Showing papers on "Menarche published in 1982"

Evidence for a Secular Trend in Age of Menarche

Abstract: WE present data documenting a secular trend toward an earlier age of menarche in Europe and the United States in the past century. There has been recent controversy on whether such a change has tak...

The experience of menarche.

Abstract: A survey methodology was used to examine girls' 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 to first menstruation, current symptoms, and self-image was completed by 639 public school girls at 3 grade levels: 5-6, 7-8, and 11-12. In addition, 120 premenarcheal fifth and sixth graders were followed longitudinally, half of whom were recruited from the public school sample and half from Girl Scout troops in the area. Girls' reactions to menarche reflected mixed emotional reactions, immediate though not subsequent concern with secrecy, and moderate though not debilitating or restrictive symptomatology. Girls who were unprepared or reached menarche early were more likely than average maturers to be negative on these measures. Based on the overall pattern of results, we suggest that, initially, menarche may create inconvenience, ambivalence, and confusion, particularly for early-maturing and unprepared girls, but that it may not be as traumatic as portrayed in previous articles.

Risk Factors for Breast Cancer in Women in Northern Alberta, Canada, as Related to Age at Diagnosis

Abstract: A population-based case-control study involving interviews with 577 female breast cancer patients and 826 controls in northern Alberta. Canada, revealed that some determinants of breast cancer varied according to age. Among women under age 45, risk factors included a younger age at menarche, late age at last birth, high parity, and recent use of oral contraceptives. At older ages risk was related to natural as opposed to surgical menopause, late age at first birth, low parity, late age at natural menopause, and tonsillectomy. At all ages there was an increased risk of breast cancer associated with difficulty in conceiving, benign breast disease, not having breast fed, and a history of breast cancer among mothers or sisters. For some variables the age differences were pronounced; the combination of low parity and late age at first birth was associated with a sevenfold increase in breast cancer risk at risk at ages 55-80 but a slight decrease at ages under 45. The effect of tonsillectomy steadily increased with age and represents a new lead, but certain features of the data suggest that the link to oral contraceptives among among younger women and the inverse relation to breast feeding at all ages may not be causal. Even though design limitations (cases interviewed in a different setting from controls) appeared not to influence conclusions, the results may have been subjected to interview bias and thus should be interpreted cautiously.

The development of menstrual-related beliefs and behaviors during early adolescence

Abstract: Adolescent girls' menstrual-related beliefs and behaviors are examined from a developmental perspective. 2 studies, 1 cross-sectional and 1 longitudinal, were conducted. In the first, 639 girls in grades 5-6, 7-8, and 11-12 were seen. In the second, 46 pairs of girls were seen twice: all were premenarcheal at the first testing; at the second testing, one-half had begun to menstruate in the last few months and one-half were a matched premenarcheal comparison group. Girls answered questions on menstrual symptomatology, menstrual-related attitudes, and potential informational sources. 3 questions were asked in the present study: (1) What are the expectations for menstrual symptoms that girls hold prior to menstruation and when do these develop? (2) How do expectations for menstrual symptoms and beliefs relate to the actual experience of menarche? (3) What are the sources of information for menstruation and do they relate to subsequent menstrual-related behavior? First, as early as fifth grade, premenarcheal girls had clear expectations regarding menstrual symptoms; their expectation that cycle-related changes would occur paralleled the changes reported by adult and older adolescent women. Second, girls who had begun to menstruate reported experiencing less severe menstrual distress (less pain, water retention, negative affect, and behavioral changes, and more concentration) than the premenarcheal comparison group expected to experience. In addition, early symptom expectations were positively related to later-reported menstrual distress (pain, water retention, and behavioral change) in the changing-menarcheal-status group. Third, there were few changes in the amount learned from various sources as a function of menarcheal status. However, correlational analyses indicate that girls who learned more from male sources rated menstruation as more debilitating and negative than those girls who learned less from male sources. The importance of socialization in the emergence of menstrual distress and negative menstrual attitudes is discussed.

A cross-cultural examination of the relationship between ages at menarche, marriage, and first birth

Abstract: Recent work with samples of black and white urban American women showed a clear behavioral sequence relating age at menarche to age at first intercourse to age at first birth. This paper shows that the linking of ages at menarche, intercourse, marriage, and first birth is a pattern which occurs in very diverse cultures. We present confirmatory data from the United States, Belgium, and Pakistan, and from Malay and Chinese women in Malaysia. We interpret our findings as indicating a biological process leading to (a) social interpretations of readiness for reproduction, and (b) persisting biological differences between early and late maturing women.

Age at menarche, urine estrogens and breast cancer risk.

Abstract: In 511 nulliparous women aged 15-19 years and 347 aged 30-39, an analysis has been undertaken of the relationship of urine concentrations of the three principal estrogens to age, age at menarche and Quetelet's index of adiposity. The analysis was undertaken by means of multiple regression, controlling for each of the 12 centers from which the data originated, as well as for the other study variables. In the younger women, age was strongly and positively related to concentrations of E1 and E2 and less so to E3. In the age group 30-39, follicular phase specimens showed positive relationships with age for all three fractions but luteal specimens did not. Age at menarche showed inverse relationships to levels of E1 and E2 which were significant in the younger but not in the older age group. The associations of estrogens with Quetelet's index were weak and not statistically significant. The data suggest that women whose menarche occurs early not only have a longer duration of exposure to estrogens during years which are probably important in the initiation of breast cancer but, in addition, their exposures are at a higher level during those years and probably at later ages also. These observations support the hypothesis that the mechanism of the association of early menarche with breast cancer risk is via the association of both with estrogen stimulus.

Age at menarche, probability of ovulation and breast cancer risk.

Abstract: An analysis is undertaken of the frequency of ovulation in 17 groups of women aged 15 to 19 who had been the subjects of other studies. A urine specimen of at least 8 h accumulation had been provided on the 20th or 21st day of a menstrual cycle by 681 women. Analysis is restricted to 431 specimens which had been collected between 11 and 3 days prior to the onset of the subsequent menstrual period. A pregnanediol concentration of less than 1 mg per litre in such a specimen was taken as evidence that the cycle was anovular. The probability of a cycle being anovular was inversely and significantly related to the number of years since menarche, and, with years since menarche held constant, was positively but not significiantly associated with age at menarche. This observation indicates that women with early menarche do not have a longer duration of exposure to anovular cycles than do those whose menarche is delayed, and that variation in the duration of exposure to post-menarcheal anovular cycles does not explain the association of breast cancer risk with early age at menarche. The 17 groups of women were classified into four categories according to ethnic origin and breast cancer incidence in the populations from which they derived. Anovular cycles were not more common in the high-risk groups; indeed, the two centers in the lowest risk category had the highest proportion of anovular cycles.

The psychological impact of menarche on early adolescent females: a review of the literature.

Abstract: Menarche is an important event for all girls yet there is relatively little research on this topic and the existing research contains a number of conceptual and methodological problems. In this paper attitudes toward menarche and personality characteristics of pubertal girls are reviewed and memories of menarche from late adolescent and adult women are examined. Studies of the impact of timing (early and late menarche) are also reviewed. The study indicates that menarche is a memorable and significant event for girls. Frequently the experience is perceived negatively but there is also a positive integrating result to menarche. Factors influencing the psychological impact of menarche include age at time of 1st period social factors amount of preparation and cultural factors. Research problems and suggestions for future research are noted. (authors modified)

Interaction of Familial and Hormonal Risk Factors for Breast Cancer

Abstract: A case-control study, conducted among participants in the Breast Cancer Detection Demonstration Project, obtained detailed information on family history of breast cancer and other risk factors from 1,362 breast cancer patients and 1,250 control subjects. An affected first-degree relative was reported by 22.4% of the patients and 12.2% of the control subjects. This finding was associated with a twofold increased risk of breast cancer, although greater elevations in risk were seen in younger study subjects and in those reporting both an affected mother and a sister. Analysis of other risk factors showed that, compared to women without a family history of breast cancer, control subjects with a family history of breast cancer tended to have early or late menarche, were older at first childbirth, and were younger at oophorectomy. In addition, the effect of family history on breast cancer risk was modified by age at menarche, but not by age at first birth or type of menopause. These findings suggest that familial susceptibility to breast cancer may be mediated through hormonal factors that operate early in a woman's life. A synergistic relationship was also observed between family history of breast cancer and the occurrence of multiple biopsies for benign breast disease, although the mechanisms for this relationship remain to be elucidated.

Growth data as indicators of social inequalities: The case of Poland

Abstract: Recent studies of the effects of socioeconomic stratification on stature and age at menarche in Poland are reviewed. The data are derived from a survey of conscripts in 1976, three nationwide growth surveys in 1955, 1966, and 1978, and several surveys of the timing of menarche. The data indicate a clear social gradient in stature during childhood, youth, and young adulthood, and in the age at menarche. Individuals from the larger urban centers and small families with college-educated fathers, on the average, tend to be the tallest and to mature earliest, while those from peasant (farmers) families are at the opposite extreme in size and maturity. Also, the data show marked secular trends towards increased stature and earlier maturation. The influence of social variables underlying the socioeconomic stratification, i.e., income, family size, education, occupational status, and urbanization, are discussed relative to their effects on growth and maturation of Polish children.

Association of Breast Cancer Risk With Age at First and Subsequent Births: A Study in the Population of the Estonian Republic

Abstract: Information on reproductive history was obtained from 362 urban breast cancer patients attending the oncological dispensaries at Tallinn and Tartu, Estonian Republic, and from 694 urban women participating in gynecologic screening programs offered by the same centers. The 2 groups were compared by means of Mantel-Haenszel and logistic regression procedures to estimate age-adjusted odds ratios. Women whose first birth occurred before 20 years of age had a breast cancer risk less than one-third the risk of nulliparous women. Risk increased with increase in age at first birth (AFB) but remained below 1.0 (relative to nulliparae), even in the highest AFB categories. The fertility rate in Estonia during the period of this study was relatively low, which facilitated an evaluation of the effect of births subsequent to the first. After adjustment for AFB, it appeared that in this population subsequent births had a protective effect additional to that conferred by the first birth. Moreover, for women who had only 2 children, the age at the time of birth of the second child was a determinant of that effect. Compared to nulliparous women, the breast cancer odds ratio for uniparous women who had their child before age 25 was 0.62, and the ratio for duoparous women who had both their children under that age was 0.18. Neither lactation nor menarche was a risk factor for breast cancer in this pouplation.

Reproductive system function in women cross-country runners.

Abstract: Reproductive system function in women cross-country runners. Med. Sci. Sports Exercise, Vol. 14, No. 4, pp. 263-269, 1982. The incidence and etiology of altered menstrual cycle function in women engaged in endurance athletic activities were investigated by studying endocrine, anthropometric, and training parameters in 41 cross-country runners. The prevalence of altered menstrual cycle patterns was significantly higher in the subjects than in college-aged; 49% reported normal cycles and 51% were either oligomenorrheic (46%) or amenorrheic (5%). No significant differences between those reporting normal menstrual cycling (N) and those reporting oligo/amenorrhea (O/A) were found in the following areas: number of miles run/week, number of years of training, age when training began, sum of skinfold thicknesses, somatotype, or post-exercise levels of growth hormone, prolactin, or hematocrit. However, a difference (P less than 0.05) was found in the mean age of menarche (N = 12.9 +/- 0.3 yr; O/A = 14.3 +/- 0.5 yr). In addition, more O/A (68%) than N (42%) began training in the year of or prior to menarche. Evaluation of seven runners from one school who qualified for the national meet (1 amenorrheic, 5 oligomenorrheic, and 1 normal) revealed that the basal estrogen, progesterone, prolactin, and thyroid hormone levels were normal and that there were normal luteinizing hormone and follicle-stimulating hormone responses to synthetic gonadotropin-releasing hormone (GnRH). These data are consistent with an alteration of hypothalamic-pituitary-ovarian function above the level of the pituitary.

Advanced Maturation Associated With Centripetal Fat Pattern

Abstract: The role of maturation in the acquisition of a centripetal fat pattern was studied in a cross-sectional sample of 5,012 white subjects aged 1 to 17 years and 7,974 white females aged 20 to 74 years and derived from the Health and Nutritional Examination Survey I. Based on assessments of bone age and age at menarche, the subjects were classified into early maturing (bone age greater than the 85th ageand sexspecific percentile for bone age or age at menarche) and late maturing (bone age less than the 15th ageand sex-specific percentile for bone age or age at menarche) groups. The present findings indicate that advanced maturation is associated with an accentuation of the centripetal distribution of subcutaneous fat. Epidemiological studies concerned with the relationship of fat distribution and susceptibility to disease have found that a centripetal fat distribution (trunk and upper body) is associated with a high incidence of coronary heart disease, high serum triglyceride concentration, and diabetes (Vague, 1956; Albrink and Meigs, 1964; Feldman et al. 1969; West et al. 1974). Since fatter boys and girls tend to mature earlier than their leaner counterparts (Talbot, 1945; Reynolds, 1951; Garn and Haskell, 1959) and since fatness levels in infancy appear to persist into childhood (Huenemann, 1974; Mellbin and Vuille, 1976), adolescence (Anguelov, 1976; Johnston and Mack, 1978) and adulthood (Garn and Bailey, 1978), one might expect long-term differences in the fat distribution of early and late maturing individuals. For this reason, the purpose of this paper is to investigate the relationship of: (1) skeletal maturation on fat distribution of white children, (2) age at menarche on fat distribution of white adult females, derived from the data sets of the U.S. Health and Nutrition Examination Survey I of 1971-1973. Materials and Methods

The pubescent rhesus monkey: some characteristics of the menstrual cycle.

Abstract: Forty-eight untreated rhesus females (Macaca mulatta) were studied from birth until menarche and for the 12 intermenstrual periods following menarche. The 48 animals were studied in two subsets: one in Oregon (N = 22) and the other in Wisconsin (N = 26). The Oregon animals menstruated 127.3 +/- 6.6 (SEM) weeks after birth, whereas the Wisconsin animals reached menarche 133.0 +/- 3.1 weeks postnatum. These ages did not differ significantly nor was there a significant difference in mean body weight at menarche between the two groups. A linear pattern of ponderal growth was observed from birth to menarche with an acceleration in ponderal growth closely following menarche. The first 12 cycles after menarche gradually decreased in length from 13.0 to 13.6 weeks (range between groups) for the first intermenstrual interval to 4.9 to 6.1 weeks (range between groups) for the 12th cycle. In these cycles the percentage of animals ovulating gradually increased with time (0% in cycle 1, 6.3% in cycle 2, 50% in cycle 8 and 90% in cycle 12). These data showed a significant linear correlation (r = 0.9328, P less than 0.01). Although cycle lengths in adults were significantly greater during June through August than during the rest of the year, no effect of season could be ascertained in the pubescent animals. Serum samples from two animals bled frequently from the onset of menarche through the first ovulatory cycle contained preovulatory amounts of estradiol-17 beta in anovulatory cycles. This suggests that follicle growth in occurring but ovulation does not occur during the early cycles of adolescence. These data support the concept that recovery from adolescent sterility in rhesus monkeys takes approximately 18 months and that recovery occurs in a nearly linear fashion within a given population. We hypothesize that the inability of a young female to ovulate reflects an inability to respond to ovarian estrogen by releasing ovulatory amounts of gonadotropin.

Recollections of menarche, current menstrual attitudes, and perimenstrual symptoms

Abstract: By menarche, girls are likely to have been influenced not only by cultural stereotypes about menstruation, but also by information acquired through significant others. Their own expectations about menstruation are likely to influence their reports of menarcheal experience. Moreover, some suggest that menarcheal experiences are likely to influence subsequent attitudes toward menstruation, and that these expectations may, in turn, influence perceptions of menstrual symptoms through psychophysiologic mechanisms. The purpose of this study was to explore the relationships between characteristics of women's menarche, their adult attitudes toward menstruation, and current experiences of perimenstrual symptoms. We selected 179 nonpregnant menstruating women between the ages of 18 and 35 from 5 lower to upper middle income neighborhoods. We found that negative recollections of their first menstruation had little effect on current menstrual attitudes. Moreover, positive recollections of menarche were associated with premenstrual and menstrual negative affect and impaired performance, and not in the expected direction. Current menstrual attitudes were more strongly associated with women's current menstrual symptoms. These results do not support the theory that menarcheal experiences have profound effects on subsequent menstrual attitudes and symptoms.

Memories of menarche: Age, preparation, and prior knowledge as determinants of initial menstrual experience

Abstract: The relationships between age at menarche, preparation for menarche, and initial experience of menarche, were assessed in a retrospective questionnaire administered to 97 college-aged women. The more knowledgeable a girl was prior to menarche, the more adequate she perceived her preparation for menarche to have been; and the older she was at the time of menarche, the more likely she was to report a positive initial experience. These data support clinical anecdotes describing initial responses to menarche, and provide information about the factors which can moderate the extent to which menarche is experienced as a traumatic and disruptive event.

Malnutrition and Fertility

Abstract: Bongaarts view that the length of lactational amenorrhea depends mainly on the suckling stimulus is not supported by studies of lactating Gambian women on both supplemented and unsupplemented diets. Plasma prolactin levels dropped more rapidly among mothers on supplemental diets although the frequency of breastfeeding remained the same. Significant differences in maternal nutrition and physical labor but not the frequency of infant feeding were associated with seasonal variations in plasma prolactin and milk yield. Another study showed that the period of postpartum infertility may be shortened by lower hormonal levels associated with improved maternal nutrition in spite of prolonged breastfeeding. A prospective study in Bangladesh by Chen et al. related long periods of lactational amenorrhea (median 17 months) both to childfeeding practices and to the poor nutritional status of mother and child. In his discussion of the interaction of nutritional status and frequency of suckling Bongaart omitted the important fact that after 6 months of age or earlier breast milk alone is insufficient for the proper growth and health of the infant but continued nursing is important as breast milk is often the only source of high quality protein. Bongaarts claim of the delaying effect of undernutrition on age of menarche is based on the assumption that menarche is an independent event in the reproductive span. Data show that age of menarche is integrated with rates of physical growth and reproductive potential. Among the marginally malnourished Bush people of the Kalahari average age of menarche is 15.5-16.0 years but because of the long period of adolescent subfecundity the average maternal age at birth of the 1st child among the Bush people is 20-21 years. In the U.S. mean age of menarche is 12.8 years and the girls usually complete their growth and period of subfecundity by age 16; this makes the 16-year old American bride at high risk of pregnancy during the 1st years of marriage. Data also show that menopause now occurs on the average at 51 years of age in a well-nourished society but because of contraceptive use reproduction actually ends long before the natural age of menopause is reached.

Growth and development in sickle cell anemia. Preliminary report.

Abstract: Historically, adults with sickle cell anemia were described as being short, thin, and eunuchoid in appearance with a particular body habitus. More current investigations in children have suggested decreased height, weight, and hypogonadism although Jamaican studies suggest supranormal heights in adolescence. All studies to date have evaluated children at one point in time. We evaluated children with sickle cell anemia longitudinally at six monthly intervals over 3 years to assess somatic growth and the development of sexual maturation. Our data support reduced height and weight as compared to National Health Statistic norms, with normal skin fold thickness. Bone ages were significantly retarded. When a patient's chronological age was replaced by his bone age and tanner staging was done, sexual development was appropriate for bone age, suggesting delayed sexual maturation. In addition, menarche was significantly delayed. Pituitary gonadotropins showed an appropriate increase with puberty. Gonadal end organ hormones supported normal responsiveness, although an occasional patient showed depressed levels. Longitudinal data is necessary to assess children with suspected delay in somatic and sexual development. Hormonal replacement does not seem warranted in the majority of patients.

Menarche and subsequent ovarian function in girls with congenital adrenal hyperplasia.

Abstract: The mean age at menarche in 6 girls on treatment for congenital adrenal hyperplasia from infancy was 13.6 years (range 12.6–14.5 years). Menarche or regular menses did not occur until plasma testosterone concentrations were within normal limits. This was achieved using single daily dexamethasone, 0.25–0.75 mg/day. The potency of this glucocorticoid in suppressing adrenal steroid biosynthesis relative to cortisol is about 80:1. The onset of regular, ovulatory menstrual cycles, as judged by daily salivary progesterone profiles, was achieved within 2–3 years of menarche using this treatment regimen. Such patients have a good prognosis for normal fertility.

Epidemiology of breast carcinoma IV: Age and histologic tumor type

Abstract: The purpose of this study was to correlate major chronologic events known to have a bearing on the risk for developing breast carcinoma with histologic tumor type. Data were obtained for 1024 consecutively treated patients with the seven most common forms of mammary carcinoma. The age of occurrence of the following events was determined: menarche; first marriage; first pregnancy and first childbirth; last pregnancy and last childhood; diagnosis. The interval between each of these events and diagnosis of breast cancer was also calculated. Patients with medullary carcinoma had a significantly lower mean age at diagnosis than those with any of the other tumor types. Because of the lower mean age at diagnosis, medullary carcinoma patients were found to have significantly shorter intervals between age at diagnosis and the following: menarche, first pregnancy or first childbirth, and last pregnancy or last childbirth, Intervals between age at diagnosis and these other events were not significantly different among patients with other types of carcinoma. The ages of menarche, marriage, or pregnancy were not related independently to any tumor type. These data indicate that except for current age. the age of occurrence of major risk factors for developing breast cancer is unrelated to the histological type of tumor a patient develops.

Menarche and interest in infants: biological and social influences.

Abstract: 2 studies are reported in which 12-13-year-old girls, half of whom were premenarcheal and half post-menarcheal, responded to pictures of infants. In study 1, the 40 postmenarcheal girls preferred pictures of infants to those of adults more often than did their 40 premenarcheal peers. In the second study, 20 boys, 20 premenarcheal girls, and 20 postmenarcheal girls rated pictures of infants, peers, college students, and 30-50-year-olds. Only postmenarcheal girls rated infants more positively than boys did. Concurrent assessments of interest in motherhood, cognitive sophistication about the relationship between menarche and childbearing, attitudes toward menarche, and sex-role self-image did not differentiate pre- and postmenarcheal girls. The effects of experience with infants differed in the 2 studies.

The reproductive cycle in female macaques

Abstract: Among long-living primates the attainment of fertile menstrual cycles requires concerted and sequential interactions between the hypothalamus, pituitary, ovaries, and uterus over many years. The longitudinal progression of these reproductive events during fetal development, infancy, menarche, adulthood, and menopause are discussed. The utility of laboratory primates for the study of this ontogeny, as well as their application for investigation of fertility problems afflicting women is well documented. Interactions within the hypothalamic-pituitary-ovarian axis in the menstrual cycle and interdependencies between the maternal and feto-placental compartments in pregnancy are of great importance.

Sexual maturation of Jerusalem schoolgirls and its association with socio-economic factors and ethnic group

Abstract: SummaryA status quo study was undertaken in Jerusalem, Israel in 1977 in order to determine the mean age of attainment of breast stages 2 and 3 (B2 and B3), pubic hair stages 2 and 3 (PH2 and PH3), and menarche. A sample of 285 Jewish girls in grades 3 through 8 were examined for signs of pubertal development and questioned about their menarcheal status. The data were analysed by probit analysis. The mean age found for B2 was 10·30±0·28 years; for B3 was 11·01±0·16 years; for PH2 was 10·58±0·22 years; for PH3 was 11·39±0·11 years; and for menarche was 13·29±0·45 years. These are the first data available on an Israeli population of mean age of breast and pubic hair development. A trend was found for later mean age of attainment of B2, B3, PH2 and PH3 among girls of the lowest social class (as measured by father's occupation), girls whose mothers were poorly educated, and girls from large families. A trend towards early mean age of attainment of B2 and B3 was found among girls of European-American-Israeli e...