighest vs. Lowest quartile 0.88, 95% CI 0.81–0.97, ptrend=0.02 for former-heavy smokers; HRHighest vs. Lowest quartile 0.89, 95% CI 0.80–0.99, ptrend=0.04 for current-heavy smokers). Conclusion Age at natural menopause is a complex trait; the determinants of age at natural menopause, including physical activity, may differ by smoking status. PMID:23435025

Increased long-term recreational physical activity is associated with older age at natural menopause among heavy smokers: the California Teachers Study.

PubMed

Emaus, Aina; Dieli-Conwright, Christina; Xu, Xinxin; Lacey, James V; Ingles, Sue A; Reynolds, Peggy; Bernstein, Leslie; Henderson, Katherine D

2013-03-01

Although physical activity modulates the hypothalamic-pituitary-ovarian axis, the few studies that have investigated whether physical activity is associated with age at natural menopause have yielded mixed results. We set out to determine whether physical activity is associated with the timing of natural menopause in a large cohort of California women overall and by smoking history. We investigated the association between long-term physical activity (h/wk/y) and age at natural menopause among 97,945 women in the California Teachers Study. Multivariable Cox proportional hazards regression methods were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). The impact of cigarette smoking (never smoker, former light smoker, former heavy smoker, current light smoker, and current heavy smoker) as an effect modifier was evaluated. In a multivariable model adjusted for body mass index at age 18 years, age at menarche, race/ethnicity, and age at first full-term pregnancy, increased physical activity was statistically significantly associated with older age at natural menopause (P(trend) = 0.005). Higher body mass index at age 18 years (P(trend) = 0.0003) and older age at menarche (P(trend) = 0.0003) were also associated with older age at natural menopause. Hispanic ethnicity (vs non-Hispanic whites; HR, 1.17; 95% CI, 1.09-1.26), current smokers (vs never smokers; HR, 1.68; 95% CI, 1.60-1.75 for current light smokers; HR, 1.38; 95% CI, 1.33-1.44 for current heavy smokers), and older age at first full-term pregnancy (HR(≥29, 2+ full-term pregnancies) vs HR(<29, 2+ full-term pregnancies), 1.10; 95% CI, 1.06-1.14) were associated with earlier age at natural menopause. Upon stratification by smoking history, increased physical activity was statistically significantly associated with older age at natural menopause among heavy smokers only (HR(highest quartile) vs HR(lowest quartile), 0.88; 95% CI, 0.81-0.97; P(trend) = 0.02 for former heavy smokers; HR(highest quartile) vs HR(lowest quartile), 0.89; 95% CI, 0.80-0.99; P(trend) = 0.04 for current heavy smokers). Age at natural menopause is a complex trait; the determinants of age at natural menopause, including physical activity, may differ by smoking status.

Body size and pubertal development explain ethnic differences in structural geometry at the femur in Asian, Hispanic, and white early adolescent girls living in the U.S.

PubMed

Osborne, D L; Weaver, C M; McCabe, L D; McCabe, G P; Novotny, R; Van Loan, M D; Going, S; Matkovic, V; Boushey, C J; Savaiano, D A

2012-11-01

Variation in structural geometry is present in adulthood, but when this variation arises and what influences this variation prior to adulthood remains poorly understood. Ethnicity is commonly the focus of research of skeletal integrity and appears to explain some of the variation in quantification of bone tissue. However, why ethnicity explains variation in skeletal integrity is unclear. Here we examine predictors of bone cross sectional area (CSA) and section modulus (Z), measured using dual-energy X-ray absorptiometry (DXA) and the Advanced Hip Analysis (AHA) program at the narrow neck of the femur in adolescent (9-14 years) girls (n=479) living in the United States who were classified as Asian, Hispanic, or white if the subject was 75% of a given group based on parental reported ethnicity. Protocols for measuring height and weight follow standardized procedures. Total body lean mass (LM) and total body fat mass (FM) were quantified in kilograms using DXA. Total dietary and total dairy calcium intakes from the previous month were estimated by the use of an electronic semi-quantitative food frequency questionnaire (eFFQ). Physical activity was estimated for the previous year by a validated self-administered modifiable activity questionnaire for adolescents with energy expenditure calculated from the metabolic equivalent (MET) values from the Compendium of Physical Activities. Multiple regression models were developed to predict CSA and Z. Age, time from menarche, total body lean mass (LM), total body fat mass (FM), height, total calcium, and total dairy calcium all shared a significant (p<0.05), positive relationship with CSA. Age, time from menarche, LM, FM, and height shared significant (p<0.05), positive relationships with Z. For both CSA and Z, LM was the most important covariate. Physical activity was not a significant predictor of geometry at the femoral neck (p≥0.339), even after removing LM as a covariate. After adjusting for covariates, ethnicity was not a significant predictor in regression models for CSA and Z. Variability in bone geometry at the narrow neck of the femur is best explained by body size and pubertal maturation. After controlling for these covariates there were no differences in bone geometry between ethnic groups. Published by Elsevier Inc.

Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis.

PubMed

van Eijk, Anna Maria; Sivakami, M; Thakkar, Mamita Bora; Bauman, Ashley; Laserson, Kayla F; Coates, Susanne; Phillips-Howard, Penelope A

2016-03-02

To assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs. Systematic review and meta-analysis. We searched PubMed, The Global Health Database, Google Scholar and references for studies published from 2000 to September 2015 on girls' MHM. India. Adolescent girls. Information on menarche awareness, type of absorbent used, disposal, hygiene, restrictions and school absenteeism was extracted from eligible materials; a quality score was applied. Meta-analysis was used to estimate pooled prevalence (PP), and meta-regression to examine the effect of setting, region and time. Data from 138 studies involving 193 subpopulations and 97,070 girls were extracted. In 88 studies, half of the girls reported being informed prior to menarche (PP 48%, 95% CI 43% to 53%, I(2) 98.6%). Commercial pad use was more common among urban (PP 67%, 57% to 76%, I(2) 99.3%, n=38) than rural girls (PP 32%, 25% to 38%, I(2) 98.6%, n=56, p<0.0001), with use increasing over time (p<0.0001). Inappropriate disposal was common (PP 23%, 16% to 31%, I(2) 99.0%, n=34). Menstruating girls experienced many restrictions, especially for religious activities (PP 0.77, 0.71 to 0.83, I(2) 99.1%, n=67). A quarter (PP 24%, 19% to 30%, I(2) 98.5%, n=64) reported missing school during periods. A lower prevalence of absenteeism was associated with higher commercial pad use in univariate (p=0.023) but not in multivariate analysis when adjusted for region (p=0.232, n=53). Approximately a third of girls changed their absorbents in school facilities (PP 37%, 29% to 46%, I(2) 97.8%, n=17). Half of the girls' homes had a toilet (PP 51%, 36% to 67%, I(2) 99.4%, n=21). The quality of studies imposed limitations on analyses and the interpretation of results (mean score 3 on a scale of 0-7). Strengthening of MHM programmes in India is needed. Education on awareness, access to hygienic absorbents and disposal of MHM items need to be addressed. CRD42015019197. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The relation between athletic sports and prevalence of amenorrhea and oligomenorrhea in Iranian female athletes

PubMed Central

Dadgostar, Haleh; Razi, Mohammad; Aleyasin, Ashraf; Alenabi, Talia; Dahaghin, Saeideh

2009-01-01

Background In 1992, the concept of female athlete triad was introduced to describe the interrelated problems of amenorrhea, eating disorders and osteoporosis seen in female athletes. To gain a clearer picture of amenorrhea/oligomenorrhea in Iran, one of the main components of the female athlete triad, we therefore established this study on the prevalence of amenorrhea/oligomenorrhea in elite Iranian female athletes, also evaluating the risk factors of these disorders in the same population. Methods This study performed as a cross-sectional study. All elite Iranian female athletes of 34 sports federation, including female athletes in national teams and medalists of Tehran were invited to participate. A total of 788 (95% response rate) returned the questionnaires and were examined. Younger athletes under the age of menarche were excluded. Each athlete completed a self-administered questionnaire, which covered the following questions about participant's demographic information, athletic history, history of injuries and menstrual pattern. In order to diagnose the causes of amenorrhea/Oligomenorrhea including polycystic ovary syndrome(PCOS), participants with amenorrhea/Oligomenorrhea underwent further investigation. They were evaluated by following Para clinic investigation, and an ultrasonographic study of ovary. Results The age ranged from 13–37 (mean = 21.1, SD = 4.5). Seventy one (9.0%) individuals had amenorrhea/oligomenorrhea, among those, 11 (15.5%) had PCOS. There was also a positive association between amenorrhea/oligomenorrhea and the following: age under 20 OR; 2.67, 95%CI(1.47 – 4.85), weight class sports OR; 2.09, 95%CI(1.15 – 3.82), endurance sports OR; 2.89, 95%CI(1.22 – 6.84), late onset of menarche OR; 3.32 95%CI(1.04–10.51), and use of oral contraceptive pills OR; 6.17, 95%CI(3.00 – 12.69). Intensity of training sport or BMI were not risk factors. Conclusion These findings support the previous findings in the literature that the prevalence of amenorrhea/oligomenorrhea is high in athletes. Furthermore, we provided the first report on the prevalence of PCOS in female athletes with amenorrhea/oligomenorrhea. Athletes would be greatly benefited by greater general awareness about the complications of amenorrhea/oligomenorrhea. To increase awareness of exercise-associated menstrual cycle irregularities, it is necessary to design complete and comprehensive education programs for female athletes, their parents, their coaches, and the relevant authorities. PMID:19642982

Reproductive profiles and risk of breast cancer subtypes: a multi-center case-only study.

PubMed

Brouckaert, Olivier; Rudolph, Anja; Laenen, Annouschka; Keeman, Renske; Bolla, Manjeet K; Wang, Qin; Soubry, Adelheid; Wildiers, Hans; Andrulis, Irene L; Arndt, Volker; Beckmann, Matthias W; Benitez, Javier; Blomqvist, Carl; Bojesen, Stig E; Brauch, Hiltrud; Brennan, Paul; Brenner, Hermann; Chenevix-Trench, Georgia; Choi, Ji-Yeob; Cornelissen, Sten; Couch, Fergus J; Cox, Angela; Cross, Simon S; Czene, Kamila; Eriksson, Mikael; Fasching, Peter A; Figueroa, Jonine; Flyger, Henrik; Giles, Graham G; González-Neira, Anna; Guénel, Pascal; Hall, Per; Hollestelle, Antoinette; Hopper, John L; Ito, Hidemi; Jones, Michael; Kang, Daehee; Knight, Julia A; Kosma, Veli-Matti; Li, Jingmei; Lindblom, Annika; Lilyquist, Jenna; Lophatananon, Artitaya; Mannermaa, Arto; Manoukian, Siranoush; Margolin, Sara; Matsuo, Keitaro; Muir, Kenneth; Nevanlinna, Heli; Peterlongo, Paolo; Pylkäs, Katri; Saajrang, Suleeporn; Seynaeve, Caroline; Shen, Chen-Yang; Shu, Xiao-Ou; Southey, Melissa C; Swerdlow, Anthony; Teo, Soo-Hwang; Tollenaar, Rob A E M; Truong, Thérèse; Tseng, Chiu-Chen; van den Broek, Alexandra J; van Deurzen, Carolien H M; Winqvist, Robert; Wu, Anna H; Yip, Cheng Har; Yu, Jyh-Cherng; Zheng, Wei; Milne, Roger L; Pharoah, Paul D P; Easton, Douglas F; Schmidt, Marjanka K; Garcia-Closas, Montserrat; Chang-Claude, Jenny; Lambrechts, Diether; Neven, Patrick

2017-11-07

Previous studies have shown that reproductive factors are differentially associated with breast cancer (BC) risk by subtypes. The aim of this study was to investigate associations between reproductive factors and BC subtypes, and whether these vary by age at diagnosis. We used pooled data on tumor markers (estrogen and progesterone receptor, human epidermal growth factor receptor-2 (HER2)) and reproductive risk factors (parity, age at first full-time pregnancy (FFTP) and age at menarche) from 28,095 patients with invasive BC from 34 studies participating in the Breast Cancer Association Consortium (BCAC). In a case-only analysis, we used logistic regression to assess associations between reproductive factors and BC subtype compared to luminal A tumors as a reference. The interaction between age and parity in BC subtype risk was also tested, across all ages and, because age was modeled non-linearly, specifically at ages 35, 55 and 75 years. Parous women were more likely to be diagnosed with triple negative BC (TNBC) than with luminal A BC, irrespective of age (OR for parity = 1.38, 95% CI 1.16-1.65, p = 0.0004; p for interaction with age = 0.076). Parous women were also more likely to be diagnosed with luminal and non-luminal HER2-like BCs and this effect was slightly more pronounced at an early age (p for interaction with age = 0.037 and 0.030, respectively). For instance, women diagnosed at age 35 were 1.48 (CI 1.01-2.16) more likely to have luminal HER2-like BC than luminal A BC, while this association was not significant at age 75 (OR = 0.72, CI 0.45-1.14). While age at menarche was not significantly associated with BC subtype, increasing age at FFTP was non-linearly associated with TNBC relative to luminal A BC. An age at FFTP of 25 versus 20 years lowered the risk for TNBC (OR = 0.78, CI 0.70-0.88, p < 0.0001), but this effect was not apparent at a later FFTP. Our main findings suggest that parity is associated with TNBC across all ages at BC diagnosis, whereas the association with luminal HER2-like BC was present only for early onset BC.

Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study).

PubMed

Gao, Fei; Machin, David; Chow, Khuan-Yew; Sim, Yu-Fan; Duffy, Stephen W; Matchar, David B; Goh, Chien-Hui; Chia, Kee-Seng

2012-11-19

Gail and others developed a model (GAIL) using age-at-menarche, age-at-birth of first live child, number of previous benign breast biopsy examinations, and number of first-degree-relatives with breast cancer as well as baseline age-specific breast cancer risks for predicting the 5-year risk of invasive breast cancer for Caucasian women. However, the validity of the model for projecting risk in South-East Asian women is uncertain. We evaluated GAIL and attempted to improve its performance for Singapore women of Chinese, Malay and Indian origins. Data from the Singapore Breast Screening Programme (SBSP) are used. Motivated by lower breast cancer incidence in many Asian countries, we utilised race-specific invasive breast cancer and other cause mortality rates for Singapore women to produce GAIL-SBSP. By using risk factor information from a nested case-control study within SBSP, alternative models incorporating fewer then additional risk factors were determined. Their accuracy was assessed by comparing the expected cases (E) with the observed (O) by the ratio (E/O) and 95% confidence interval (CI) and the respective concordance statistics estimated. From 28,883 women, GAIL-SBSP predicted 241.83 cases during the 5-year follow-up while 241 were reported (E/O=1.00, CI=0.88 to 1.14). Except for women who had two or more first-degree-relatives with breast cancer, satisfactory prediction was present in almost all risk categories. This agreement was reflected in Chinese and Malay, but not in Indian women. We also found that a simplified model (S-GAIL-SBSP) including only age-at-menarche, age-at-birth of first live child and number of first-degree-relatives performed similarly with associated concordance statistics of 0.5997. Taking account of body mass index and parity did not improve the calibration of S-GAIL-SBSP. GAIL can be refined by using national race-specific invasive breast cancer rates and mortality rates for causes other than breast cancer. A revised model containing only three variables (S-GAIL-SBSP) provides a simpler approach for projecting absolute risk of invasive breast cancer in South-East Asia women. Nevertheless its role in counseling the individual women regarding their risk of breast cancer remains problematical and needs to be validated in independent data.

Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study)

PubMed Central

2012-01-01

Background Gail and others developed a model (GAIL) using age-at-menarche, age-at-birth of first live child, number of previous benign breast biopsy examinations, and number of first-degree-relatives with breast cancer as well as baseline age-specific breast cancer risks for predicting the 5-year risk of invasive breast cancer for Caucasian women. However, the validity of the model for projecting risk in South-East Asian women is uncertain. We evaluated GAIL and attempted to improve its performance for Singapore women of Chinese, Malay and Indian origins. Methods Data from the Singapore Breast Screening Programme (SBSP) are used. Motivated by lower breast cancer incidence in many Asian countries, we utilised race-specific invasive breast cancer and other cause mortality rates for Singapore women to produce GAIL-SBSP. By using risk factor information from a nested case-control study within SBSP, alternative models incorporating fewer then additional risk factors were determined. Their accuracy was assessed by comparing the expected cases (E) with the observed (O) by the ratio (E/O) and 95% confidence interval (CI) and the respective concordance statistics estimated. Results From 28,883 women, GAIL-SBSP predicted 241.83 cases during the 5-year follow-up while 241 were reported (E/O=1.00, CI=0.88 to 1.14). Except for women who had two or more first-degree-relatives with breast cancer, satisfactory prediction was present in almost all risk categories. This agreement was reflected in Chinese and Malay, but not in Indian women. We also found that a simplified model (S-GAIL-SBSP) including only age-at-menarche, age-at-birth of first live child and number of first-degree-relatives performed similarly with associated concordance statistics of 0.5997. Taking account of body mass index and parity did not improve the calibration of S-GAIL-SBSP. Conclusions GAIL can be refined by using national race-specific invasive breast cancer rates and mortality rates for causes other than breast cancer. A revised model containing only three variables (S-GAIL-SBSP) provides a simpler approach for projecting absolute risk of invasive breast cancer in South-East Asia women. Nevertheless its role in counseling the individual women regarding their risk of breast cancer remains problematical and needs to be validated in independent data. PMID:23164155

Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls.

PubMed

Misra, Madhusmita; Aggarwal, Avichal; Miller, Karen K; Almazan, Cecilia; Worley, Megan; Soyka, Leslie A; Herzog, David B; Klibanski, Anne

2004-12-01

Anorexia nervosa (AN) is an eating disorder that leads to a number of medical sequelae in adult women and has a mortality rate of 5.6% per decade; known complications include effects on hematologic, biochemical, bone density, and body composition parameters. Few data regarding medical and developmental consequences of AN are available for adolescents, in particular for an outpatient community-dwelling population of girls who have this disorder. The prevalence of AN is increasing in adolescents, and it is the third most common chronic disease in adolescent girls. Therefore, it is important to determine the medical effects of this disorder in this young population. We examined clinical characteristics and performed hematologic, biochemical, hormonal, and bone density evaluations in 60 adolescent girls with AN (mean age: 15.8 +/- 1.6 years) and 58 healthy adolescent girls (mean age: 15.2 +/- 1.8 years) of comparable maturity. Nutritional and pubertal status; vital signs; a complete blood count; potassium levels; hormonal profiles; bone density at the lumbar and lateral spine; total body, hip, and femoral neck (by dual-energy x-ray absorptiometry) and body composition (by dual-energy x-ray absorptiometry) were determined. All measures of nutritional status such as weight, percentage of ideal body weight, body mass index, lean body mass, fat mass, and percentage of fat mass were significantly lower in girls with AN than in control subjects. Girls with AN had significantly lower heart rates, lower systolic blood pressure, and lower body temperature compared with control subjects. Total red cell and white cell counts were lower in AN than in control subjects. Among girls with AN, 22% were anemic and 22% were leukopenic. None were hypokalemic. Mean age at menarche did not differ between the groups. However, the proportion of girls who had AN and were premenarchal was significantly higher compared with healthy control subjects who were premenarchal, despite comparable maturity as determined by bone age. Ninety-four percent of premenarchal girls with AN versus 28% of premenarchal control subjects were above the mean age at menarche for white girls, and 35% of premenarchal AN girls versus 0% of healthy adolescents were delayed >2 SD above the mean. The ratio of bone age to chronological age, a measure of delayed maturity, was significantly lower in girls with AN versus control subjects and correlated positively with duration of illness and markers of nutritional status. Serum estradiol values were lower in girls with AN than in control subjects, and luteinizing hormone values trended lower in AN. Levels of insulin-like growth factor-I were also significantly lower in girls with AN. Estradiol values correlated positively with insulin-like growth factor-I, a measure of nutritional status essential for growth (r = 0.28). All measures of bone mineral density (z scores) were lower in girls with AN than in control subjects, with lean body mass, body mass index, and age at menarche emerging as the most important predictors of bone density. Bone density z scores of <-1 at any one site were noted in 41% of girls with AN, and an additional 11% had bone density z scores of <-2. A high prevalence of hemodynamic, hematologic, endocrine, and bone density abnormalities are reported in this large group of community-dwelling adolescent girls with AN. Although a number of these consequences of AN are known to occur in hospitalized adolescents, the occurrence of these findings, including significant bradycardia, low blood pressure, and pubertal delay, in girls who are treated for AN on an outpatient basis is of concern and suggests the need for vigilant clinical monitoring, including that of endocrine and bone density parameters.

Breast cancer risk accumulation starts early – Prevention must also

PubMed Central

Colditz, Graham A; Bohlke, Kari; Berkey, Catherine S.

2014-01-01

Purpose Nearly 1 in 4 breast cancers is diagnosed before the age of 50, and many early-stage premalignant lesions are present but not yet diagnosed. Therefore, we review evidence to support the strategy that breast cancer prevention efforts must begin early in life. Methods Literature review Results Exposures during childhood and adolescence affect a woman’s long-term risk of breast cancer, but have received far less research attention than exposures that occur later in life. Breast tissue undergoes rapid cellular proliferation between menarche and first full-term pregnancy, and risk accumulates rapidly until the terminal differentiation that accompanies first pregnancy. Evidence on childhood diet and growth in height, and adolescent alcohol intake, among other adolescent factors are related to breast cancer risk and risk of premalignant proliferative benign lesions. Conclusion Breast cancer prevention efforts will have the greatest effect when initiated at an early age and continued over a lifetime. Gaps in knowledge are identified and deserve increase attention to inform prevention. PMID:24820413

Common allelic variants of the vitamin receptor D gene rs7975232 (ApaI) do not influence bone mineral density figures in postmenopausal osteoporotic women.

PubMed

Pedrera-Canal, Maria; Moran, Jose M; Vera, Vicente; Roncero-Martin, Raul; Lavado-Garcia, Jesus M; Aliaga, Ignacio; Pedrera-Zamorano, Juan D

2015-01-01

This study examined the association between bone mineral density (BMD) and the rs7975232 (ApaI) polymorphism of the vitamin receptor D (VDR) gene. The polymorphism was detected using the real-time PCR TaqMan method. The rs7975232 genotype was determined in 274 postmenopausal osteoporotic Spanish women who were 60.53±8.02 years old. The observed genotype frequencies were in agreement with Hardy-Weinberg equilibrium (χ(2)=1.85, P=0.1736). There were no significant differences in the rs7975232 genotype groups in our total sample of osteoporotic women regarding age, years since menopause, height, weight, and BMD at femoral neck, femoral trochanter and lumbar spine. Significant differences were found in menarche age (aa vs Aa; P=0.008) and BMI (aa vs AA; P=0.029). We conclude that the VDR gene rs7975232 polymorphism is not related to figures of bone mineral density in postmenopausal osteoporotic Spanish women.

Reproductive hormones and menstrual changes with exercise in female athletes.

PubMed

Arena, B; Maffulli, N; Maffulli, F; Morleo, M A

1995-04-01

The endocrine equilibrium which regulates reproductive function in women can be affected by physical and psychological factors. Blood levels of hormones depend on a balance between production, metabolism and clearance rates. Intensive physical exercise may affect this balance via different mechanisms, such as stress associated with competition, dieting, reduction of body fat and body weight, production of heat or hypoxia. Women who engage in regular high intensity exercise may be at risk, as a consequence of these hormonal changes, of developing menstrual disturbances such as oligomenorrhoea, delayed menarche and amenorrhoea. Impaired production of gonadotrophins, which leads to luteal phase deficiency and anovulation, is a common hormonal finding with exercise-induced menstrual disturbances, but several other hormones may show significant alterations. In this article we have reviewed the recent literature on the effects of intensive physical exercise on the menstrual cycle, on some important physical parameters such as bone mineral density and bodyweight, and on those hormones (gonadotrophins, prolactin, melatonin, opioid peptides and steroids) which regulate, directly or indirectly, the reproductive function in women.

Polycystic Ovary Syndrome

PubMed Central

McCartney, Christopher R.; Marshall, John C.

2017-01-01

A 22-year-old woman reports having hirsutism and irregular menses. She describes unpredictable and infrequent menses (five or six per year) since menarche at 11 years of age. Dark, coarse facial hair began to develop at 13 years of age. The symptoms worsened after she gained weight in college. The physical examination includes a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 29, blood pressure of 135/85 mm Hg, and moderate hirsutism without virilization. Laboratory tests reveal a total testosterone level of 65 ng per deciliter (2.3 nmol per liter) (assay reference range, 14 to 53 ng per deciliter [0.5 to 1.8 nmol per liter]), calculated free testosterone level of 15.3 pg per milliliter (53.1 pmol per liter) (assay reference range, 0.6 to 6.8 pg per milliliter [2.1 to 23.6 pmol per liter]), and glycated hemoglobin level of 5.7% (normal value, ≤5.6%). How should this case be evaluated and managed? PMID:27406348

Menstrual Management for Adolescents With Disabilities.

PubMed

Quint, Elisabeth H; O'Brien, Rebecca F

2016-07-01

The onset of menses for adolescents with physical or intellectual disabilities can affect their independence and add additional concerns for families at home, in schools, and in other settings. The pediatrician is the primary health care provider to explore and assist with the pubertal transition and menstrual management. Menstrual management of both normal and abnormal cycles may be requested to minimize hygiene issues, premenstrual symptoms, dysmenorrhea, heavy or irregular bleeding, contraception, and conditions exacerbated by the menstrual cycle. Several options are available for menstrual management, depending on the outcome that is desired, ranging from cycle regulation to complete amenorrhea. The use of medications or the request for surgeries to help with the menstrual cycles in teenagers with disabilities has medical, social, legal, and ethical implications. This clinical report is designed to help guide pediatricians in assisting adolescent females with intellectual and/or physical disabilities and their families in making decisions related to successfully navigating menarche and subsequent menstrual cycles. Copyright © 2016 by the American Academy of Pediatrics.

Breast cancer risk accumulation starts early: prevention must also.

PubMed

Colditz, Graham A; Bohlke, Kari; Berkey, Catherine S

2014-06-01

Nearly one in four breast cancers is diagnosed before the age of 50, and many early-stage premalignant lesions are present but not yet diagnosed. Therefore, we review evidence to support the strategy that breast cancer prevention efforts must begin early in life. This study follows the literature review methods and format. Exposures during childhood and adolescence affect a woman's long-term risk of breast cancer, but have received far less research attention than exposures that occur later in life. Breast tissue undergoes rapid cellular proliferation between menarche and first full-term pregnancy, and risk accumulates rapidly until the terminal differentiation that accompanies first pregnancy. Evidence on childhood diet and growth in height, and adolescent alcohol intake, among other adolescent factors is related to breast cancer risk and risk of premalignant proliferative benign lesions. Breast cancer prevention efforts will have the greatest effect when initiated at an early age and continued over a lifetime. Gaps in knowledge are identified and deserve increase attention to inform prevention.

Food Versus Pharmacy: Assessment of Nutritional and Pharmacological Strategies to Improve Bone Health in Energy-Deficient Exercising Women.

PubMed

Southmayd, Emily A; Hellmers, Adelaide C; De Souza, Mary Jane

2017-10-01

The review aims to summarize our current knowledge surrounding treatment strategies aimed at recovery of bone mass in energy-deficient women suffering from the Female Athlete Triad. The independent and interactive contributions of energy status versus estrogen status on bone density, geometry, and strength have recently been reported, highlighting the importance of addressing both energy and estrogen in treatment strategies for bone health. This is supported by reports that have identified energy-related features (low body weight and BMI) and estrogen-related features (late age of menarche, oligo/amenorrhea) to be significant risk factors for low bone mineral density and bone stress injury in female athletes and exercising women. Nutritional therapy is the recommended first line of treatment to recover bone mass in energy-deficient female athletes and exercising women. If nutritional therapy fails after 12 months or if fractures or significant worsening in BMD occurs, pharmacological therapy may be considered in the form of transdermal estradiol with cyclic oral progestin (not COC).

Ovulatory disturbances. Causative factors among Japanese student nurses in a dormitory.

PubMed

Nagata, I; Kato, K; Seki, K; Furuya, K

1986-01-01

The incidence of ovulatory disturbances in student nurses living in a restricted circumstance was evaluated by observing a basal body temperature (BBT) chart recorded for three to nine months by all of the student nurses in our medical college. The students were 18-21 years of age and were all living in a school dormitory. One hundred of the 154 students (64.9%) were anovulators during the school term. However, 40 of the anovulators showed ovulatory cycles with biphasic BBT patterns during their spring and/or summer holidays. The subjects' living conditions were investigated by questionnaire. Age of menarche, sport activity, self-perceived physical and mental work load, and native region did not appear to be related to their ovulatory disturbances. Weight-height-derived indices indicated that the anovulators had a tendency to corpulence as compared to the regular ovulators. Serum luteinizing hormone, follicle stimulating hormone, and prolactin levels of the anovulators were not significantly different from the regular ovulators.

Lack of HPV in Benign and Malignant Epithelial Ovarian Tumors in Iran

PubMed

Farzaneh, Farah; Nadji, Seyed Alireza; Khosravi, Donya; Hosseini, Maryam Sadat; Hashemi Bahremani, Mohammad; Chehrazi, Mohammad; Bagheri, Ghazal; Sigaroodi, Afsaneh; Haghighatian, Zahra

2017-05-01

Background: Ovarian epithelial tumors one of the most common gynecological neoplasms; we here evaluated the presence of HPV in benign and malignant examples. Methods: In this cross-sectional study the records of 105 patients with epithelial ovarian tumors (benign and malignant) referred to Imam Hossein University Hospital from 2012 to 2015 were evaluated along with assessment of the presence of the HPV infection using PCR. Results: Among 105 patients, comprising 26 (24.8%) with malignant and 79 (75.2%) with benign lesions, the factors found to impact on malignancy were age at diagnosis, age at first pregnancy, number of pregnancies and hormonal status. However, malignancies was not related to abortion, late menopause, and early menarche. In none of the ovarian tissues (benign and malignant) was HPV DNA found. Conclusion: In this study HPV DNA could not be found in any epithelial ovarian tumors (benign and malignant) removed from 105 women; more studies with larger sample size are needed for a definite conclusion. Creative Commons Attribution License

Primary Ovarian Insufficiency: X chromosome defects and autoimmunity.

PubMed

Persani, Luca; Rossetti, Raffaella; Cacciatore, Chiara; Bonomi, Marco

2009-08-01

Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche or premature depletion of ovarian follicles before the age of 40 years. However, in several instances the distinction between definitive or intermittent POF may be difficult on clinical bases, therefore the more appropriate term Primary Ovarian Insufficiency (POI) has been recently proposed and will be used in this review. POI is a heterogeneous disorder affecting approximately 1% of women <40 years. The most severe forms present with absent pubertal development and primary amenorrhea, whereas forms with post-pubertal onset are characterized by disappearance of menstrual cycles (secondary amenorrhea) associated with a defective folliculogenesis. POI is generally characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Heterogeneity of POI is reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. Several data indicate that POI has a strong genetic component. In this manuscript we discuss the X chromosome abnormalities that are associated with POI.

Nutrition for synchronized swimming: a review.

PubMed

Lundy, Bronwen

2011-10-01

Synchronized swimming enjoys worldwide popularity and has been part of the formal Olympic program since 1984. Despite this, relatively little research has been conducted on participant nutrition practices and requirements, and there are significant gaps in the knowledge base despite the numerous areas in which nutrition could affect performance and safety. This review aimed to summarize current findings and identify areas requiring further research. Uniform physique in team or duet events may be more important than absolute values for muscularity or body fat, but a lean and athletic appearance remains key. Synchronized swimmers appear to have an increased risk of developing eating disorders, and there is evidence of delayed menarche, menstrual dysfunction, and lower bone density relative to population norms. Dietary practices remain relatively unknown, but micronutrient status for iron and magnesium may be compromised. More research is required across all aspects of nutrition status, anthropometry, and physiology, and both sports nutrition and sports medicine support may be required to reduce risks for participants.

Partitioning heritability by functional annotation using genome-wide association summary statistics.

PubMed

Finucane, Hilary K; Bulik-Sullivan, Brendan; Gusev, Alexander; Trynka, Gosia; Reshef, Yakir; Loh, Po-Ru; Anttila, Verneri; Xu, Han; Zang, Chongzhi; Farh, Kyle; Ripke, Stephan; Day, Felix R; Purcell, Shaun; Stahl, Eli; Lindstrom, Sara; Perry, John R B; Okada, Yukinori; Raychaudhuri, Soumya; Daly, Mark J; Patterson, Nick; Neale, Benjamin M; Price, Alkes L

2015-11-01

Recent work has demonstrated that some functional categories of the genome contribute disproportionately to the heritability of complex diseases. Here we analyze a broad set of functional elements, including cell type-specific elements, to estimate their polygenic contributions to heritability in genome-wide association studies (GWAS) of 17 complex diseases and traits with an average sample size of 73,599. To enable this analysis, we introduce a new method, stratified LD score regression, for partitioning heritability from GWAS summary statistics while accounting for linked markers. This new method is computationally tractable at very large sample sizes and leverages genome-wide information. Our findings include a large enrichment of heritability in conserved regions across many traits, a very large immunological disease-specific enrichment of heritability in FANTOM5 enhancers and many cell type-specific enrichments, including significant enrichment of central nervous system cell types in the heritability of body mass index, age at menarche, educational attainment and smoking behavior.

Dysmenorrhea in a multiethnic population of adolescent Asian girls.

PubMed

Wong, Li Ping; Khoo, Ee Ming

2010-02-01

To determine the prevalence of dysmenorrhea, its impact, and the treatment-seeking behavior of adolescent Asian girls. A cross-sectional study with 1092 girls from 15 public secondary schools and 3 ethnic groups in the Federal Territory of Kuala Lumpur, Malaysia. Overall, 74.5% of the girls who had reached menarche had dysmenorrhea; 51.7% of these girls reported that it affected their concentration in class; 50.2% that it restricted their social activities; 21.5% that it caused them to miss school; and 12.0% that it caused poor school performance. Ethnicity and form at school were significantly associated with the poor concentration, absenteeism, and restriction of social and recreational activities attributed to dysmenorrhea. Only 12.0% had consulted a physician, and 53.3% did nothing about their conditions. There were ethnic differences in the prevalence, impact, and management of dysmenorrhea. There is a need for culture-specific education regarding menstruation-related conditions in the school curriculum. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.