Study on age of menarche between generations and the factors associated with it

Intergenerational transitions in age at menarche: insights from Chandauli district, Uttar Pradesh, India

BACKGROUND

Menarche, a milestone in a woman's reproductive journey, is influenced by various factors such as lifestyle and dietary habits. Recent studies have corroborated this claim and prompted further investigation. This study explores the connection between menarche timing with lifestyle and dietary habits among three generations of women from the Sakaldiha block of Chandauli district and presents valuable insights into the role of diet and lifestyle in this crucial reproductive event.

METHODS

The study is based on primary data collected using multistage stratified random sampling. A comparative analysis of the mean age at menarche across independent variables has been conducted using the one-way analysis of variance (ANOVA) technique. Additionally, a multiple regression model has been developed to investigate the association between menarcheal age and various dietary, lifestyle and socio-economic factors among 400 respondents.

RESULTS

The average age of menarche for respondents was 14.29 years (95% CI: 14.12, 14.45), which has decreased by 1.66 years from 14.89 years (95% CI: 14.63, 15.15) in women over 40 years of age to 13.23 years (95% CI: 12.97, 13.49) in the < 20 years age group. The study additionally found that dietary and lifestyle factors had an impact on the age of menarche, with those who regularly consumed junk food, occasionally ate meat/fish or eggs, completely avoided curd or buttermilk and engaged in non-resting leisure activities experiencing an earlier onset of menarche.

CONCLUSION

The study shows that diet and lifestyle affect age at menarche, with current generations experiencing an earlier onset of menstruation. The effect of socioeconomic status remains inconclusive.

Current trend of sexual maturity, teeth eruption, and bone fusion in the present female population, relative to documented age and development of prediction model for age of females

Background

Understanding sexual maturity and bone fusion is crucial in forensic investigations and legal contexts. This study investigates the contemporary trend of sexual maturity and bone fusion in females, comparing the observed age-related characteristics with documented ages. Such analyses contribute to the accuracy of age estimation methods used in medico-legal scenarios.

Methods

A comprehensive study was conducted involving a diverse sample of females, and their sexual maturity and bone fusion were assessed relative to documented ages. The research utilized a cross-sectional design, collecting data through interviews, medical examinations, and radiographic imaging. Ethical approval was obtained, and participants provided informed consent. Variables included documented age, age of menarche, stages of sexual maturity, dentition, and bone fusion. Validation of model performance was conducted.

Results

Among 70 cases studied, the mean age of menarche was 10.48 years (range: 7-12 years). Maternal reports indicated menarche onset between 12-17 years. Tanner's Staging 5 for pubic hair and fully developed breasts occurred at 14 years. Permanent teeth increased with age, with 28 or more teeth present at age 14 or above. Fusion of the distal end of the Radius and Ulna with the parent bone was positive from 15 years onwards. The regression model predicted age accurately (97.99% fit).

Conclusion

The results highlight the early onset of sexual maturation, consistent teeth eruption, and bone fusion patterns in females. The observed correlations offer valuable insights for medicolegal practitioners and forensic experts.

A study of association between early menarche and anxiety in undergraduate students

Background

Anxiety has been reported to be one of the most common epidemics in recent years. The present study focused on understanding the association between early menarche and the prevalence of anxiety and anxiety symptoms among adult undergraduate students.

Methods

This was an observational, case-control study. The sample included 146 young female adults aged more than or equal to 18 years pursuing the Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Sciences (BDS). Using an online questionnaire, participants were asked to recall and enter the age at which they attained menarche. We used the Generalized Anxiety Disorder 7- Item Questionnaire (GAD-7) to measure the severity of their present anxiety symptoms.

Results

The results showed a significant increase in anxiety symptoms in participants who had early menarche compared to those who did not have early menarche. The mean score on the GAD-7 Questionnaire for the cases was 9.93 and the control group was 6.89. The GAD-7 scores among the cases group were significantly higher in the GAD-7 scores than in the control group.

Conclusions

This study concluded that early menarche is associated with higher anxiety levels in young adults.

Menstrual health and hygiene amongst adolescent girls and women of reproductive age: a study of practices and predictors, Odisha, India

BACKGROUND

Menstruation is a major physiological change in a woman's life, but lack of knowledge, poor practices, socio-cultural barriers, poor access to products and their improper disposal have significant consequences on health, dignity and well-being of women and adolescent girls.

OBJECTIVES

This study aimed to assess the knowledge and practices related to menstrual health and hygiene amongst females of 10-49 years of age; explore the experiences and challenges of women during menstruation; and identify the key predictors of healthy menstrual health and hygiene.

METHODS

Using a cross-sectional study design, we adopted a mixed methods approach for data collection. For quantitative household survey, a total of 921 respondents were selected from three districts of Odisha. Qualitative findings through focus group discussions and in-depth interviews supplemented the survey findings and helped to identify the barriers affecting good menstrual practices. Epi data version 2.5 and R 4.2.2 was used for data entry and data analysis, respectively. Descriptive statistics was used to calculate proportion, mean and standard deviation; Chi square test was used to measure the association between categorical variables. Bivariate and multivariate logistics analyses were done to identify predictors of healthy menstrual health and hygiene. For qualitative data analysis, thematic analysis approach was adopted using software Atlas.ti 8.

RESULTS

For 74.3% respondents, mothers were the primary source of information; about 61% respondents were using sanitary pad. The mean age at menarche was 12.9 years and almost 46% of respondents did not receive any information about menstruation before menarche. Lower age and education up to higher secondary level or above had statistically significant associations with the knowledge about menstruation. Age, caste, respondent's education, mother's education, sanitation facility, availability of water, accessibility and affordability for sanitary pads were found to be strongly associated with good menstrual hygiene practices.

CONCLUSION

Traditional beliefs regarding menstruation still persists at the community level. Educating mothers, increasing awareness about safe menstrual hygiene, providing adequate water and sanitation facilities and ensuring proper disposal of menstruation products need priority attention.

Mental health and well-being of women (menarche, perinatal, and menopause)

Mental well-being is now an increasingly researched and discussed topic that primarily involves taking care of mental health in a preventive manner and is more of a subjective concept. Mental well-being ensures mental health and measures taken toward it can protect the person's overall health. Discussing and researching this concept is of paramount importance as this will not just safeguard an individual life but the society at large. The lifetime of a woman is multidimensionally unique with a complex interplay of biological, sociocultural, and environmental aspects. This demands a diverse variety of factors required to ensure mental well-being in a woman. In addition to this, these determinants vary on the life stage the woman is in. Factors that influence this well-being are also specific when it comes to an Indian context. This chapter considers and discusses in detail the various aspects of the mental health and well-being of women in the pubertal, perinatal, and menopausal age groups. Determinants are unique to particular age groups of women, and measures to focus on and ensure it will be elaborated on. Finally, recommendations towards policy making are also suggested.

A Prospective Study of the Age at Menarche in North Indian Girls, Its Association With the Tanner Stage, and the Secular Trend

Background Menarche is an important event in a female's reproductive health. However, the age at menarche is variable and has implications on the future health of the girl. The purpose of this study was to estimate the mean age at menarche of North Indian adolescent girls and its association with the Tanner stage and to study the trend of menarcheal age in India in the 21st century. Materials & methods A longitudinal descriptive study was conducted on 470 healthy girls aged nine to 16 years in expectant menarche (Tanner stage II). They were followed for six months to check for the attainment of menarche. Those who achieved menarche were grouped in Group I and the rest in Group II. The data were analyzed using the independent t-test. Results Menarche was achieved by 263 girls in the six-month follow-up period. The mean (SD) age of menarche was 13.13 (1.23) years. Group I girls were mostly in Tanner stage IV and above. Group II girls had a mean (SD) age of 11.53 (1.1) years and were mostly in Tanner stage III or below. The estimated decline in the age of menarche in the 21st century was about 0.41 years per decade. Conclusion The girls who achieved menarche had a significantly higher age and Tanner stage of sexual maturity than girls who did not achieve menarche in the study period. Tanner stage is a better measure to estimate the pubertal onset than age. The studies on the age of menarche in the current century reveal that the declining trend in the menarcheal age is continuing in India.

Early menarche in visually impaired girls: evidence and hypothesis of light-dark cycle disruption and blindness effect on puberty onset

Puberty onset is tightly regulated by a broad spectrum of neuroendocrine signals and peripheral stimuli which coordinate the hypothalamic-pituitary-gonadal (HPG) axis activation. Numerous studies suggest that light stimulation influences HPG axis function; however, the effect of blindness on puberty timing remains controversial. Given that menarche is a suitable marker for sexual development initiation, the evaluation of the age at which blind girls attain it allows to indirectly assess the effect of light-dark cycle disruption on pubertal development. The present investigation aimed to review the evidence regarding menarcheal age drift in visually impaired girls, as well as to discuss the findings based on the existing hypotheses of the physiological mechanisms linking the light-dark cycle and photic sensitivity loss to the onset of puberty. Eleven studies were retrieved from a literature search conducted in PubMed, Scopus, ScienceDirect, SpringerLink, and Google Scholar databases. Eight studies concluded that light perception impairment is related to a moderately earlier age at menarche. Moreover, the evidence gathered in this review suggests a positive association between the degree of light perception loss and precocious menarcheal onset; yet, no conclusive outcomes were found regarding menarche advancement in acquired versus congenital blindness. We encourage further research aiming to elucidate the physiological mechanism underlying photosensitive regulation and blindness effect on the neuroendocrine pathways involved in human sexual maturation.