Showing papers on "Menarche published in 2015"

Puberty timing associated with diabetes, cardiovascular disease and also diverse health outcomes in men and women: the UK Biobank study

Abstract: Early puberty timing is associated with higher risks for type 2 diabetes (T2D) and cardiovascular disease in women and therefore represents a potential target for early preventive interventions. We characterised the range of diseases and other adverse health outcomes associated with early or late puberty timing in men and women in the very large UK Biobank study. Recalled puberty timing and past/current diseases were self-reported by questionnaire. We limited analyses to individuals of White ethnicity (250,037 women; 197,714 men) and to disease outcomes with at least 500 cases (~ 0.2% prevalence) and we applied stringent correction for multiple testing (corrected threshold P < 7.48 × 10(-5)). In models adjusted for socioeconomic position and adiposity/body composition variables, both in women and men separately, earlier puberty timing was associated with higher risks for angina, hypertension and T2D. Furthermore, compared to the median/average group, earlier or later puberty timing in women or men was associated with higher risks for 48 adverse outcomes, across a range of cancers, cardio-metabolic, gynaecological/obstetric, gastrointestinal, musculoskeletal, and neuro-cognitive categories. Notably, both early and late menarche were associated with higher risks for early natural menopause in women. Puberty timing in both men and women appears to have a profound impact on later health.

The Normal Menstrual Cycle and the Control of Ovulation

Abstract: Menstruation is the cyclic, orderly sloughing of the uterine lining, in response to the interactions of hormones produced by the hypothalamus, pituitary, and ovaries. The menstrual cycle may be divided into two phases: (1) follicular or proliferative phase, and (2) the luteal or secretory phase. The length of a menstrual cycle is the number of days between the first day of menstrual bleeding of one cycle to the onset of menses of the next cycle. The median duration of a menstrual cycle is 28 days with most cycle lengths between 25 to 30 days (1-3. Patients who experience menstrual cycles that occur at intervals less than 21 days are termed polymenorrheic, while patients who experience prolonged menstrual cycles greater than 35 days, are termed oligomenorrheic. The typical volume of blood lost during menstruation is approximately 30 mL (4). Any amount greater than 80 mL is considered abnormal (4). The menstrual cycle is typically most irregular around the extremes of reproductive life (menarche and menopause) due to anovulation and inadequate follicular development (5-7). The luteal phase of the cycle is relatively constant in all women, with a duration of 14 days. The variability of cycle length is usually derived from varying lengths of the follicular phase of the cycle, which can range from 10 to 16 days. For complete coverage of this and related topics, please visit www.endotext.org.

Age at Menarche and Risks of Coronary Heart and Other Vascular Diseases in a Large UK Cohort

Abstract: Background—Early menarche has been associated with increased risk of coronary heart disease (CHD), but most studies were relatively small and could not assess risk across a wide range of menarcheal ages; few have examined associations with other vascular diseases. We examined CHD, cerebrovascular disease, and hypertensive disease risks by age at menarche in a large prospective study of UK women. Methods and Results—In 1.2 million women (mean±SD age, 56±5 years) without previous heart disease, stroke, or cancer, menarcheal age was reported to be 13 years by 25%, ≤10 years by 4%, and ≥17 years by 1%. After 11.6 years of follow-up, 73 378 women had first hospitalization for or death from CHD, 25 426 from cerebrovascular disease, and 249 426 from hypertensive disease. Using Cox regression, we calculated relative risks for each vascular outcome by single year of menarcheal age. The relationship was U-shaped for CHD. Compared with women with menarche at 13 years, the adjusted relative risk for CHD for menarche ...

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

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. IMPORTANCE 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.

A comparison of the menstruation and education experiences of girls in Tanzania, Ghana, Cambodia and Ethiopia

Abstract: The barriers to menstrual hygiene management faced by adolescent schoolgirls in low-income countries are gaining interest at practice and policy levels. The challenges include inadequate water, sanitation and disposal facilities for the management of menses with privacy and dignity, and insufficient guidance to help girls feel confident in attending school during menses. The studies described here aimed to examine how menarche impacts the lives of schoolgirls in three low-income countries (Ghana, Cambodia and Ethiopia). The focus included girls’ school participation; their relationship with parents, teachers and peers; their evolving sanitation and hygiene needs; their understanding of cultural issues and taboos around menses; and what education, if any, they received prior to and during puberty. This comparative analysis was aimed at identifying similarities between the three countries that would enable the adaptation to each context of a training book on menstruation issues for girls, which was develope...

Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: the EPIC study.

Abstract: Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for 5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for 9 vs. 1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR=1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR=1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause.

Putting menarche and girls into the global population health agenda

Abstract: Menarche, the onset of menstruation is a fundamental part of a girl’s transition from childhood to adolescence. Studies show that girls in many countries experience menarche with insufficient information and support. Girls from around the world report feeling ashamed and afraid. The potential health effects of such experiences include a weakening of girls’ sense of self-confidence and competence, which in turn may comprise girls’ abilities to assert themselves in different situations, including in relation to their sexuality and sexual and reproductive health. There is an important need for the public health community to assure that girls receive the education and support they need about menstruation, so they are able to feel more confident about their bodies, and navigate preventable health problems – now and in the future. For too long, the global health community has overlooked the window of opportunity presented by menarche. Family planning programs have generally focused their efforts on married couples and HIV programs have focused safer sex promotion on older adolescent girls and boys. Starting the conversation at menarche with girls in early adolescence would fully use this window of opportunity. It would engage young adolescent girls and be a natural first step for later, more comprehensive conversations about sexuality, reproduction and reproductive health. There are a number of initiatives beginning to tackle the provision of puberty information to girls and boys, but the global health community is overdue to set a global standard for the provision of such guidance.

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

Abstract: 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 u...

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

Abstract: study question: Is sugar-sweetened beverage (SSB) consumption associated with age at menarche? summaryanswer: More frequent SSB consumption was associated with earlier menarche in a population of US girls. what is known already: 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. studydesign,size,duration: 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 ¼ 5227) of girls reported their age at menarche, and 3% (n ¼ 159) remained premenarcheal in 2001; 4% (n ¼ 197) of eligible girls were censored, primarily for missing age at menarche. participants/materials, setting, methods: 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. mainresultsandtheroleofchance: 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: 24.1, 21.3 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. limitations, reasons for caution: 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. widerimplicationsofthefindings: 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.

Circulating MKRN3 levels decline prior to pubertal onset and through puberty: a longitudinal study of healthy girls.

Abstract: Context: Puberty is initiated by a complex interaction of suppressing and stimulating factors. Genetic studies of familial central precocious puberty have suggested makorin ring finger protein 3 (MKRN3) as a major inhibitor of GnRH secretion during childhood. Furthermore, genetic variation near MKRN3 (rs12148769) affects age at menarche in healthy girls. Objective: The purpose of this study was to evaluate whether serum levels of MKRN3 declined before pubertal onset in healthy girls. Design: This was a population-based longitudinal study of healthy Danish girls and a cohort study of early maturing girls. Setting: The study was performed in the general community and in a tertiary referral center for pediatric endocrinology. Patients or Other Participants: Healthy girls (n = 38) aged 9.3 years (range, 5.9–11.3 years) at baseline and followed for 6.0 years (2.7–7.6 years) (2006–2014) with blood sampling every 6 months and early maturing girls (n = 13) with breast development ay <8.3 years of age were include...

Prevalence of Dysmenorrhea and Its Correlating Lifestyle Factors in Japanese Female Junior High School Students

Abstract: 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.

Association of Obesity with Onset of Puberty and Sex Hormones in Chinese Girls: A 4-Year Longitudinal Study

Abstract: Objective To examine the influence of childhood obesity on the early onset of puberty and sex hormones in girls.

Genetic Regulation of Puberty Timing in Humans.

Abstract: Understanding the regulation of puberty timing has relevance to developmental and human biology and to the pathogenesis of various diseases. Recent large-scale genome-wide association studies on puberty timing and adult height, body mass index (BMI) and central body shape provide evidence for shared biological mechanisms that regulate these traits. There is a substantial genetic overlap between age at menarche in women and BMI, with almost invariable directional consistency with the epidemiological associations between earlier menarche and higher BMI. By contrast, the genetic loci identified for age at menarche are largely distinct from those identified for central body shape, while alleles that confer earlier menarche can be associated with taller or shorter adult height. The findings of population-based studies on age at menarche show increasing relevance for other studies of rare monogenic disorders and enrich our understanding of the mechanisms that regulate the timing of puberty and reproductive function.

Factors affecting age of onset of menopause and determination of quality of life in menopause.

Abstract: Menopause is a process in the climacteric period, characterized by a reduction in ovarian activity, a fall in the fertility rate, and a range of symptoms including irregular menstruation intervals. Most women enter menopause in their 40s, but this can vary from one individual to another. Although there are many factors affecting the age of menopause onset, there is no general agreement on them. Studies have shown many factors to affect the age of menopause, such as the mother's age at menopause, the age at menarche, gestational age, use of oral contraceptives, irregular menstrual cycle, number of pregnancies, body mass index, use of tobacco and alcohol, physical activity, unilateral oophorectomy, serum lead levels, consumption of polyunsaturated fat, socioeconomic status and educational level. During this period, hormonal and biochemical changes give rise to various symptoms in the woman's body. In menopause period, physical, psychological, social and sexual changes have a negative effect on quality of life in women. Recently, different measures have been used to assess women's quality of life in this period of change. The purpose of this review was to examine the factors affecting the onset age of menopause and the measures of quality of life related to menopause.

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

Abstract: BACKGROUND 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. METHODS 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. RESULTS 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). CONCLUSIONS 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.

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

Abstract: 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.

Puberty in females enhances the risk of an outcome of multiple sclerosis in children and the development of central nervous system autoimmunity in mice

Abstract: Background:For reasons that remain unclear, three times more women develop multiple sclerosis (MS) than men. This preponderance among women is evident only after 12 years of age, implicating pubertal factors in the risk of MS.Objective:To investigate the influence of female puberty on central nervous system (CNS) autoimmunity.Methods:We examined the relationship between age of menarche on MS outcomes in 116 female children (< 16 years old) whom presented with incident ‘acquired demyelinating syndromes’ (ADS) and were followed prospectively in the national Canadian Pediatric Demyelinating Disease Study, from 2004–2013. Furthermore, we directly investigated the effects of puberty on susceptibility to experimental autoimmune encephalomyelitis (EAE) in two groups of female mice that differed only in their pubertal status.Results:In the ADS children, a later age of menarche was associated with a decreased risk of subsequent MS diagnosis. This relationship persisted, after accounting for patient age at ADS pres...

Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey.

Abstract: Background: To our knowledge, no large population – based studies have been performed on the topic of menstrual patterns among Egyptian adolescent in recent years. The aims of this study were to identify menstrual patterns and associated disorders as well as the sources of menstrual health knowledge among Egyptian adolescents. Methods: A cross-sectional survey. A total of 800 questionnaires were administered to post-menarcheal Egyptian adolescents attending secondary schools in Giza, Egypt, from September 1, 2012, to December 1, 2013. Participants were asked to respond to a semi-structured questionnaire on menstrual health awareness. The questionnaire included items on girl’s socio-demographic and menstrual pattern characteristics, concerning their age at menarche, menstrual cycle length and regularity, duration and amount of flow, type and severity of pain related to menstruation, need for analgesia; and symptoms suggestive of premenstrual syndrome (PMS) Main Outcome Measure: description of menstrual patterns, disorders and source of knowledge. Results: Four hundred twelve (51.5 %) out of 800 adolescents completed the questionnaire. The mean age of the girls was 14.67± 1.7 years. Mean age at menarche was 12.49±1.20 years. 382 respondents reported various menstrual disorders, giving a prevalence rate of 95 %. Dysmenorrhea was the most prevalent (93 %) menstrual disorder in our sample, followed by PMS (65 %), and abnormal cycle lengths (43 %). Menstrual disorders interfered with social and academic life of 33 and 7.7 % of respondents respectively. Most participants lacked menstrual health knowledge and only 8.9 % of girls reported consulting a physician. Conclusion: To the best of our knowledge, this is one of the largest studies on menstrual pattern and disorders among Egyptian adolescent girls. Our Findings of the present study are consistent with other studies and reported higher than expected prevalence of menstrual disorders.

Breastfeeding and Maternal Hypertension and Diabetes: A Population-Based Cross-Sectional Study

Abstract: Objective: This study aimed to assess the association of breastfeeding and maternal hypertension and diabetes in Beijing, China. Subjects and Methods: A cross-sectional study was conducted in four urban communities of Beijing, China, with 9,128 parous women 40–81 years of age who had had only one lifetime birth. Each participant completed a detailed survey and accepted blood pressure measurement and blood glucose testing. Moreover, self-reported hypertension and diabetes were confirmed by review of medical records. Results: After the analysis was adjusted for the potential confounders, including age, body mass index (BMI), waist to hip ratio (WHR), working status, educational level, drinking, smoking, family history of hypertension, age of menarche, menopause, oral contraceptive use, age of child-bearing, and postpartum BMI, the odd ratio (OR) of hypertension was 1.18 (95% confidence interval [CI], 1.05–1.32) for women who did not breastfeed, compared with women who did. In addition, the ORs for ...

Trends and correlates of age at menarche in Colombia: Results from a nationally representative survey

Abstract: Surveillance of age at menarche could provide useful information on the impact of changing environmental conditions on child health. Nevertheless, nationally representative data are exceedingly rare. The aim of this study was to examine trends and sociodemographic correlates of age at menarche of Colombian girls. The study sample included 15,441 girls born between 1992 and 2000 who participated in the Colombian National Nutrition Survey of 2010. We estimated median menarcheal age using Kaplan-Meier time-to-event analyses. Hazard ratios with 95% confidence intervals were estimated with Cox regression models. The median age at menarche was 12.6 years. There was an estimated decline of 0.54 years/decade (P<0.001) over the birth years; this decline was only observed among girls from urban areas, and was more pronounced among girls from wealthier versus poorer families. Child height and BMI, maternal BMI and education, and family wealth were each inversely associated with menarcheal age whereas food insecurity and number of children in the household were positively associated with age at menarche. In conclusion, a negative trend in age at menarche is ongoing in Colombia, especially in groups most likely to benefit from socioeconomic development.

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

Abstract: studyquestion: Do prenatal exposure to cigarette smoking and birthweight influence age at menarche (AAM) in a cohort of Australian girls? summaryanswer: 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. what is known already: 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. study design, size, duration: Statistical analysis of longitudinal survey data collected from a large cohort (n ¼ 2446) of Australian children using data from birth to 12– 13 years of age. participants/materials, setting, methods: 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. main results and the role of chance: 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 ¼ 0.05. limitations, reasons for caution: 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. wider implications of the findings: 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. studyfunding/competinginterest(s): No funding was received for this study and there are no competing interests to declare.

Secular trends in age at menarche among Chinese girls from 24 ethnic minorities, 1985 to 2010.

Abstract: Background : Declining age at menarche has been observed in many countries. In China, a decrease of 4.5 months per decade in the average age at menarche among the majority Han girls has recently been reported. However, the trends in age at menarche among ethnic minority girls over the past 25 years remain unknown. Objectives : To compare the differences in median age at menarche among girls aged 9–18 years across 24 ethnic minorities in 2010 and to estimate the trends in age at menarche in different ethnic minorities from 1985 to 2010. Design : We used data from six cross-sectional Chinese National Surveys on Students’ Constitution and Health (1985, 1991, 1995, 2000, 2005, and 2010). The median age at menarche was estimated by using probit analysis. Results : In 2010, the ethnic minorities with the earliest age at menarche were the Koreans (11.79 years), Mongolians (12.44 years), and Zhuang (12.52 years). The three ethnic minorities with the latest age at menarche were the Sala (14.32 years), Yi (13.74 years), and Uighurs (13.67 years). From 1985 to 2010, the age at menarche declined in all 24 minority groups. The Lisu, Kazakh, and Korean minorities showed the largest reductions in age at menarche by 1.79 ( p 0.05), 0.15 ( p> 0.05), and 0.15 ( p> 0.05) years, respectively, in the same period. Conclusion : A large variation in age at menarche was observed among different ethnic minorities, with the earliest age at menarche found among Korean girls. A reduction in the average age at menarche appeared among most of the ethnic minorities over time, and the largest decrease was observed in Lisu, Kazakh, and Korean girls. Thus, health education should focus on targeting the specific needs of each ethnic minority group. Keywords: menarche; puberty development; China; girls; ethnic minorities; trend analysis (Published: 27 July 2015) Citation: Glob Health Action 2015, 8 : 26929 - http://dx.doi.org/10.3402/gha.v8.26929 Supplementary material: To access the supplementary material for this article, please see Supplementary files under ‘Article Tools’

Relationship between some indicators of reproductive history, body fatness and the menopausal transition in Hungarian women.

Abstract: This paper analyzed the relationship between some indicators of reproductive history and body fatness in relation to the timing of the menopause transition in Hungarian women using survival analysis after controlling for birth cohort. Data on menstruation and reproductive history were collected during the personal interviews in a sample of 1932 women (aged 35+ years). Menarcheal age, the length of menstrual cycles and menstrual bleedings, regularity of menstrual cycles, number of gestations, lactation, the ever use of contraceptives, menopausal status and age at menopause were used as indicators of reproductive history. The body fat fraction was estimated by bioelectrical impedance analysis. Body fatness was also estimated by dividing women into obese and non-obese categories (considering body mass index and waist-to-hip ratio). Survival analyses were used to analyze the relationship between the indicators of reproductive history and body fatness during the menopausal transition. Only the menarcheal age among the investigated reproductive life characteristics showed secular changes in the studied decades in Hungary; the mean age at menarche decreased by approximately 2.5 months per decade from the 1920s until the 1970s. Ever use of hormonal contraceptives, a relatively long cycle length in the perimenopausal transition and higher parity were all related with lower risk of early menopause. Later menarcheal age, normal length of menstrual cycle or bleeding in the climacterium, irregular bleeding pattern and postmenopausal status were associated with a higher amount of body fatness, while never use of contraceptives, regular menstruation, postmenopausal status and relatively early menopause were associated with a higher risk of abdominal obesity. This report confirms that age of menarche is not significantly predictive of age at menopause but prior use of oral contraceptives, longer mean cycle length and smaller number of gestations all are. In addition, age of menarche, irregular bleeding pattern before the climacterium, length of menstrual cycles and bleedings during the climacterium and postmenopausal status were associated with obesity during the climacterium.

Earlier menarche is associated with fatty liver and abdominal ectopic fat in midlife, independent of young adult BMI: The CARDIA study

Abstract: Objective The hypothesis that earlier menarche is associated with higher non alcoholic fatty liver disease (NAFLD) and ectopic adiposity, independent of young adult body mass index (BMI), was tested. Methods The data from 1,214 black and white women in the Coronary Artery Risk Development in Young Adults (CARDIA) study who reliably reported menarche age at exam years 0 and 2, who had multiple-slice abdominal computed tomography (CT) at exam year 25, and who had no known liver disease or secondary causes of steatosis were included. Women were aged 18-30 at year 0 and 43-55 at year 25. Liver attenuation, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and inter-muscular adipose tissue (IMAT) were derived from CT. NAFLD was defined as liver attenuation less than 51 Hounsfield units. Results One-year earlier menarche was associated with higher NAFLD (RR = 1.15; 95% CI: 1.07, 1.24), and VAT (6.7 cc; 95% CI: 4.3, 9.0 cc), IMAT (1.0 cc; 95% CI: 0.6, 1.4 cc), and SAT (19.6 cc; 95% CI: 13.2, 26.0 cc) after confounder adjustment. Associations remained significant (P < 0.05) after further adjustment for year 0 BMI. Only VAT remained significant (P = 0.047) after adjustment for weight gain between years 0 and 25. Conclusions Earlier menarche is positively associated with NAFLD and ectopic fat independent of confounders and young adult BMI. Weight gain between young adulthood and midlife explains some of this association.