Trends in Menarcheal Age between 1955 and 2009 in the Netherlands

Aim

To assess and compare the secular trend in age at menarche in Dutch girls (1955–2009) and girls from Turkish and Moroccan descent living in the Netherlands (1997–2009).

Methods

Data on growth and maturation were collected in 20,867 children of Dutch, Turkish and Moroccan descent in 2009 by trained health care professionals. Girls, 9 years and older, of Dutch (n = 2138), Turkish (n = 282), and Moroccan (n = 295) descent were asked whether they had experienced their first period. We compared median menarcheal age in 2009 with data from the previous Dutch Nationwide Growth Studies in 1955, 1965, 1980 and 1997. Age specific body mass index (BMI) z-scores were calculated to assess differences in BMI between pre- and postmenarcheal girls in different age groups.

Results

Median age at menarche in Dutch girls, decreased significantly from 13.66 years in 1955 to 13.15 years in 1997 and 13.05 years in 2009. Compared to Dutch girls there is a larger decrease in median age of menarche in girls of Turkish and Moroccan descent between 1997 and 2009. In Turkish girls age at menarche decreased from 12.80 to 12.50 years and in Moroccan girls from 12.90 to 12.60 years. Thirty-three percent of Turkish girls younger than 12 years start menstruating in primary school. BMI-SDS is significantly higher in postmenarcheal girls than in premenarcheal girls irrespective of age.

Conclusion

There is a continuing secular trend in earlier age at menarche in Dutch girls. An even faster decrease in age at menarche is observed in girls of Turkish and Moroccan descent in the Netherlands.     

Menarcheals age and socio-economical factors in Marrakech (Morocco)

Data on the menarcheal age was collected from a sample of 749 girls, aged between 11 and 17 years of age, drawn from the population of Marrakech (Morocco). The mean age at menarche calculated for the entire sample was of 14.26 year of age (SD=1.20). Once having grouped the girls according to the different environmental factors, we calculated the mean menarcheal age for earch group. Comparisons of these means show that only the family size and the number of sibling have an effect on the age at menarche.     

The variation in age at menarche: an indicator of historic developmental tempo

Ample literature describes the history of the association between the advances in the health and wealth of people, and mortality rates, life expectancy and adult height. Twenty-nine German studies with n > 200 subjects published since 1848 on menarcheal age, were reanalyzed, and 101 studies from various other European and non-European countries. On average, mean age at menarche declined since the mid-19th century. Historic urban samples tended to decline earlier than rural groups, upper class women earlier than working class women. In Germany, minimum values for the age at menarche were seen already between the two World Wars (Leipzig 12.6 years in 1934, Halle 13.3 years in 1939). Values for mean age and SD for age at menarche were strongly associated. With improving historic circumstances, the two parameters declined in parallel. The standard deviation for menarcheal age dropped from over 2.5 years in mid-19" century France to little more or even less than 1 year in most modern countries. In the German studies the correlation between menarcheal age and SD was almost complete with r = 0.96 (y = 0.35x - 3.53). Similar associations between mean age at menarche and SD for age were found in other European countries. The obvious and immediate effects of historic events on menarcheal age, and particularly on the age distribution, indicate that menarche is a sensitive indicator of public health and wealth, and may be an appropriate estimator for the socio-economic background of historic populations.     

Age at menarche among the Bhotias of Mana Valley

The mean menarcheal age of the Bhotia girls of Mana Valley (Uttar Pradesh) has been found to be 16.38 +/- 1.53 years, which is the highest value so far reported from Indian populations. It is observed that altitude and nutritional status have a great bearing on the onset of menarche. The results obtained are compared with those from other Indian populations.     

新疆伊犁六个民族的初潮年龄

1983年7月至1984年7月,用回忆法调查了新疆伊犁地区3972名12—23岁的女性的初潮年龄,其中哈萨克族924人,维吾尔族864人,锡伯族486人,回族209人,蒙古族216人,汉族1273人。其平均初潮年龄是:哈萨克族14.37±1.09岁,维吾尔族14.34±1.41岁,蒙古族14.21±1.05岁,回族13.89±1.32岁,锡伯族13.78±1.02岁,汉族13.61±1.11岁。各族中均以七、八、九三个月来月经的最多。此外,还发现六个民族中1969—1972年出生的与1961—1964年出生的相比,平均初潮年龄都明显提前。在八年中,回族提前2.67岁,蒙古族提前1.90岁,锡伯族提前1.78岁,汉族提前1.64岁,哈萨克族提前1.17岁,维吾尔族提前1.13岁。     

Secular Trends in Menarcheal Age in India-Evidence from the Indian Human Development Survey

Background

Evidence from a number of countries in Europe and North America point towards the secular declining trend in menarcheal age with considerable spatial variations over the past two centuries. Similar trends were reported in several developing countries from Asia, Africa and Latin America. However, data corroborating any secular trend in the menarcheal age of the Indian population remained sparse and inadequately verified.

Methods

We examined secular trends, regional heterogeneity and association of socioeconomic, anthropometric and contextual factors with menarcheal age among ever-married women (15–49 years) in India. Using the pseudo cohort data approach, we fit multiple linear regression models to estimate secular trends in menarcheal age of 91394 ever-married women using the Indian Human Development Survey.

Results

The mean age at menarche among Indian women was 13.76 years (95 % CI: 13.75, 13.77) in 2005. It declined by three months from 13.83 years (95% CI: 13.81, 13.85) among women born prior to 1955–1964, to nearly 13.62 years (95% CI: 13.58, 13.67) among women born during late 1985–1989. However, these aggregate national figures mask extensive spatial heterogeneity as mean age at menarche varied from 15.0 years in Himachal Pradesh during 1955–1964 (95% CI: 14.89–15.11) to about 12.1 years in Assam (95% CI: 11.63–12.56) during 1985–1989.

Conclusion

The regression analysis established a reduction of nearly one month per decade, suggesting a secular decline in age at menarche among Indian women. Notably, the menarcheal age was significantly associated with the area of residence, geographic region, linguistic groups, educational attainment, wealth status, caste and religious affiliations among Indian women.     

Season of birth and recalled age at menarche.

All 8th-form schoolgirls from the municipality of Odense in Denmark were asked at what age they reached menarche, and 886 girls (97.6%) gave this information. There is no evidence for seasonality in the time of birth but for far more girls than expected menarche occurred during winter or summer and fewer than expected during spring and autumn. This pattern appears primarily in girls living in the suburbs and was not seen in those living in central Odense. The seasonality appears to be brought about by differences in mean age at menarche according to time of the year at birth.     

Results of long-term studies of the development of children in Goerlitz in the last 3 decades

The author reports on the results of investigations concerning the development of 15173 girls born in G?rlitz between 1944 and 1973. With regard to maturation a significant tendency toward deceleration has been observed. Late menarche is increasing, while early menarche is decreasing. Seasonal influences on the development are discussed. September born girls, for example, are characteristic for a high menarcheal age, those born in December for a low menarcheal age. Furthermore one can assume some relations between the month of birth and the birthweight.     

Secular trend in age at menarche in China: a case study of two rural counties in Anhui Province.

There is increasing evidence that age at menarche has decreased in Europe and the United States during the last century and in Japan over the last several decades. Data from a community-based survey conducted in two rural counties of Anhui Province in China indicate a similar, downward secular trend in age at menarche for Chinese women. The present study shows the mean age at menarche decreased by 2.8 years, from 16.5 to 13.7, over an approximate 40-year time interval. This rapid decrease in age at menarche may partly be due to better nutrition and living standards reflected by the improved socioeconomic standards experienced in China over the past few decades. To test this hypothesis, a number of determinants of age at menarche were assessed; year of birth, literacy status, county of residence, amount of physical labour, general health status, pesticide exposure before age at menarche, and drinking water source were all found to be associated with age at menarche.     

Intake of Dairy Products,Calcium, Magnesium,and Phosphorus in Childhood and Age at Menarche in the Tehran Lipid and Glucose Study

Purpose

Studies indicate that milk intake is associated with insulin-like growth factor 1 (IGF-1) concentrations and height in childhood, whether milk and other dairy products promote puberty remains unclear. This study aimed to investigate influences of pre-pubertal intakes of milk, yogurt and cheese on menarcheal age in Tehranian girls. The associations of total dietary calcium (Ca), magnesium (Mg), and phosphorus (P) with menarcheal age were also examined.

Methods

This prospective study was conducted on 134 pre-pubertal girls, aged 4-12 years at baseline, who participated in the Tehran Lipid and Glucose Study (TLGS), and were followed for a median of 6.5 years. Dietary intakes were determined at initiation of the study using two non-consecutive 24-h dietary recalls and the age of menarche was documented during the follow-up. Logistic regression was used to calculate the risk of reaching menarche ≤ 12 years according to pre-pubertal levels of dairy or mineral intakes.

Results

The risk of earlier menarche was higher in girls with higher intakes of milk [OR: 2.28 (95% CI: 1.03–5.05)], Ca [OR: 3.20 (95%CI: 1.39–7.42)], Mg [OR: 2.43 (95% CI: 1.12–5.27)] and P [OR: 3.37 (95 % CI: 1.44–7.87) after controlling for energy and protein intake, interval between the age at study initiation and the age of menarche, and maternal age at menarche (Model 1). Girls in the middle tertile of cheese intakes had a lower risk of reaching menarche ≤ 12 years than those in the lowest tertile after controlling for covariates in model 1. These associations remained significant after further adjustment of BMI Z-score at baseline. The relationship of Ca, Mg, and P with menarche remained after further adjustment for height Z-score at baseline, whereas the association between milk and cheese intakes became non-significant.

Conclusions

Pre-pubertal intake of milk, but not cheese and yogurt, may hasten age at menarche.     

Detecting menarcheal status through dental mineralization stages?

Menarche is an indicator frequently used to study variation in growth, development, and related health conditions among members of living populations. As a life event, menarche is often associated with changes in an individual's social identity. The reproductive lifespan, which for females starts with menarche, is a paramount feature of palaeodemographic studies. Determination of menarche status from the skeletal remains of individuals of past populations can be obtained by assessing the developmental status of the iliac crest, as well as the hand and wrist bones, which are, unlike teeth, often poorly recovered in bioarchaeological contexts. The present study seeks to evaluate the link between dental mineralization and menarche in a population of known menarche status. The relationship between permanent teeth mineralization and menarche status was investigated by using data of developing permanent teeth (167 radiographs) rated in accordance with the well‐known standards of Demirjian et al. and Moorrees et al. collected among 73 living French females of known menarcheal status. Using correlation ratios, GLMM and CART algorithm, menarcheal status is correlated with mineralization of the premolars. Menarcheal status is predicted correctly for 92 and 77% of radiographs of the learning and validation samples, respectively. Although promising, the results require caution prior to generalization to other populations. The age of menarche in this particular sample may simply coincide with the development of the premolars in this particular sample. Therefore, further investigation applied to populations with various mean ages of menarche is required in order to provide new evidence of variation in human growth and development from the correspondence between the mineralization of the permanent teeth and menarche.     

Age of the menarche of girls in Thessaloniki, Greece

In 1982-1983 a total of 977 girls from Thessaloniki has been investigated for their menarcheal ages, using the retrospective and the status quo methods. 565 of these girls aged between 11 and 18.5 years (age classes 1964-1972) were found to menstruate. The mean menarcheal age amounts to 12.0 years. The results are compared with corresponding data from literature. They confirm a clear secular trend for the menarcheal age in Greek population.     

Age at menarche in Iceland

The purpose of this study was to elucidate the mean age at menarche in Icelandic girls and compare it with results from other Scandinavian populations as well as in other ethnic groups. The study was performed during the school year 1972-1973 on a cross-sectional sample of 682 girls (aged 8.5 to over 17 years), constituting 9.5% of the girls from the third to eleventh forms in all the primary and secondary schools of Reykjavik. The mean age at menarche in Iceland, elicited by the status quo method, proved to be 13.06 +/- 0.10 years (S.D. 1.17 years). According to the information given by the girls (recall method), the earliest time of menstruation was 9.83 years and the latest 15.17 years, at which age all but one of the girls were menstruating.     

Menarcheal age in medio-altitude sample. Comparison with another populations of same province. Cuenca (Spain)

Environmental contributions to variation on menarcheal age were studied in 2018 Spanish girls and women from de Province of Cuenca. (Spain). This province has a big variation in altitude and is one of the most representative as middle-altitude population in Spain. Maturation's delay in high populations is well referenced but there are less studies in European middle-altitude populations. To give news about this topic is the main objective of this paper. Retrospective Method was employed in adult sample and Status-Quo in young population (9 to 15 years old) Another social, nutritional, somatic and educational levels was recording to give a variation contest. Our study shows a significantly variation between the provincial areas. In effect, the population of “Sierra”, the mountain region has the last maturation in the adults (13.45±0.73) as well as in girls (13.26±1.07). Secular change was observed in relation with this parameter., but less intense that in total, of province. We can confirm the utility of the age of menarche as evaluator of human variation in time and ecological situations.     

The maturation rate of girls living in rich and poor rural regions of Poland before and after the transformation of 1989.

The aim of this study was to find out whether the political and economic system transformation in Poland in 1989 had an influence on the rate of maturation of girls from various categories of the rural population in two regions, differing in wealth. The stratification of the villagers was based on the source of the family income (farmers, farmer-workers and non-farmers), on parents' education, and on the number of children per family. The age at menarche (AM) was used as biological indicator of living conditions. Rural girls aged 9.5-18.5 years were studied in 1987 in Leszno (L), a rich region (n = 2049), and in 1989 in Suwa?ki (S), a poor region (n = 2077). The study was repeated in 2001 in the same villages, the numbers of subjects amounting to 2440 and 2122, respectively. In the 1980s, AM in regions L and S amounted to 13.18 and 13.88 years, respectively, and was strongly related to social stratification. The earliest AM was found in daughters of non-farmers and the latest in the girls from farmers' families. In 2001, the acceleration in AM amounted to 0.14 years in the rich region and to 0.46 years in the poor region. The percentage of families owning a car, freezer, colour TV and automatic washing machine markedly increased and the education of parents improved. Such results are indicative of an improvement in the living standard of the groups investigated, but the villagers regard themselves as the losers as a result of the system transformation in Poland. Since the Polish population is considered as ethnically homogenous, the great differences in AM within the rural population, as well as the differences between the inhabitants of villages and large cities should be regarded as biological effects of social inequalities. Such differences indicate that Polish rural girls are far below the genetic potential for menarcheal age.     

Correlates and predictors of the age of menarche

In a cross-sectional study of 452 girls between 10 and 16 years of age 36 indices of physical and 50 of mental development were tested for their correlation with age at menarche and chronological age, as well as for their predictive power for estimating menarche by multiple regression analysis. Indices of physical maturity and body weight when adjusted for chronological age showed the highest partial correlation coefficients with age at menarche. Among mental characters which show lower intercorrelations with menarche occurred the highest correlation coefficients for a handmotor factor "Spurennachzeichnen" and a factor "Gruppenabh?ngigkeit" (which indicates a type of social motivation). In general physical and mental factors correlate higher with chronological age than with age at menarche. By multiple regression analysis we determined 14 physical and 25 mental predictors explaining 21% and 17% respectively of the variance of age at menarche. The error of the estimate predicting menarche on body weight without knowledge of onset of menarche is +/- 1 year. Using chronological age in a sample of girls before menarche the error of the estimate only is +/- 6 months. To compare the predictive power of chronological age combined with body weight or with skeletal age the time interval is calculated within which 95% of girls attain menarche. The range of prediction extends from 4.3 to 1 year on chronological age (11-16 years); using mean body weight it can be improved by 1.8 to 6 months, while using mean skeletal age an improvement of 0.2 to 3.9 months is possible compared with body weight. The correlations between age at menarche and physical and mental variables are attributed to a common hormonal influence on rate of development.     

Secular trend of menarcheal age in southern Chinese girls.

Southern Chinese girls aged 11 years and 9 months to 12 years and 3 months in Hong Kong have a mean menarcheal age of 11.50 years (standard deviation of 0.47) using the recollection method. Highly significant differences are found when compared to the 12-year-old girls in Hong Kong studied in the past decades. Therefore, a secular trend of earlier menarcheal age is demonstrated.     

Formula feeding in infancy is associated with adolescent body fat and earlier menarche.

The tempo, level of growth and maturation during adolescence may have important implications to future adult health. The purpose of the study was to examine factors associated with menarche. Three hundred and forty girls, 9 to 14 years old, were selected from all age eligible girls at Kaiser Permanente Oahu (Honolulu). Girls' age, ethnicity, menstrual status and feeding pattern during infancy were obtained by questionnaire. The mean age of girls was 11.5 +/- 1.4 yr and the mean age at menarche among 112 (33%) girls who had reached menarche was 11.6 +/- 1.1 yr. In logistic regression, achievement of menarche was positively explained by age, Asian ethnicity and formula feeding during infancy. In simple linear regression, higher body mass index (BMI) and subcutaneous fat were also positively associated with formula feeding during infancy. The study suggests that girls who were formula fed deposit more body fat than girls who were breast-fed, resulting in early attainment of menarche.     

Recent data about age at menarche in the biscay province (Basque Country, Spain)

Data on menarcheal age were collected by thestatus quo method on a sample of 808 schoolgirls (8–19 years of age), from the Margen Izquierda area of the Biscay province (Basque Country). Probit analysis provided a mean age at menarche of 12.5±0.05 years with a standard deviation of 1.0 years. The result was compared with data from other previous Basque studies and related to age at PHV of the same sample.     

Changes in age at menarche in Spain (1909–1965)

The data used in this work have been collected from clinical histories of women who have been examined at the Ginecology and Obstetritian Service of the Santa cruz y San Pablo Hospital of Barcelona. The sample consisted of 12,803 Spanish women, born between 1909 and 1965, by regions of birth. The method used is retrospective. The maximum menarcheal age in Spain (13.91±0.049 years) is found among those women born between 1925 and 1929 and the minimum menarcheal age (12.92±0.036 years) among women born between 1955 and 1959; so in an interval of 30 years, a reduction of almost a year (11.88 months) has taken place in age at first menstruation. This means a reduction of almost four months per decade. These differences are significant (p=.0000). The higher menarcheal age appears in the Northern Zone, due to the influence of Galicia in the sample (Galicia being a depressed zone with a great emigration rate). The earliest menarcheal age appears in the Mediterranean Zone due to the great percentage of catalan women (Catalonia being a region with a higher socioeconomical level). It is also to be observed that although the menarcheal age has decreased in all the zones, it has done so more dramatically in those zones which had higher values at the beginning. Although the secular trend of reduction in the age at menarche varies greatly from region to region, it may be considered that, in general, the socieconomic conditions have been the decisive factor in the change in physical maturation of Spanish women.