Menarche

About: Menarche is a research topic. Over the lifetime, 5116 publications have been published within this topic receiving 165744 citations.

Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network

Abstract: Objective. To determine the current prevalence and mean ages of onset of pubertal characteristics in young girls seen in pediatric practices in the United States. Methods. A cross-sectional study was conducted by 225 clinicians in pediatric practices belonging to Pediatric Research in Office Settings, a practice-based research network. After standardized training in the assessment of pubertal maturation, practitioners rated the level of sexual maturation on girls 3 through 12 years who were undergoing complete physical examinations. Results. Data were analyzed for 17 077 girls, of whom 9.6% were African-American and 90.4% white. At age 3, 3% of African-American girls and 1% of white girls showed breast and/or pubic hair development, with proportions increasing to 27.2% and 6.7%, respectively, at 7 years of age. At age 8, 48.3% of African-American girls and 14.7% of white girls had begun development. At every age for each characteristic, African-American girls were more advanced than white girls. The mean ages of onset of breast development for African-American and white girls were 8.87 years (SD, 1.93) and 9.96 years (SD, 1.82), respectively; and for pubic hair development, 8.78 years (SD, 2.00) and 10.51 years (SD, 1.67), respectively. Menses occurred at 12.16 years (SD, 1.21) in African-American girls and 12.88 years (SD, 1.20) of age in white girls. Conclusions. These data suggest that girls seen in a sample of pediatric practices from across the United States are developing pubertal characteristics at younger ages than currently used norms. Practitioners may need to revise their criteria for referral of girls with precocious puberty, with attention to racial differences.

Menstrual cycles: fatness as a determinant of minimum weight for height necessary for their maintenance or onset.

Abstract: Weight loss causes loss of menstrual function (amenorrhea) and weight gain restores menstrual cycles. A minimal weight for height necessary for the onset of or the restoration of menstrual cycles in cases of primary or secondary amenorrhea due to undernutrition is indicated by an index of fatness of normal girls at menarche and at age 18 years, respectively. Amenorrheic patients of ages 16 years and over resume menstrual cycles after weight gain at a heavier weight for a particular height than is found at menarche. Girls become relatively and absolutely fatter from menarche to age 18 years. The data suggest that a minimum level of stored, easily mobilized energy is necessary for ovulation and menstrual cycles in the human female.

Variation of the human menstrual cycle through reproductive life.

Abstract: 30 years of data directed to the study of the temporal characteristics of the human menstrual cycle and some of its associated phenomena are presented. Approximately 2700 record-keeping collaborators and their daughters were enrolled. Only records of greater than 6 months uninterrupted recording are included. A record of all surgery illness or medication which might influence menstruation was recorded as well. Age of the patient and age since menarche are recorded. By 1961 this study had accumulated 25825 person-years of menstrual experience with 2750 intervening pregnancies. Justification of the belief that women normally vary in menstrual interval around a value of 28 days was unsupported. Each woman has her own central trend and variation which changes with age. The menstrual interval should be expected to average within a few days of 28 when assembled in large groups. Variation as opposed to regularlity is the rule in the menstrual cycle. The early and late years of menstrual life have the greatest variation in pattern of both long and short cycles and tend to mirror each other. The middle years of menstruation is characterized by linear change in both central tendency and variation; falling 2-3 days in this age span. Variation in menstrual cycle reaches its minimum at around 36 years of age. Determining the pattern of variation in menstrual history for anticipated intervals needs further study. The practice of birth control through the use of rhythm methods alone must introduce elements of uncertainty which are serious problems.

Primary Ovarian Insufficiency

Abstract: A 30-year-old woman presents with a history of no menses since she stopped taking oral contraceptives 6 months ago in order to conceive. She had undergone puberty that was normal in both timing and development, with menarche at 12 years of age. At 18 years of age, she started taking oral contraceptives for irregular menses. She reports stress at work. Her weight is 59 kg, and her height 1.66 m; her body-mass index (the weight in kilograms divided by the square of the height in meters) is 21.3. There is no galactorrhea, hirsutism, or acne. The pelvic examination is normal, a pregnancy test is negative, the prolactin level is normal, and the follicle-stimulating hormone (FSH) level is in the menopausal range. How should she be evaluated and treated?

Estrogen Deficiency and Risk of Alzheimer's Disease in Women

Abstract: The authors explored the possibility that estrogen loss associated with menopause may contribute to the development of Alzheimer's disease by using a case-control study nested within a prospective cohort study. The Leisure World Cohort includes 8,877 female residents of Leisure World Laguna Hills, a retirement community in southern California, who were first mailed a health survey in 1981. From the 2,529 female cohort members who died between 1981 and 1992, the authors identified 138 with Alzheimer's disease or other dementia diagnoses likely to represent Alzheimer's disease (senile dementia, dementia, or senility) mentioned on the death certificate. Four controls were individually matched by birth date (+/- 1 year) and death date (+1 year) to each case. The risk of Alzheimer's disease and related dementia was less in estrogen users relative to nonusers (odds ratio = 0.69, 95 percent confidence interval 0.46-1.03). The risk decreased significantly with increasing estrogen dose and with increasing duration of estrogen use. Risk was also associated with variables related to endogenous estrogen levels; it increased with increasing age at menarche and (although not statistically significant) decreased with increasing weight. This study suggests that the increased incidence of Alzheimer's disease in older women may be due to estrogen deficiency and that estrogen replacement therapy may be useful for preventing or delaying the onset of this dementia.