成都市初中女生月经知识、态度、行为现况调查

目的:了解成都市初中女生月经知识、态度及行为,为月经保健提供背景资料及建议,更好地促进月经健康。方法:采用分层随机整群抽样的方法对成都市5所中学的初中3个年级女生进行调查,对有效样本采用SPSS软件包进行统计分析。结果:初潮平均年龄为(12. 35±0 .85 )岁,较1997年提前0 . 19岁;痛经的发生率为74 . 7% ,与初潮年龄、初潮时的心理反应及经血中有无血块有关(P <0 . 0 5 ) ;有关月经生理及保健的常识性问题中,77 .9%的人答对2～6题;75 . 9%的少女在遇到月经方面的问题时会首先向母亲求助;少女的月经知识来源于网络的占39.1%。结论:应做好少女的月经保健,进一步加强学校教育,教育时间应与初潮年龄的提前相协调,并应重视母亲及网络在教育中的重要地位。     

Precocious puberty: a comprehensive review of literature

CONTEXT: Precocious puberty currently affects 1 in 5,000 children and is 10 times more common in girls. Statistics indicate that girls in the United States are maturing at an earlier age than they did 30 years ago and the number of girls with diagnosed precocious puberty (the appearance of secondary sex characteristics before 8 years of age or the onset of menarche before age 9) is on the rise. A summary of the growing body of literature on this topic is necessary to inform nurses and other health care providers of the current trends and incidence of precocious puberty to better meet the physical and psychosocial needs of these girls and their families. METHODS: EBSCOhost Research Databases that included CINAHL Plus, Health Source: Nursing Edition, MEDLINE, PsycINFO, and Women's Studies International were searched for journal articles published in the past 10 years (1997-2006) that explicitly examined precocious puberty in females and proposed theories to describe the phenomenon. Search terms included precocious puberty, sexual maturation, menarche, and secondary sex characteristics. These terms were searched individually and in combination with proximate determinants such as endocrine disruptors, environmental toxins, phthalates, stress, skin care, genetics, age, ethnicity, obesity, and assisted reproduction. The search yielded 947 articles addressing this issue. RESULTS: Eighty-two studies or case reports met the criteria for inclusion in this literature review that captured six attributable causes of early sexual maturation in female children. These included genetic, ethnic, and pediatric obesity, as well as environmental toxins that disrupt endocrine function (chemicals, toxins, plasticizers, infant feeding methods, skin and hair products, assisted reproductive technologies), psychosocial stress, and early exposure to a sexualized society. The robustness of the reports varied and few of the studies were widely generalizable but did offer suggestions for assessment and nursing care. CONCLUSIONS: Precocious puberty has health and social implications that are complex and influenced by multiple factors. Further research is needed to expand and elucidate theoretical relationships between the early development of secondary sex characteristics in young girls and the proposed causative factors.     

临沂市青少年膝、踝关节长骨干骺融合情况调查

目的评价临沂市青少年膝、踝关节长骨发育状况,为临床医学、教育等提供参考资料。方法用分层整群抽样方法调查临沂市10～20岁健康青少年1204人,拍摄膝、踝关节X线片,用单位概率法计算长骨干骺融合时间;同时,测量生长发育指标、询问女生月经初潮情况并进行相关性分析。结果膝、踝关节长骨干骺融合时间明显提前。干骺融合时间踝关节明显早于膝关节且女明显早于男。女月经初潮时间亦明显提前,与各骨干骺融合时间成高度正相关(P<0.05)。结论临沂市青少年生长发育明显提前,本研究可为相关专业提供参考资料且提示有必要制定新的骨龄标准。     

城市女孩月经初潮早发的相关因素对照研究

目的：探讨城市女孩月经初潮早发的相关影响因素，为采取干预措施和健康教育提供理论依据。方法：采用1：2配比的病例对照研究方法对123例月经初潮早发女孩和246例对照进行调查，对所有调查因素进行单因素及多因素条件logistic回归分析。结果：单因素分析中有13个因素有显著意义，其中5个因素进入多因素分析，依次是：家庭人均食品支出、体块指数、母亲初潮年龄、家庭亲密度实际状况与理想的距离、家庭适应性实际状况。结论：女孩月经初潮早发不仅与遗传、营养、体脂等因素有关，也与心理社会因素有关。     

Change in leptin, body composition and other hormones around menarche--a visual representation

Abstract Aim: To present a visual representation of changes in body composition, leptin, insulin, estradiol and follicular stimulating hormone (FSH) levels in relation to menarche in girls. Methods: Participants were a subset of healthy girls (n = 108) enrolled in a longitudinal study of growth and development conducted at the General Clinical Research Center at the Massachusetts Institute of Technology (MIT). Participants were seen annually from before menarche until 4 years postmenarche for measures of body composition and serum levels of leptin, insulin, estradiol and FSH. Body composition was determined by bioelectrical impedance. Standardized body composition and hormone levels were smoothed and plotted relative to menarche to visualize patterns of change. Results: At menarche, the mean percentage body fat (%BF) of girls was 24.6% (SD = 4.1%) after menarche %BF was approximately 27%. Leptin levels averaged 8.4 ng/mL (SD = 4.6) at menarche and were approximately 12 ng/mL after menarche. Changes in leptin levels closely paralleled changes in %BF. Insulin, estradiol and FSH levels followed expected patterns relative to menarche. Leptin began rising closer to menarche than did insulin or the other sex hormones. Conclusion: We provide a visual presentation of hormonal and body composition changes occurring throughout the pubertal period in girls which may be useful in generating new hypotheses related to the timing of menarche.     

中国中小学女生月经初潮年龄和月经模式调查分析

目的调查我国青春期在校女生月经初潮情况及初潮后月经模式的变化规律。方法采用分阶段整群抽样,对全国8个省城市和农村的5 981例小学五年级到高中三年级的女生进行计算机辅助的自填问卷调查,总结我国在校青春期女生月经初潮情况及初潮后月经模式的变化规律。结果共调查5 981例女生,平均月经初潮年龄为(12.7±0.0)岁,城市及农村女生初潮年龄分别为(12.4±0.0)岁和(13.0±0.0)岁(P0.01)。月经初潮到月经规律平均间隔时间为(1.2±0.0)年。按月经初潮后不同时间分层分析显示初潮后随时间推移规律周期比例无明显变化(P=0.33);经期4~7 d、经量适中的女生比例逐渐增加(P0.01);痛经发生率逐渐增加(P0.01),痛经程度逐渐加重(P0.01)。结论城市女生月经初潮年龄较农村女生提前0.6年;初潮1年后规律月经周期比例随时间推移无明显变化,经期及经量逐渐转变为性成熟女性模式;痛经比例及中重度痛经比例逐年增加。     

Evaluation of PvuII and XbaI polymorphisms in the estrogen receptor alpha gene (ESR1) in relation to menstrual cycle timing and reproductive parameters in post-menopausal women

Objective: To evaluate the association of −397T>C and −351A>G single nucleotide polymorphisms (SNPs) – also called PvuII and XbaI, respectively – located on estrogen receptor alpha (ERS1) gene with age at menarche, menopause onset, fertility and miscarriage in a population of post-menopausal women. Study design: Cross-sectional study with 273 healthy, high miscegenated, post-menopausal women (mean age of 63.1 ± 9.7 years old). Subjects were genotyped for PvuII and XbaI SNPs by PCR-RFLP and confirmed by automatic sequencing. Reproduction informations (age at menarche, age at menopause, number of pregnancies, fertility rate and miscarriages) were obtained by retrospective study using a questionnaire. Result(s): Age at menarche, menopause onset, number of pregnancies, total fertility rate, and parity did not seem to be influenced by any of the studied genotypes (chi-square, p > 0.05). However, women carrying the xx genotype showed a 44% higher chance of miscarriage, whereas this value did not trespass 16% for any other genotype analyzed. It has been also observed a higher occurrence of miscarriage in association with combined xxpp genotype of ERS1 gene (chi-square, p < 0.01). Conclusion(s): The present data indicate that the studied SNPs on ERS1 gene do not influence the menstrual cycle timing and parity but there is a strong relationship between the xx ERS1 SNP genotype and the incidence of miscarriage in the post-menopausal population analyzed.     

Age of Menarche in a Longitudinal US Cohort

Study Objective

Menarche is a critical milestone in a woman's life, and historically has been determined using several approaches. The goals of this study were to: (1) determine age at menarche from multiple reports of parents and adolescent participants in a prospective study; (2) examine factors affecting age at menarche; and (3) determine correlates of menarche and pubertal tempo.