Showing papers on "Menarche published in 2011"

Menstrual Hygiene: Knowledge and Practice among Adolescent School Girls of Saoner, Nagpur District

Abstract: Background: Menstruation is generally considered as unclean in the Indian society. Isolation of the menstruating girls and restrictions being imposed on them in the family, have reinforced a negative attitude towards this phenomenon. There is a substantial lacuna in the knowledge about menstruation among adolescent girls. Good hygienic practices such as the use of sanitary pads and adequate washing of the genital area are essential during menstruation. Menstrual hygiene and management will directly contribute to the Millennium Development Goal (MDG)-2 on universal education and MDG -3 on gender equality and women empowerment. Aim and Objectives: To assess the knowledge and the practices of menstrual hygiene among rural and urban school going adolescent girls. Materials and Methods: A community based, cross sectional study was conducted in January- March, 2011 on 387 school going girls. The present study was undertaken among adolescent school going girls in the field practice area of the Rural Health Unit and Training Centre, Saoner, in the Nagpur district. Three hundred and eighty seven girls of the 8th and 9th standards were purposively selected for the study. A pre-designed, pretested and structured questionnaire was used in the study. The data collection technique was a personal interview of the study subjects. Results: Only 36.95% of the girls were aware of menstruation before menarche. The major source of information about menstruation for them was found to be their mothers. More than three fourth of the girls in the study were not aware of the cause and the source of the bleeding. A majority of them had knowledge about the use of sanitary pads. The mean age of menarche in the study subjects was 12.85 ± 0.867 years; sanitary pads were used by 49.35% of the selected girls. The practice of the use of old clothes was reported in 45.74% of the subjects. Satisfactory cleaning of the external genitalia was practised by 33.85% of the girls. Three fourth of the study girls practised various restrictions during menstruation. Some menstrual hygiene indices have shown a significant difference in the rural and urban girls. Conclusion: A variety of factors are known to affect menstrual behaviours, the most influential being economic status and residential status (urban and rural). Awareness regarding the need for information about healthy menstrual practices is very important. It is essential to design a mechanism to address and for the access of healthy menstrual knowledge.

Association of Perfluorooctanoic Acid (PFOA) and Perfluorooctane Sulfonate (PFOS) with age of puberty among children living near a chemical plant.

Abstract: Animal studies suggest that perfluorocarbons (PFCs) may alter sexual maturation. Relationships of human PFC exposure with puberty are not clear. We conducted a cross-sectional study to investigate whether perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) were associated with indicators of sexual maturation in a 2005-2006 survey of residents with PFOA water contamination from the Mid-Ohio Valley. Participants were 3076 boys and 2931 girls aged 8-18 years. They were classified as having reached puberty based on either hormone levels (total >50 ng/dL and free >5 pg/mL testosterone in boys and estradiol >20 pg/mL in girls) or onset of menarche. We estimated the odds of having reached puberty classified by these criteria and the fitted median age of reaching puberty in relation to serum PFOA and PFOS concentrations measured when puberty status was assigned. For boys, there was a relationship of reduced odds of reached puberty (raised testosterone) with increasing PFOS (delay of 190 days between the highest and lowest quartile). For girls, higher concentrations of PFOA or PFOS were associated with reduced odds of postmenarche (130 and 138 days of delay, respectively). In conclusion, our study showed a later age of puberty in this population correlated with PFC concentrations.

Age at menarche and menstrual cycle pattern among school adolescent girls in Central India.

Abstract: Background: The onset of menstruation is part of the maturation process. However, variability in menstrual cycle characteristics and menstrual disorders are common. The purpose of this study was to determine the age at menarche and patterns of menstruation among school adolescent girls and explore its variation across socio-economic and demographic factors. Methodology: This is a cross-sectional descriptive study carried out on 1100 school adolescent girls in district Wardha, Central India. Data were collected using a self-administered structured questionnaire on menstruation. Data was entered and analyzed by using Epi Info 6.04 software package. Chi- square value was used for testing statistical significance. Results: Mean ages of menarche were 13.51 + 1.04 years and 13.67 + 0.8 years for urban and rural areas respectively. Abnormal cycle length was common and affected 30.48%. The majority 56.15 experienced dysmenorrhoea and 56.16 percent had premenstrual syndrome. Self medication was practiced by 7.13% of the adolescent girls. The most common premenstrual symptom was headache 26.74%. Absenteeism from the school 13.9% was the effect of menstruation related problems on their daily routine. Dysmenorrhea and premenstrual symptoms were perceived as most distressing symptoms leading to school absenteeism. Majority of the girls 75.58% had discussed menstrual problems with someone, most commonly with their mothers 38.15%. There was a general lack of information about menstrual issues especially with regards to cycle length, duration of menses and age at menarche. Girls from families of high socio-economic class have significantly lower mean menarcheal age in both urban and rural area. The mean age of menarche was significantly higher in girls involved in vigorous sporting activity in urban area compared to their non-sporting counterparts. Conclusion: Age at menarche was delayed. The menstrual disorders among female adolescents are common. A school health education on menstrual problems targeting adolescent girls and their parents and routine screening for menstrual problems by healthcare providers can help to prevent the absenteeism in the school.

Cultural and social practices regarding menstruation among adolescent girls.

Abstract: 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.

Early age at menarche, lung function, and adult asthma.

Abstract: Rationale: Hormonal and metabolic status appears to influence lung health in women, and there are findings suggesting that early menarche may be related to asthma, cardiovascular disease, diabetes, and breast cancer. Objectives: This study investigates whether age at menarche is related to adult lung function and asthma. Methods: Among participants in the European Community Respiratory Health Survey II, 3,354 women aged 27-57 years from random population samples in 21 centers responded to a questionnaire concerning women's health (1998-2002). Of these women, 2,873 had lung function measurements, 2,136 had measurements of bronchial hyperreactivity, and 2,743 had IgE measurements. Logistic, linear, and negative binomial regression analyses included adjustment for age, height, body mass index, education, smoking, family size, and center. Measurements and Main Results: FEV1 and FVC were lower and asthma was more common in women with early menarche. Women reporting menarche at age 10 years or less, as compared with women with menarche at age 13 years (reference category), had lower FEV1 (adjusted difference, -113 ml; 95% confidence interval [CI], -196 to -33 ml) and FVC (-126 ml; 95% CI, -223 to -28 ml); also lower FEV1 expressed as a percentage of the predicted value (-3.28%; 95% CI, -6.25 to -0.30%) and FVC expressed as a percentage of the predicted value (-3.63%; 95% CI, -6.64 to -0.62%). Women with early menarche more often had asthma symptoms (odds ratio, 1.80; 95% CI, 1.09-2.97), asthma with bronchial hyperreactivity (odds ratio, 2.79; 95% CI, 1.06-7.34), and higher asthma symptom score (mean ratio, 1.58; 95% CI, 1.12-2.21). Conclusions: Women with early menarche had lower lung function and more asthma in adulthood. This supports a role for metabolic and hormonal factors in women's respiratory health.

Age at menarche and its association with the metabolic syndrome and its components: results from the KORA F4 study.

Abstract: Objective The metabolic syndrome is a major public health challenge and identifies persons at risk for diabetes and cardiovascular disease. The aim of this study was to examine the association between age at menarche and the metabolic syndrome (IDF and NCEP ATP III classification) and its components. Design 1536 women aged 32 to 81 years of the German population based KORA F4 study were investigated. Data was collected by standardized interviews, physical examinations, and whole blood and serum measurements. Results Young age at menarche was significantly associated with elevated body mass index (BMI), greater waist circumference, higher fasting glucose levels, and 2 hour glucose (oral glucose tolerance test), even after adjusting for the difference between current BMI and BMI at age 25. The significant effect on elevated triglycerides and systolic blood pressure was attenuated after adjustment for the BMI change. Age at menarche was inversely associated with the metabolic syndrome adjusting for age (p-values: <0.001 IDF, 0.003 NCEP classification) and additional potential confounders including lifestyle and reproductive history factors (p-values: 0.001, 0.005). Associations remain significant when additionally controlling for recollected BMI at age 25 (p-values: 0.008, 0.033) or the BMI change since age 25 (p-values: 0.005, 0.022). Conclusion Young age at menarche might play a role in the development of the metabolic syndrome. This association is only partially mediated by weight gain and increased BMI. A history of early menarche may help to identify women at risk for the metabolic syndrome.

Timing of menarche and depressive symptoms in adolescent girls from a UK cohort

Abstract: Background A growing number of studies suggest a link between timing of menarche and risk of depressive symptoms in adolescence, but few have prospectively examined the emergence of depressive symptoms from late childhood into adolescence. Aims To examine whether girls who experience earlier menarche than their peers have higher levels of depressive symptoms in adolescence. Method The study sample comprised 2184 girls from the Avon Longitudinal Study of Parents and Children. The association between timing of menarche and depressive symptoms at 10.5, 13 and 14 years was examined within a structural equation model. Results Girls with early menarche (<11.5 years) had the highest level of depressive symptoms at 13 (P = 0.007) and 14 years (P<0.001) compared with those with normative and late timing of menarche. Conclusions Early maturing girls are at increased risk of depressive symptoms in adolescence and could be targeted by programmes aimed at early intervention and prevention.

Normal pubertal development: Part I: The endocrine basis of puberty.

Abstract: 1. Brian Bordini, MD* 2. Robert L. Rosenfield, MD* 1. *Section of Adult and Pediatric Endocrinology, The University of Chicago Pritzker School of Medicine, Chicago, IL. After completing this article, readers should be able to: 1. Explain how puberty is regulated by the hypothalamic-pituitary-gonadal axis. 2. Describe the hormonal interactions involved in pubertal development in boys and girls. Puberty is a defining developmental stage of every child's life, both physically and psychosocially. Concerns about the normalcy of pubertal development and menstrual patterns are among the most common questions posed to every physician caring for children. This article reviews the primary physiologic changes in the hypothalamic-pituitary-gonadal (HPG) axis and in adrenal androgen and growth hormone (GH) production that underlie the normal pubertal milestones. Understanding of these changes allows interpretation of laboratory data in children suspected of having pubertal abnormalities. Puberty is the developmental stage during which a child becomes a young adult, characterized by the maturation of gametogenesis, secretion of gonadal hormones, and development of secondary sexual characteristics and reproductive functions. Adolescence is used widely as a generally synonymous term for puberty, but the term often is used to convey an added connotation of cognitive, psychological, and social change. Thelarche denotes the onset of breast development, an estrogen effect. Pubarche denotes the onset of sexual hair growth, an androgen effect. Menarche indicates the onset of menses and spermarche the appearance of spermatozoa in seminal fluid. Gonadarche refers to the onset of pubertal function of the gonads, which produce most of the sex hormones that underlie the pubertal changes in secondary sex characteristics. Adrenarche refers to the onset of the adrenal androgen production that contributes to pubarche. ### The Hypothalamic-Pituitary-Gonadal Axis Normal puberty results from sustained, mature activity of the HPG axis. (1). The major hormones of the HPG axis are shown in Figure …

Familial concordance for age at menarche: analyses from the Breakthrough Generations Study.

Abstract: Age at menarche is correlated within families, but estimates of the heritability of menarcheal age have a wide range (0.45-0.95). We examined the familial resemblance for age at menarche and the extent to which this is due to genetic and shared environmental factors. Between 2003 and 2010 data were retrospectively collected by questionnaire from participants within the UK-based Breakthrough Generations Study. These analyses included 25,970 female participants aged 16-98 with at least one female relative who was also a study participant. A woman's menarche was significantly delayed for each yearly increase in the menarcheal age of her monozygotic twin (average increase = 7.2 months, P < 0.001), dizygotic twin (average increase = 3.0 months, P = 0.03), older sister (average increase = 3.3 months, P < 0.001), mother (average increase = 3.4 months, P < 0.001), maternal grandmother (average increase = 1.5 months, P = 0.04), maternal aunt (average increase = 1.4 months, P < 0.001) and paternal aunt (average increase = 3.0 months, P < 0.001). There was not a significant association between the menarcheal ages of half-sister pairs or of paternal grandmother-granddaughter pairs, based on small numbers. Heritability was estimated as 0.57 [95% confidence interval 0.53, 0.61]. Shared environmental factors did not have an effect in the model. In conclusion, approximately half of the variation in age at menarche was attributable to additive genetic effects with the remainder attributable to non-shared environmental effects.

Mendelian Randomisation Study of Childhood BMI and Early Menarche.

Abstract: To infer the causal association between childhood BMI and age at menarche, we performed a mendelian randomisation analysis using twelve established “BMI-increasing” genetic variants as an instrumental variable (IV) for higher BMI. In 8,156 women of European descent from the EPIC-Norfolk cohort, height was measured at age 39–77 years; age at menarche was self-recalled, as was body weight at age 20 years, and BMI at 20 was calculated as a proxy for childhood BMI. DNA was genotyped for twelve BMI-associated common variants (in/near FTO, MC4R, TMEM18, GNPDA2, KCTD15, NEGR1, BDNF, ETV5, MTCH2, SEC16B, FAIM2 and SH2B1), and for each individual a “BMI-increasing-allele-score” was calculated by summing the number of BMI-increasing alleles across all 12 loci. Using this BMI-increasing-allele-score as an instrumental variable for BMI, each 1 kg/ increase in childhood BMI was predicted to result in a 6.5% (95% CI: 4.6–8.5%) higher absolute risk of early menarche (before age 12 years). While mendelian randomisation analysis is dependent on a number of assumptions, our findings support a causal effect of BMI on early menarche and suggests that increasing prevalence of childhood obesity will lead to similar trends in the prevalence of early menarche.

Secular trends in age at menarche in women in the UK born 1908–93: results from the Breakthrough Generations Study

Abstract: P>Morris DH, Jones ME, Schoemaker MJ, Ashworth A, Swerdlow AJ. Secular trends in age at menarche in women in the UK born 1908-93: results from the Breakthrough Generations Study. Paediatric and Perinatal Epidemiology 2011; 25: 394-400. Menarcheal age decreased over time in Western countries until cohorts born in the mid-20th century. It then stabilised, but limited data are available for recent cohorts. Menarche data were collected retrospectively by questionnaire in 2003-10 from 94 170 women who were participating in the Breakthrough Generations Study, aged 16-98 years, born 1908-93 and resident in the UK. Average menarcheal age declined from women born in 1908-19 (mean = 13.5 years) to those born in 1945-49 (mean = 12.6 years). It was then stable for several birth cohorts, but resumed its downward trend in recent cohorts (mean = 12.3 years in 1990-93 cohort). Trends differed between socio-economic groups, but the recent decline was present in each group. In conclusion, menarcheal age appears to have decreased again in recent cohorts after a period of stabilisation.

Associations Between Early Life Stress, Child Maltreatment, and Pubertal Development Among Girls in Foster Care

Abstract: The present study investigated pubertal development in girls with maltreatment histories (N = 100), assessed at four time points over 2 years beginning in the spring of their final year of elementary school. This sample is unique, in that participants were subject to an unusual level of environmental risk early in life and resided in foster care at the start of the study. Analyses replicated the previously established association between sexual abuse and earlier onset of maturation and earlier age at menarche. Physical abuse was related to a more rapid tempo of pubertal development across the period assessed. These results strengthen previous investigations of childhood maltreatment and puberty, highlighting the complexity and specificity of early life experiences for later development.

Milk Intake and Total Dairy Consumption: Associations with Early Menarche in NHANES 1999-2004

Abstract: Background Several components of dairy products have been linked to earlier menarche. Methods/Findings This study assessed whether positive associations exist between childhood milk consumption and age at menarche or the likelihood of early menarche (<12 yrs) in a U.S sample. Data derive from the National Health and Nutrition Examination Survey (NHANES) 1999–2004. Two samples were utilized: 2657 women age 20–49 yrs and 1008 girls age 9–12 yrs. In regression analysis, a weak negative relationship was found between frequency of milk consumption at 5–12 yrs and age at menarche (daily milk intake β = −0.32, P<0.10; “sometimes/variable milk intake” β = −0.38, P<0.06, each compared to intake rarely/never). Cox regression yielded no greater risk of early menarche among those who drank milk “sometimes/varied” or daily vs. never/rarely (HR: 1.20, P<0.42, HR: 1.25, P<0.23, respectively). Among the 9–12 yr olds, Cox regression indicated that neither total dairy kcal, calcium and protein, nor daily milk intake in the past 30 days contributed to early menarche. Girls in the middle tertile of milk intake had a marginally lower risk of early menarche than those in the highest tertile (HR: 0.6, P<0.06). Those in the lowest tertiles of dairy fat intake had a greater risk of early menarche than those in the highest (HR: 1.5, P<0.05, HR: 1.6, P<0.07, lowest and middle tertile, respectively), while those with the lowest calcium intake had a lower risk of early menarche (HR: 0.6, P<0.05) than those in the highest tertile. These relationships remained after adjusting for overweight or overweight and height percentile; both increased the risk of earlier menarche. Blacks were more likely than Whites to reach menarche early (HR: 1.7, P<0.03), but not after controlling for overweight. Conclusions There is some evidence that greater milk intake is associated with an increased risk of early menarche, or a lower age at menarche.

Gestational weight gain and daughter's age at menarche.

Abstract: Background: Sexual development begins in utero and enters a dormant phase during infancy. The influence of maternal gestational weight gain (GWG) on daughter's age at menarche has not been explored. Methods: We investigated the association between maternal GWG and age at menarche ( 15 years of age) in a large cohort study of U.S. nurses, The Nurses' Health Study II (NHS II), and the Nurses' Mothers' Cohort Study. Results: Among 32,218 respondents, 7% reported age at menarche age 15. Compared with women whose mothers gained 20–29 lbs during pregnancy, those whose mothers reported 40 lbs of GWG were 30% more likely to report early onset menarche (<11 years of age) in logistic regression models adjusted for sociodemographic and maternal characteristics, and childhood body size and physical activity: adjusted odds ratio (OR) 1.31, 95% confidence interval (CI) 1.05-1.62, and 1.27, 95% CI 1.06-1.56. Maternal GWG was not associated ...

Reproductive factors and exogenous hormone use and risk of adult glioma in women in the NIH-AARP Diet and Health Study.

Abstract: Experimental evidence suggests that estrogen and other steroid hormones may protect against glioma. Although epidemiologic studies provide only weak support for a role of exogenous or endogenous hormones in gliogenesis, few cohort studies have addressed this question. The authors, therefore, examined the association between menstrual and reproductive factors, exogenous hormone use, and glioma risk among 225,355 women aged 50-71 years who completed the baseline questionnaire in the NIH-AARP Diet and Health Study. During 7.5 years of follow-up, 174 cases of incident, primary glioma were ascertained. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for exposures, taking potential confounders into account. Older age at menarche was positively associated with risk: HR 1.67 (95% CI: 1.03, 2.69). Other reproductive factors, including age at first live birth, parity, age at menopause, type of menopause (natural vs. medical) and exogenous hormone use showed no association with glioma risk. The results were similar when the analysis was restricted to cases with glioblastoma (N = 130). The present study provides only limited support for the hypothesis that menstrual/reproductive factors or exogenous hormone use play a role in gliogenesis.

A Prospective Cohort Study of Menstrual Characteristics and Time to Pregnancy

Abstract: lengths <25, 25–26, 30–31, 32–33, and � 34 days were 0.64 (95% confidence interval (CI): 0.49, 0.84), 0.94 (95% CI: 0.77, 1.13), 1.10 (95% CI: 0.97, 1.25), 1.35 (95% CI: 1.06, 1.73), and 1.17 (95% CI: 0.91, 1.49), respectively. Compared with cycles that regularized within 2 years after menarche, fecundability ratios for cycles that regularized 2–3 and � 4 years after menarche were 0.90 (95% CI: 0.80, 1.02) and 0.89 (95% CI: 0.77, 1.03), respectively. Fecundability ratios were 0.87 (95% CI: 0.72, 1.05) comparing <3 with 3–4 days of menstrual bleeding and 0.70 (95% CI: 0.43, 1.13) comparing very heavy with moderate flow. In the present study, shorter cycle length was associated with delayed time to pregnancy. Age at menarche, time to menstrual regularization, and duration or intensity of menstrual flow were not appreciably associated with fecundability.

A cross sectional study of knowledge and practices about reproductive health among female adolescents in an urban slum of mumbai

Abstract: Objective: To study knowledge about reproductive health among female adolescents and to assess their treatment seeking behavior regarding reproductive health problems in an urban slum of Mumbai. Materials and methods: Cross sectional descriptive study was undertaken in an urban slum area of Mumbai for period of 3 months. All adolescent girls from 10 – 19 years of age, who had attained menarche, attending general OPD and STI clinic were included. Subjects were interviewed face to face using pretested semi-structured questionnaire after obtaining informed consent. The questionnaire contained information regarding socio demographic parameters and that related to reproductive health i.e. menstrual hygiene, knowledge and practices related to HIV / AIDS, contraception, abortion, Medical Termination of Pregnancy (MTP), etc. and their treatment seeking behavior in last 3 months for reproductive health problems. Privacy and confidentiality was strictly maintained. Analysis was done with SPSS version 17. Results: Seventy nine (32.8%) subjects had unsatisfactory menstrual hygienic practices. Two hundred twelve (88%) women were aware about availability of ANC services. Sixty six percent of women had correct knowledge of modes of transmission of HIV while only 18.7% knew about safe sexual practices. Education status and early adolescents age group (10 -14 years) was found to be significantly associated with knowledge of adolescents regarding menstruation. Conclusion: Female adolescents should be given appropriate knowledge regarding puberty and sexual health to help them confidently deal with their reproductive and sexual health issues.

Pubertal Timing and Substance Use in Middle Adolescence: A 2-Year Follow-Up Study.

Abstract: Earlier research has associated early puberty with emotional and behavioral symptoms particularly among girls, while among boys, findings have been contradictory as to whether risks are associated with early or late pubertal timing. We studied the association between pubertal timing and substance use behaviors in middle adolescence in a 2-year follow up study of 2,070 (mean age 15.5 years, SD 0.36; 56.4% females) Finnish adolescents. Pubertal timing was measured by age at menarche/oigarche. Eleven years or less was classified as early, 12–13 years as normative and 14 years or later as late pubertal timing. Substance use behaviors were elicited by a number of questions related to alcohol use patterns, smoking and cannabis use. As factors that could explain the association between pubertal timing and substance use, we studied depressive symptoms, delinquency and aggression, and parental monitoring. In boys, all these substance use behaviors were the more common the earlier the puberty and the associations persisted at age 17. Among girls, early pubertal timing was similarly associated with substance use behaviors at age 15, but no longer at age 17. The associations between pubertal timing and substance use behaviors persisted when symptom dimensions and parental monitoring were added into the models. Early puberty is a risk factor for substance use particularly among boys. Among girls, the impact of pubertal timing already tempers off during adolescence.

Puberty and Influencing Factors in Schoolgirls Living in Istanbul: End of the Secular Trend?

Abstract: OBJECTIVE: To (1) establish the median ages at menarche and pubertal stages and investigate influential factors and (2) assess the secular trend in reaching puberty in a transitional society. MATERIALS AND METHODS: A probit method was used to calculate the median age at menarche and pubertal stages from a cross-sectional study of 4868 healthy schoolgirls (aged 6–18 years) in Istanbul, Turkey. The findings were compared with those from a similar study performed 4 decades earlier. Logistic regression was used to analyze the associations between the odds of attaining puberty stages and putatively influential factors. Simple statistical models were used to test the effects of BMI and consumption of certain foods on the onset of menarche. RESULTS: The median age at menarche is 12.74 years. The median ages at breast stages 2 through 5 are 9.65, 10.10, 11.75, and 14.17 years, respectively, and at pubic-hair stages 2 through 5 are 10.09, 11.19, 12.33, and 14.68 years, respectively. Girls from upper socioeconomic classes are more likely to reach menarche and B4 and B5 stages. Higher BMI seems to be a promoting factor for attaining menarche. Intrauterine growth and gestational age had no effect. The average age at menarche was not associated with the consumption of milk, eggs, chicken, or fish. CONCLUSIONS: The secular trend in puberty is probably about to end in Turkey. Although the median ages at the breast stages show a decreasing trend, the median age at menarche is approximately the same as it was 4 decades ago. Socioeconomic status and BMI are important, and related, factors that affect the age at menarche and pubertal stages.

The effects of nutrition, puberty and dancing on bone density in adolescent ballet dancers.

Abstract: 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.

Age at menarche and metabolic markers for type 2 diabetes in premenopausal women: the BioCycle Study.

Abstract: Early age at menarche may represent another indicator of metabolic risk for development of type 2 diabetes.

Reproductive risk factors for cardiovascular disease mortality among postmenopausal women in Korea: the Kangwha Cohort Study, 1985-2005.

Abstract: Objective The relationship between reproductive factors and the risk of mortality from cardiovascular disease in postmenopausal women is unclear. In this study, we aimed to investigate this relationship in Korean postmenopausal women. Methods Subcohort analysis was carried out using the data of 3,257 postmenopausal women (age, ≥55 y at study entry) from the Kangwha Cohort Study who were followed up from 1985 until 2005. Cox proportional hazards models were used to evaluate the associations between reproductive factors and cardiovascular disease mortality. Results The risk of cardiovascular mortality in women who were 20 to 22 years old at first childbirth was 26% lower (95% CI, 0.60-0.92) than that in women younger than 20 years at first childbirth, after adjustment for age at entry, body mass index, hypertension, drinking, smoking, education, and occupation. Early first childbirth was associated with increased cardiovascular disease mortality (P trend = 0.036). The risk of coronary heart disease mortality was 51% lower in women who were 17 to 18 years old at menarche (95% CI, 0.25-0.95) than that in women who were younger than 17 years at menarche. Conclusions An inverse relationship between age at first childbirth and the risk of cardiovascular disease mortality exists. In addition, early menarche may be a reproductive risk factor for coronary heart disease mortality.

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

Abstract: 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.