Menarcheal age and growth pattern of Indian girls adopted in Sweden. I. Menarcheal age

The median menarcheal age of 107 girls adopted from India by families in Sweden was 11.6 years, which was significantly lower than in Swedish and most Indian studies. Five girls had menarche before the age of 9 years, the earliest at 7.3 years. Those who arrived at a later age had earlier menarche. No differences in menarcheal age were found with respect to geographic origin. The reasons for the earlier pubertal maturation are not clear. Factors associated with the rapid transition from an underprivileged to a privileged environment are probably involved, besides genetic determinants. The serious medical, social and emotional consequences of very early pubertal development necessitate further clarification of the underlying mechanisms.     

Menarcheal age among urban Kenyan primary school girls

Aim: To determine the mean menarcheal age among urban primary school girls in Kenya. Subjects and methods: A structured questionnaire was administered to 820 primary grade 6–8 girls aged between 12 and 17 years in five public primary schools, Langata division of Nairobi West district, Nairobi Kenya. The girls came from low and middle socioeconomic status residences. Declared menarcheal age by recall to the nearest month was recorded. Data were analysed using SPSS version 15.0 for windows. The results are presented using tables and bar charts. Results: The mean menarcheal age was 12.5 ± 2.8 years with peak at 12–14 years. A substantial number of girls (10.8%) attained menarche before the age of 11 years, with 2% of them attaining it before 10 years. None attained menarche before nine or after 16 years. Of those who attained early menarche, 64.3% were from middle while only 35.7% came from low socioeconomic status residence, respectively. Conclusion: Mean menarcheal age of 12.5 years is lower than previously reported with over 10% of the girls attaining menarche by 11 years. Early commencement of reproductive health education and follow‐up for complications of early menarche is recommended.     

Age at menarche in a Korean population: secular trends and influencing factors

This study was designed to identify the secular trend in the age at menarche and to investigate the possible factors that influence the age at menarche using representative Korean data from the 2005 Korean National Health and Nutrition Survey. Three thousand five hundred sixty-two women born between 1920 and 1985 were enrolled to identify secular trends in the age at menarche and 620 girls born between 1986 and 1995 were recruited to evaluate the factors influencing the age at onset of menarche. Mean age at menarche decreased from 16.90 ± 1.25 years for women born between 1920 and 1925 to 13.79 ± 1.37 years for those born between 1980 and 1985, indicating a downward trend of 0.68 years per decade (95% CI, 0.64–0.71) in age at menarche. Mean age at menarche of girls born between 1986 and 1995 was 13.10 ± 0.06 years as estimated by the Kaplan–Meier method. Among girls born between 1986 and 1995, menarcheal girls had a larger waist circumference, a higher body mass index (BMI), and lower maternal menarcheal age and maternal age at birth than premenarcheal girls. The energy and nutrient intake of protein, sugar, fiber, ash, phosphate, natrium, thiamine, riboflavin, and niacin were greater for menarcheal girls than for premenarcheal girls. These data indicate a decreasing secular trend of age at menarche in a Korean population born between 1920 and 1995. Furthermore, maternal menarcheal age, BMI, maternal age at birth, and nutrition are important variables that appear to influence age at menarche in Korean girls.     

Age at menarche in contemporary Greek girls: evidence for levelling-off of the secular trend

AIM: To examine the secular trend of menarcheal age in Greek girls during the last decade. METHODS: Seven hundred and fifty senior high schoolgirls were asked through a questionnaire to report their date of menarche, participation in physical activities and their weight status at menarche. The data were compared with those of a study of 1996. RESULTS: Mean age at menarche (+/-SD) in 2006 was 12.29 (1.19) and in 1996 it was 12.27 (1.13) years, p = 0.73. Maternal menarcheal age was 13.02 (1.32). There was a significant correlation between age at menarche of the schoolgirls and their mothers, p < 0.0001. There was a significant difference in the age at menarche according to the schoolgirls' perceived weight status. Menarcheal age of obese girls (n = 56) was 11.73 (1.21) years, of normal weight girls (n = 474) was 12.29 (1.21) years and of lean girls (n = 220) was 12.42 (1.14) years, p < 0.001. There was no significant difference in the age at menarche between the girls that participated, 12.23 (1.19), and those that did not participate in sporting activities, 12.32 (1.19), p = 0.31. CONCLUSION: Levelling-off of the age at menarche over the last 10 years occurred in Greek girls living in Athens. Menarcheal age is influenced by the weight status and maternal menarcheal age.     

Menarcheal age and growth pattern of Indian girls adopted in Sweden. II. Catch-up growth and final height

Adopted girls (n=107) previously studied regarding menarcheal age in relation to age at arrival, were analysed as to growth pattern and final height related to nutritional status at arrival and menarcheal age. It was found that most girls had catch-up growth regarding height and half of them regarding weight. Faster catch-up and later arrival age in Sweden were associated with earlier menarche. The catch-up growth was, however, incomplete, and lower the initial height for age, lower was the height for age at the succeeding measurements, and the final height. The mean final height was 154 cm, but 8% of the girls were 145 cm or shorter. The data suggest that linear growth and final height is influenced by the preadoptive nutritional condition, as well as by the degree and timing of subsequent catch-up growth, and the timing of puberty. Pubertal onset is related to the degree and timing of catch-up growth.     

Does handedness and altitude affect age at menarche?

Although there is knowledge about earlier mean age at menopause among left-handed postmenopausal women, it is unclear from the literature whether age of menarche is influenced by the prenatal hormonal pattern and cerebral lateralization. We therefore planned to investigate the relation between age of menarche and cerebral lateralization in girls at an altitude of nearly 2000 m. Sixty-two girls, aged between 9.4 and 15.5 years, were interviewed by questionnaire about manual dominance and menarcheal age. All girls were divided into two groups: left-handers (n = 31) and right-handers (n = 31). It was shown that there was a significantly lower average age of menarcheal appearance (12.96 +/- 1.34 years) in the left-handers' compared with the right-handers' (13.72 +/- 1.41 years; p = 0.025). The earliest menarcheal age was 9.4 years in left-handers and 10.1 years in right-handers.A menarcheal age of 13.34 +/- 1.35 years was found for the whole group at an altitude of nearly 2000 m. This data leads us to believe the existence of a link between functional brain asymmetry and menarche. It would appear that the activation of the hypothalamic-pituitary-gonadal axis is earlier in left-handed females than in right-handed females.     

北京市儿童青少年女性青春期性征发育流行病学研究

摘要 目的：了解北京市6~18岁学龄女生青春期第二性征发育现状,以及人群性早熟发生率。方法：利用2004年北京市儿童代谢综合征调查（BCAMS）总样本中9 778名6~18岁中小学女生的青春期发育数据，用概率单位回归法计算月经初潮、乳房、阴毛不同发育时期的中位年龄。8岁前乳房或阴毛发育达Tanner II 期（B2,P2），或10岁前月经初潮者被定义为性早熟。结果：9 778名6~18岁中小学女生中城市人口5 040人，占总样本51.5%。北京市学龄女生月经初潮年龄平均为 （12.1±1.1）岁，城市女生（11.9±1.1）岁，农村女生（12.5±1.1）岁；女性第二性征开始发育年龄（总体/城市/农村）分别为，乳房：（9.5±1.2）岁/（9.3±1.1）岁/(9.6±1.2）岁；阴毛:(11.1±1.1）岁/(10.8±1.1）岁/(11.4±1.1）岁。城市女生月经初潮、乳房和阴毛发育均显著早于农村女生。月经初潮早发生率为0.79%，城市高于农村（1.03%：0.55%；x2=6.93，P<0.01）；乳房、阴毛早发育率分别为2.91%和0.22%。1962~1982年期间，北京女生月经初潮年龄平均每10年提前0.7岁（8.4个月）；近10年平均提前0.43岁（5.2个月）。结论：北京市城区女生青春期第二性征发育明显早于郊区县女生。月经初潮年龄提前的长期变化趋势依然存在，但近10年这一趋势趋于减缓。     

Timing and secular trend of pubertal development in Beijing girls

Background

Historical research is limited in changes in pubertal development in Chinese girls. We aimed to identify the timing of pubertal characteristics and the secular trend of menarche age among Beijing girls from the 1980s through the 2000s.

Methods

Six data sets were analyzed, including the Beijing Child and Adolescent Metabolic Syndrome study in 2004, where 9778 Bejing girls aged 6–18 years were studied. The Fetal Origins of Adult Disease study provided retrospective menarche age from 1940 through 1960. Other four studies were conducted in Beijing to obtain supplementary information to assess secular trend in menarche age. Linear regression method was used to analyze the data.

Results

Among Beijing girls in 2004, the median age at menarche was 12.1 years, which was 0.6 years earlier in urban than in rural areas. The median age at Breast Tanner Stage 2 was 9.5±1.2 years, representing 9.4±1.1 years and 9.6±1.2 years for urban and rural girls, respectively. In contrast, the median age at Pubic Hair Tanner Stage 2 was 11.1±1.1 years, representing 10.8±1.1 and 11.4±1.1 years for urban and rural girls, respectively. The menarche age of urban girls decreased by 4.2 months per decade, and that of rural girls by 9.6 months per decade from 1980 to 2004.

Conclusions

Urban girls mature earlier than rural girls in Beijing. A secular trend towards earlier menarche was observed between the 1980s and the 2000s.     

Age at menarche and body mass index: a population study

OBJECTIVE: To test the hypothesis that age at menarche is inversely related to body mass index (BMI). POPULATION AND METHODS: A questionnaire was filled in by 11,293 young women at the time of discharge from compulsory military service, in order to determine the self-reported age at onset of menarche. The participants were weighed and measured and BMI was calculated. Obesity was defined as BMI >30 and leanness as BMI <20. RESULTS: The age at menarche was significantly and inversely correlated with BMI (R = -0.11, p <0.001). The age at menarche of obese women (12.9+/-1.3 years) was significantly lower than that of non-obese, non-lean women (13.3+/-1.4 years), who themselves had a lower age at menarche than lean women (13.5+/-1.4 years) (p <0.001). CONCLUSIONS: We conclude from our data that the relationship between BMI and pubertal development in girls appears to be a continuum.     

Height and weight at menarche and a hypothesis of menarche

Height and weight at menarche were estimated by interpolation of longitudinal growth data for 181 girls. Mean weight at menarche, about 48 kg, does not change as menarcheal age increases, whereas mean height increases significantly. Early and late menarcheal girls gain the same amount of height, about 22 cm, and the same amount of weight, about 17 kg, in the interval from the initiation of the adolescent spurt to menarche, though late maturers grow at slower rates during the spurt, including the year of menarche. A hypothesis of a direct relation between a critical weight and menarche is proposed. Such an interaction would explain the delaying effect of malnutrition on menarche and the secular trend to an earlier menarche.     

Age at menarche and place of residence (Marrakesh,Morocco)

Purpose

The aim of the study was to determine the age at menarche of Moroccan girls by place of residence (rural vs. urban).

Pubertal maturation in girls treated for childhood acute leukaemia

Eleven girlds treated during childhood for acute leukaemia were followed up during their pubertal development. At each examination weight, height, pubertal stage, FSH, LH, oestradiol, testosterone, androstenedione and dehydroepiandrosterone sulphate levels were evaluated. Clinical and endocrinological studies were performed according to age and pubertal stage and compared to those of healthy girls matched for age and pubertal stage. Results showed that pubertal maturation and gonadal function were not affected by oncotherapy; however menarche was attained earlier. Early menarche was explained by the overweight of treated girls during early puberty. No evidence of early hypothalamic activation was found, but endocrine patterns showed a faster hypothalamopituitary-ovarian axis maturation in patients than controls. Cranial irradiation showed no correlation with pubertal onset and age at which menarche was attained. Adolescent menstrual and endocrine patterns were normal.     

Interpreting the continued decline in the average age at menarche: results from two nationally representative surveys of U.S. girls studied 10 years apart

OBJECTIVES: To determine whether average age at menarche declined in the United States during the past decade, and whether associations between menarcheal timing, weight status, and race/ethnicity changed. STUDY DESIGN: Relative weight, race/ethnicity, and menarcheal status of girls (n = 1577) in the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) were compared with those of girls (n = 1720) in NHANES 1999-2002. Probit analysis estimated average age at menarche overall and also by race/ethnicity. Logistic regression assessed associations of relative weight and race/ethnicity with menarcheal status. RESULTS: In the United States, average age at menarche declined from 12.53 years (95% confidence interval [CI] = 12.43 to 12.63 years) in 1988-1994 to 12.34 years (95% CI = 12.24 to 12.45 years) in 1999-2002. By race/ethnicity, average age at menarche estimates were as follows: non-Hispanic whites, 12.57 years (95% CI = 12.45 to 12.69 years) and 12.52 years (95% CI = 12.38 to 12.67 years); non-Hispanic blacks, 12.09 years (95% CI = 11.82 to 12.36 years) and 12.06 years (95% CI = 11.81 to 12.32 years); and Mexican Americans, 12.24 years (95% CI = 11.88 to 12.59 years) and 12.09 years (95% CI = 11.81 to 12.37 years). Higher relative weight was consistently associated with increased likelihood of having reached menarche. CONCLUSIONS: Average age at menarche in the United States declined by 2.3 months between 1988-1994 and 1999-2002; by race/ethnicity, declines were considerably smaller. Changes in the population distribution of race/ethnicity and relative weight should be considered when interpreting trends in age at menarche.     

Age of puberty in a representative sample of Iranian girls

Background  To obtain normal references for growth and pubertal development in a given population, assessment of pubertal stages is of great importance. This study aimed to determine the age of appearance of secondary sexual characteristics in a representative sample of Iranian girls. Methods  This cross-sectional study was conducted during 2005–2006 in 3192 girl students, aged 6–17 years, in Isfahan, Iran. Participants were selected by multistage random cluster sampling from school students. Secondary sexual characteristics were evaluated by inspection and palpation, and were recorded according to Tanner staging. The self-reported date of menarche (if any) was recorded as well. Data were analyzed with Probit analysis based on the status quo method. Results  The median ages (10th–90th percentile) of Tanner stage 2 breast development (B2) and Tanner stage 2 pubic hair growth (PH2) were 10.14 years (8.33–11.95 years) and 10.78 years (9.09–12.48 years), respectively. The ages of the 3rd percentile for B2 and PH2 were 7.48 and 8.29 years, respectively. The median age of menarche among the 3192 girls who had experienced menarche was 12.65 years (11.18–14.11 years). Conclusions  The median age of puberty onset is 10.14 years, and the onset of puberty before 7.5 years is considered as precocious puberty in a representative sample of Iranian girls. The values obtained from the present study can provide baseline data for analysis of time trends, as well as for international comparisons.     

A mixed-longitudinal study on the pattern of pubertal growth: relationship to socioeconomic status and caloric-intake--IV

The pubertal growth pattern was observed on 791 girls belonging to upper and low SES. These girls ranged between 7-16 years. The effect of calorie intake on the pubertal growth was also ascertained. The development of breast was first to appear at the age of 8.25 years. It was followed by pubic and axillary hair development. The mean age of menarche was 12 years and 12.8 years for USES and LSES, respectively. The onset of menarche, breast and pubic hair was significantly delayed in LSES girls by 0.8 years. Menarche was found to correlate better with breast development than pubic or axillary hair. The girls on adequate calories showed early onset of breast, pubic hair and axillary hair development and of menarche. Similarly, these girls attained mature stage (adult) of these variables earlier compared to those who were on inadequate calories. However, intermittent developmental stages of pubic hair and axillary hair showed no consistency with intake of calories. The girls on inadequate calories showed approximately one year late onset of breast and pubic hair development. The present observations suggest that the onset of puberty is strongly influenced by environment but its attainment is under the genetical control.     

Disturbed Pubertal Growth in Girls after Acute Leukaemia: a Relative Growth Hormone Insufficiency with Late Presentation

Long-term follow-up of growth and development after acute lymphoblastic leukaemia (ALL) in childhood has previously been limited to the prepubertal period. This study describes pubertal growth, final height and the spontaneous secretion of GH in girls treated for ALL, including CNS irradiation with 24 Gy. Ten girls, treated earlier for ALL, experienced the menarche at a mean age of 12.2 years. This is significantly earlier than the mean for Swedish girls. Prepubertal growth was near normal after the end of therapy for leukaemia. Mean final height was -1.7 SD, which is 1.5 SD less than at onset and 1.0 SD less than 1 year after the end of treatment. Thirteen other girls had a blunted spontaneous secretion of GH, several years after treatment for ALL: there was no increase in GH secretion during puberty. These results suggest that girls who have been treated for ALL, including CNS irradiation, have a relative GH insufficiency. This insufficiency becomes obvious only when the girls cannot respond to the increased need for GH during the pubertal spurt.     

Relationships between age of puberty onset and height at age 18 years in girls and boys

Background

Changes during puberty may influence final adult height. Height is related to multiple health conditions, including lung function. We investigated the association between the age of onset of five puberty events and height at age 18 years, analyzing boys and girls separately.

Methods

Of 1456 children recruited into the Isle of Wight birth cohort (1989–1990), 1313 were followed up at age 18 years. Height was measured, and age of pubertal onset was collected at age 18 years. Cluster analysis was performed on the five puberty events in boys and girls and linear regression was applied with the clusters predicting height at age 18 years. Individual linear regression analyses assessed the age of onset of each pubertal event as a potential predictor for height at age 18 years.

Results

Of the 1313 children followed up at age 18 years, 653 were males and 660 were females. All puberty variables had high internal consistency. In girls, earlier age of menarche, breast development, and growth spurt were related to shorter height. In boys, earlier age of growth spurt and slower progression through puberty were related to taller height at age 18 years.

Conclusions

Given that boys and girls may have opposing associations between pubertal timing and adult height and that height is an important predictor of lung function, the effect of pubertal timing on respiratory health should be explored.     

Pubertal development in The Netherlands 1965-1997

We investigated pubertal development of 4019 boys and 3562 girls >8 y of age participating in a cross-sectional survey in The Netherlands and compared the results with those of two previous surveys. Reference curves for all pubertal stages were constructed. The 50th percentile of Tanner breast stage 2 was 10.7 y, and 50% of the boys had reached a testicular volume of 4 mL at 11.5 y of age. Median age at menarche was 13.15 y. The median age at which the various stages of pubertal development were observed has stabilized since 1980. The increase of the age at stage G2 between 1965 and 1997 is probably owing to different interpretations of its definition. The current age limits for the definition of precocious are close to the third percentile of these references. A high agreement was found between the pubic hair stages and stages of pubertal (genital and breast) development, but slightly more in boys than in girls. Menarcheal age was dependent on height, weight, and body mass index. At a given age tall or heavy girls have a higher probability of having menarche compared with short or thin girls. A body weight exceeding 60 kg (+1 SDS), or a body mass index of >20 (+1 SDS), has no or little effect on the chance of having menarche, whereas for height such a ceiling effect was not observed. In conclusion, in The Netherlands the age at onset of puberty or menarche has stabilized since 1980. Height, weight, and body mass index have a strong influence on the chance of menarche.     

Pubertal maturation in girls and the relationship to anthropometric changes: pathways through puberty

OBJECTIVE: Patterns of pubertal maturation may have an impact on several risk factors associated with adult morbidity and mortality, such as obesity. We examined the relationship of the initial manifestation of puberty in girls with anthropometric measures, as well as age at menarche. METHODS: White females (n = 1166, ages 9 and 10 at intake) were followed with annual visits for 10 years. Physical examinations included height, weight, skinfold thicknesses, and pubertal maturation assessment. RESULTS: During the course of the study, 443 of 859 eligible females (51.6%) were observed to have asynchronous maturation in the development of puberty, that is, initial areolar/breast (thelarche pathway) or pubic hair (adrenarche pathway) development, without development of the other characteristic. Using a longitudinal regression model, significant interactions were noted between initial pubertal manifestation and years since onset of puberty on the following outcomes: sum of skinfolds thickness, percent body fat, waist-to-hip ratio, and body mass index (BMI). However, age of onset of pubertal maturation was the same in the 2 groups (10.7 years). Females in the thelarche pathway had earlier menarche (12.6 vs 13.1 years) as well as greater skinfolds, body fat, and BMI at the time of menarche. Females in the thelarche pathway also had greater body fat and BMI 1 year before puberty and throughout puberty compared with those in the adrenarche pathway. CONCLUSIONS: Females who enter puberty through the thelarche pathway, as compared with the adrenarche pathway, had greater sum of skinfold thicknesses, BMI, and percent body fat 1 year before the onset, as well as throughout, puberty. Because larger body composition and earlier age of menarche of females in the thelarche pathway parallel the epidemiologic profiles of women who are obese or at risk for obesity, these females may be at greater risk for adult obesity.     

Pubertal Characteristics in Girls of Qazvin Province,Iran

Objective

Puberty is a critical time between childhood and adulthood. Many studies have reported that the mean age of breast development is decreasing. The aim of this study was to provide updated data on the pubertal development of girls and to evaluate precocious puberty in our population.

Methods

This cross sectional study was conducted in 6 to 16 year old school girls during 2009-2010 in Qazvin. 2240 healthy girls from all geographical regions with every socioeconomic status were selected by a stratified multistage cluster design to obtain representative sample of population. A questionnaire including demographic data, anthropometric measurements, secondary sexual characteristics, menarche status and its onset was filled out for every participant. Secondary sexual characteristics including breast development (B_1–5) and pubic hair (PH_1–5) were evaluated according to Marshal and Tanner recommendation.

Findings

The mean±SD of height, weight, and BMI of participants was 139.7±14.5, 36.1±12.9 and 17.9±3.7 respectively. The mean age (10th – 90th percentile) of B₂ and PH₂ were 9.71(7.67–11.4) and 9.82 years (7.84–11.42) respectively. Mean age of menstruation was 12.52 years. The mean BMI was significantly higher in pubertal females comparing to prepubertal girls (P<0.001). Average duration of puberty (the time from initiation of puberty to menarche) was 2.81 years.

Conclusion

The mean age of pubertal onset in girls living in Qazvin is 9.71 years. Menarche occurs at mean age of 12.52 and onset of puberty earlier than 6.24 years will be precocious. We found that girls in Qazvin had a slightly earlier age of initiation of puberty and of menarche in comparison with other studies in Iran.