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。     

Age at menarche and the investigation of selected biophysical parameters in the course of menarche]

DESIGN: The aim of our study was a currently clinical analysis of menarche. MATERIALS AND METHODS: The mean age of menarche was investigated in 4497 girls between 1975-1997 69 girls were examined throughly in the course of menarche. Age at menarche, body weight, height, body mass index (BMI), some of the hormones and ultrasonography of sexual organs were investigated. RESULTS: We demonstrated that mean age of menarche was 13.1 year, height 159.2 cm, weight 48 kg, body mass index (BMI) 18.9. Mean size a mucous membrane was 5.7 mm. Ratio of uterus to cervix indicated dominance of the uterus. Mean levels of hormones were: E2--89.4 pg/ml, FSH--6.2 UI/ml, LH--5.7 UI/ml. Relation LH to FSH was nearly 1.     

Age of menarche among basic level school girls in Medina, Accra

The current study was designed to determine the age at which menarche occurs among school girls in Madina, Accra. A survey was conducted among 529 girls selected using multi-stage sampling from basic schools in Madina, Accra. Respondents completed a questionnaire that recorded age-at-first menstruation by recall, household characteristics, and anthropometry. Mean age at menarche was 12.74 +/- 1.15 years; probit analysis yielded a median age of 12.09 years. Menarcheal age was significantly correlated with current age (r = 0.48; p < 0.01). Most girls (90%) had first menstruation before age 13. Their mothers' mean age at menarche was 13.6 +/- 1.08 years. In a multivariate linear regression model, household wealth (p < 0.01) and body mass index (p < 0.01) were the main modifiable independent predictors of age at onset of menarche. School girls in Madina attained menarche earlier than previously estimated. Our study suggests an influence of household level improvement in socio-economic status on menarcheal age.     

Age at menarche and the risk of operative delivery

Objectives: We sought to evaluate the impact of later menarche on the risk of operative delivery.

Population: We studied 38,069 eligible women (first labors at term with a singleton infant in a cephalic presentation) from the Norwegian Mothers and Child Cohort Study. The main exposures were the age at menarche and the duration of the interval between menarche and the first birth.

Methods: Poisson’s regression with a robust variance estimator.

Main outcome measures: Operative delivery, defined as emergency cesarean or assisted vaginal delivery (ventouse extraction or forceps).

Results: A 5 year increase in age at menarche was associated with a reduced risk of operative delivery (risk ratio [RR] 0.84, 95%CI 0.78, 0.89; p?p?p?=?.81). A 5 years increase in menarche to birth interval was associated with an increased risk of operative delivery (RR 1.26, 95%CI 1.23, 1.28; p?p?Conclusions: Later menarche reduces the risk of an operative first birth through shortening the menarche to birth interval. This observation is consistent with the hypothesis that the pattern and/or duration of prepregnancy exposure of the uterus to estrogen and progesterone contributes to uterine aging.     

Age at menarche and risk of abortion: further evidence

OBJECTIVES: To study the relationship between the age of menarche and risk of abortion. METHODS: Correspondence analysis and application of life table survival analysis were used to study the association between the age at menarche and the outcome of pregnancy on data collected from 329 women. RESULTS: Both analyses showed increased risk of abortion with increasing age of menarche. Risk of abortion associated with early age at menarche (9-11 years) was 1.2% and it increased to 66.7% when the menarche age was 15 years or above. CONCLUSION: Early age at menarche is associated with lower risk of abortion.     

Age at menarche and menopause of uterine cancer patients.

An investigation was undertaken of the ages at menarche and at menopause of cervical and endometrial cancer patients for the years 1950-55 and 1960-65. Analysis of the ages at menarche in relation to the year of birth did not show a difference between the uterine cancer groups, whereas the age at menopause did show such a difference. The menopause occurred later in the endometrial than in the cervical cancer group. There was an earlier mean age at menarche and a later mean age at menopause per decade. Therefore, the menopause seems a constitutional factor involved in the development of endometrial cancer and perhaps also cervical cancer.     

Age at menarche and age at menopause in relation to hepatocellular carcinoma in women

Objectives To assess whether age at menarche, age at menopause, parity, and selected blood hormones are associated with risk of hepatocellular carcinoma among women.
Design Case–control.
Sample and setting Data collected from 50 cases of hepatocellular carcinoma among women and 62 female controls with minor trauma or surgical conditions who attended one of three hospitals in Athens, Greece between 1995 and 1998.
Methods Researchers collected information on Reproductive variables and assayed sera samples for blood hormone levels and for chronic infection with Hepatitis B and C viruses.
Results Individuals with hepatocellular carcinoma had a lower mean age at menarche and a significantly higher mean age at menopause. After adjusting for potential confounding, age at menopause remained an important and significant predictor, increasing the risk of hepatocellular carcinoma 24% for each later year of menopause (   P < 0.001  ). For each year that menarche was delayed, risk of hepatocellular carcinoma declined 21% (   P = 0.100  ). Mean levels of insulin-like growth factor-1 and its binding protein were significantly reduced in cases compared with controls, while levels of oestradiol, testosterone and sex hormone binding globulin were somewhat higher among the cases.
Conclusions This study provides indirect, but converging evidence that steroid hormones in general, and oestrogens in particular, play an important role in the aetiology of hepatocellular carcinoma among women.     

Age at menarche in Turkish adolescents in Kahramanmaras,Eastern Mediterranean region of Turkey

Objectives To determine the age at menarche in adolescents in the Eastern Mediterranean city of Kahramanmaras, Turkey.

Methods The study was conducted in primary and high schools of Kahramanmaras, during the academic year 2003–2004. Data of 8212 female students were collected by using a standard questionnaire. Mean and median ages at menarche (with 95% confidence intervals) were calculated by Kaplan–Meier survival analysis. Also, probit analysis was performed to determine the age at menarche for all girls by estimating the age at which 10, 25, 50, 75 and 90% of the girls reached menarche.

Results According to the answers obtained through the questionnaire, 5506 (67.5%) of 8161 respondents had had their menarche. Mean age at menarche was 13.04 years (95% CI: 13.01–13.06), and median age 13.00 years (95% CI: 12.97–13.03). According to probit analyses, the probability of menstruating before the age of 11.48 years was 10% and before 15.08 years 90%.

Conclusion We provide data about age at menarche in Kahramanmaras, an Eastern Mediterranean city of Turkey.     

Age at menarche in Turkish adolescents in Kahramanmaras, Eastern Mediterranean region of Turkey.

OBJECTIVES: To determine the age at menarche in adolescents in the Eastern Mediterranean city of Kahramanmaras, Turkey. METHODS: The study was conducted in primary and high schools of Kahramanmaras, during the academic year 2003-2004. Data of 8212 female students were collected by using a standard questionnaire. Mean and median ages at menarche (with 95% confidence intervals) were calculated by Kaplan-Meier survival analysis. Also, probit analysis was performed to determine the age at menarche for all girls by estimating the age at which 10, 25, 50, 75 and 90% of the girls reached menarche. RESULTS: According to the answers obtained through the questionnaire, 5506 (67.5%) of 8161 respondents had had their menarche. Mean age at menarche was 13.04 years (95% CI: 13.01-13.06), and median age 13.00 years (95% CI: 12.97-13.03). According to probit analyses, the probability of menstruating before the age of 11.48 years was 10% and before 15.08 years 90%. CONCLUSION: We provide data about age at menarche in Kahramanmaras, an Eastern Mediterranean city of Turkey.     

Cultural practices relating to menarche and menstruation among adolescent girls in Taiwan--qualitative investigation

Study ObjectiveThe aim of this study was to qualitatively record the cultural attitudes and practices associated with menarche and menstruation in Taiwanese girls, particularly with respect to coping mechanisms.ParticipantsForty-eight adolescent girls participated.InterventionAdolescent girls were individually interviewed to investigate the effects of their cultural practices, coping mechanisms, and physiological symptoms during menarche and menstruation.Main Outcome Measure(s)The qualitative investigation revealed mixed reactions to menstruation, such as eating chocolate, using sanitary napkins, and feeling irritable or embarrassed. Cluster construction suggested that adolescents were prepared for menarche but required emotional support; in addition, the new generation employed the Internet to learn how to cope.ResultsA phenomenological approach showed that menarche and menstrual attitudes among Taiwanese adolescents were comprised in 4 dimensions: self-perception, information, and cultural practices with regard to menarche; physiological symptoms and psychological reactions during menstruation; coping mechanisms during menarche and menstruation; and methods for coping and cultural practices for menstruation. Cultural beliefs and the Internet have changed cross-cultural contacts.ConclusionsEducators and health professionals should seek to understand this generation of girls, who perceive the world as more flexible and available and have more creativity and new eating behaviors and hobbies.     

Obesity and age at menarche

A cohort study of 3,169 girls born in April 1984-April 1987 in Odense and Aalborg, Denmark, was performed to examine whether maternal prepregnancy body mass index (BMI) accounted for daughter's age of menarche (AOM) and, if so, whether it accounted for part or all of the association between daughter's BMI and AOM. Multiple regression analyses adjusted for covariates indicated a weak inverse association between maternal BMI and AOM and a much stronger inverse association between offspring BMI and AOM independent of maternal BMI.     

Sex features at menarche in relation to gonadotropin,estradiol and sex hormone-binding globulin concentrations in girls with constitutional delay of puberty. Preliminary report

Objective.?Constitutional delay of puberty (CDP) is the absence of secondary sexual features in otherwise healthy girls past the 13th year of life. The aim of the present work was to follow the development of estrogen-dependent sexual features, determine the concentrations of gonadotropins, estradiol and sex hormone-binding globulin (SHBG) in girls with CDP at menarche and compare the findings with normal controls.

Methods.?We enrolled 11 girls with CDP and 40 controls. Primary, secondary and tertiary sexual features were studied at menarche?±?3 months. The size of the ovaries and uterus was measured using transabdominal ultrasound. Maturation of breasts and pubic hair was staged according to Tanner. Concentrations of gonadotropins (follicle-stimulating hormone (FSH), luteinizing hormone) and estradiol were measured with immunoenzymatic methods. For measurement of SHBG, a radioimmunoassay was applied.

Results.?Menarche in CDP girls usually appeared with Stage IV or V of breast development and Stage IV of pubic hair development according to Tanner. CDP girls demonstrated a significantly smaller volume of the uterine body at menarche compared with controls (p?=?0.0004). Significantly lower levels of FSH (p?=?0.0363) and estradiol (p?=?0.0332), as well as a tendency towards lower levels of SHBG, were revealed in CDP girls at menarche.

Conclusion.?In CDP girls, menarche is accompanied by more mature tertiary sexual features, apparently resulting from longer exposure of estrogen-dependent tissues to the action of bioactive endogenous estrogens. The smaller volume of the uterine body in CDP girls at menarche may be attributed to decreased concentrations of FSH and estradiol, as well as to the possibility of decreased insulin-like growth factor-1 and increased neuropeptide Y levels.     

Breast malignancy in girls]

The authors described 19 year old patient with breast cancer and two teen-age patients with juvenile papillomatosis of the breast. Authors have postulated that among different problems of pediatric gynecology it is necessary to notice pathology of breast.