Menarche among Brazilian women: memories of experiences

Objective

to present women's experiences of menarche and related memories.

Design

qualitative study using focus groups for data collection.

Setting

the city of Campinas, São Paulo state, Brazil.

Participants

64 women aged 21-51 years, experiencing menstrual periods, with former or current sexual activity and no perceived infertility.

Methods

eight focus groups were carried out using a semi-structured guideline. Discussions were recorded with participants’ consent, and transcribed and revised. Thematic content analysis was carried out using gender relations as the theoretical framework.

Findings

menarche was experienced as a passage from childhood to womanhood, associated with belonging to a new group and acquiring a new status in the family. The experiences of menarche were not always welcomed or expected, but were recalled as associated with body changes and awareness of sexual issues. The mother's behaviour and attitudes towards menarche were clearly seen as generators of strong and everlasting impressions, either in a positive or negative way. Memories related to the experience of menarche extended through their life, interfering with their relation with their own body, including their reproductive health.

Key conclusions

the way in which menarche is experienced may exert an impact on women's reproductive health, sexuality and lifestyle behaviours.

Implications for practice

the acknowledgement of menarche experiences can be useful to guide health-care providers towards more effective education of girls on sexual and reproductive health issues and better attention to women's needs.     

Ovarian function and obesity—Interrelationship,impact on women's reproductive lifespan and treatment options

Insulin resistance (IR) is a consequence of obesity, and in women it is often inextricably linked with ovarian function leading to clinical reproductive manifestations such as early menarche onset, subfertility and polycystic ovary syndrome (PCOS). Likewise, the dramatic fall in oestrogen production after menopause may contribute to weight gain and changes in adipose tissue distribution. Overall, women who are obese, especially those with reproductive complications including PCOS, have been identified as specific high risk subgroups for further progression through to prediabetes, type 2 diabetes mellitus (T2DM) and potentially cardiovascular disease (CVD). This review focuses on the interrelationship between the ovarian function and obesity as well as its treatment strategies.     

Does Competence Mediate the Associations Between Puberty and Internalizing or Externalizing Problems in Adolescent Girls?

Purpose

To examine separate mediational models linking (a) menarcheal status or (b) pubertal timing to internalizing and externalizing problems through competence.

Method

This study involved cross-sectional analyses of 262 adolescent girls (age: 11–17 years; mean = 14.93, standard deviation = 2.17) enrolled in a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health. Measures of menarcheal status (pre/post), pubertal timing (early, on-time, or late), internalizing and externalizing behavior, and perceived competence (parent and adolescent report) were obtained. Structural equation modeling was used for analyses.

Results

Perceived competence was found to fully mediate the association between menarcheal status and parent report of internalizing and externalizing problems. For adolescent report, there was a full mediation effect for internalizing problems but a partial mediation effect for externalizing problems. Being menarcheal was related to lower competence, which was in turn related to higher internalizing and externalizing problems. Models including pubertal timing were not significant.

Conclusions

Perceived competence is important in understanding the associations between menarcheal status and internalizing and externalizing problems. Interventions targeting competence, particularly in postmenarcheal girls, may reduce or prevent problem behaviors.     

Knowledge and information on psychological, physiological and gynaecological problems among adolescent schoolgirls of eastern India

Background

Sex education aims to reduce the risks of potentially negative outcome from sexual behavior such as fear and stigma of menstruation, unwanted and unplanned pregnancies and sexually transmitted infections including HIV. Hence, this study was conducted to determine sex education knowledge level of school going adolescents in semi urban area of Midnapore, West Bengal, India.

Methods

A cross-sectional study was conducted in two selected premier secondary school of girls in the Midnapore Town from September - October 2007. A total of 521 adolescent aged 10–19 years were selected randomly from two secondary schools of girls. However, schools were selected purposively. All information was collected by using open-ended pre-tested questionnaire.

Results

Of the total subjects 94.2% of them were in the age of 13–16 years. Nearly, 94% respondents reported their age at menarche and maximum i.e. 54% respondents experienced in the age of 11 – 13 years. It was observed that 18%, 60.7% and 21.3% of the respondents had good knowledge, moderate or some knowledge and very poor knowledge of puberty, pubertal problems and their prevention. Thirty three percent said that they had faced one or some other kind of physical problems and out of them 60% indicated that they had visited to a doctor for their problems. The suffering of any gynecological problems had 2.48 (95% CI: 1.42 – 4.36) and 1.94 (95% CI: 1.01 – 3.73) times greater among subjects with little or some knowledge and minimum or no knowledge compare to subjects with good knowledge of sex education.

Conclusion

Thus, the results show that not only knowledge regarding sex education was poor among the subjects but also their knowledge regarding sexual infections including AIDS was not satisfactory. School based sex education programs are particularly good at providing information, skills development and attitude clarification in more formal way through lesson within the curriculum. Therefore, appropriate sex education program should be initiated from the adolescence to prevent health hazards.     

中国9～18岁少数民族女生月经初潮与形态发育关系研究

目的了解我国9~18岁少数民族女生月经初潮年龄及与形态发育之间的关系,为研究少数民族女生生长发育规律和开展青春期教育提供依据。方法利用2005年全国学生体质健康调研数据,对蒙、回、壮、朝鲜族9~18岁女生的月经初潮年龄、身高、体重、胸围和BM I等指标进行比较和统计检验。结果 2005年蒙、回、壮和朝鲜族女生月经初潮年龄分别为12.78,13.28,12.71,12.35岁。18岁组蒙、回、壮和朝鲜族女生身高分别为159.0,159.0,155.1和157.5 cm,体重分别为54.7,53.3,47.6和52.3 kg,胸围分别为78.7,78.8,75.7和79.4 cm。11~14岁已来潮女生形态发育情况要好于未来潮女生(P值均<0.01)。结论朝鲜族女生月经初潮年龄早于蒙、回、壮族,蒙古族和回族女生成年身高较高,月经初潮与形态发育关系密切。     

无锡市中学女生月经初潮年龄落后情况及其影响因素分析

目的了解无锡市女中学生初潮年龄落后情况及相关影响因素,为采取干预措施和健康教育提供理论依据。方法整群抽取无锡市4 978名初一到初三女生,对其进行月经初潮情况、家庭环境及负性生活事件调查。将初潮年龄≥14岁定义为初潮年龄落后,排除器质性病变,检出142名初潮年龄落后女生;按照1∶2配对设立对照组。结果中学女生初潮年龄落后检出率为6.1%。初潮年龄落后组与对照组在负性生活事件中差异无统计学意义,家庭环境因素中除情感表达两组间差异有统计学意义外,其他差异均无统计学意义。结论家庭环境因素及负性生活事件对初潮年龄落后女生无影响。