A study of the factors affecting the receding age of onset of menarche in young girls

Noor Dharmarha, Anuradha Konda


Background: Present study highlights that the worldwide trend of declining age at menarche is also seen in urban Indian girls. The aim of the study was to evaluate the age of menarche and to find out the factors associated with the timing of menarche.

Methods: The study was an observational cross sectional study. 258 healthy, menstruating, adolescent girls aged 10-16 years, were selected by simple random sampling. Pre-designed structured questionnaires were distributed after taking informed consent. Anthropometric measurements were taken using standard techniques. The average age of menarche was calculated. The association of the age at menarche with the proposed factors was analyzed using chi square test and Pearson’s correlation coefficient. “P value” less than 0.05 was considered as significant.

Results: The mean age at menarche was found to be 12.23±1.09 years. The study found a strong association between the respondent’s age at menarche and her sister’s age at menarche (p=0.002). The study also found a strong association between age at menarche and the socioeconomic status (p=0.021). This study however found no association of menarcheal age with factors like birth weight, type of diet, frequency of milk intake, body mass index, waist hip ratio, amount of exercise, unstable environment at home and psychosocial stress.

Conclusions: The worldwide trend of declining age at menarche is also seen in urban Indian girls. This trend underlines the importance of investigating the factors associated with it and studying the future implications of a lower age at menarche.


Adolescent gynaecology, Early menarche, Menarche, Puberty

Full Text:



Steingraber S. The falling age of puberty in US girls: what we know, what we need to know. 2007. Breast Cancer Fund: San Francisco;2011:72.

Delemarre-van de Waal HA. Secular trend of timing of puberty. In Abnormalities in Puberty. 2005;8:1-14.

Belsky J, Steinberg L, Draper P. Childhood experience, interpersonal development, and reproductive strategy: An evolutionary theory of socialization. Child Dev. 1991;62(4):647-70.

Sharma R. Kuppuswamy’s Socioeconomic Status Scale–revision for 2011 and formula for real-time updating. Indian J Pediatr. 2012;79(7):961-2.

Barba C, Cavalli-Sforza T, Cutter J, Darnton-Hill I. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157.

World Health Organization. Waist circumference and waist-hip ratio: Report of a WHO expert consultation, Geneva; 2008.

Frisancho AR. Anthropometric standards for the assessment of growth and nutritional status. University of Michigan Press; 1990.

Mane KS, Sharankumar H, Bheemayya B. Age At Menarche and Factors Associated among Girls of a Primary Health Centre Area in Davangere, India. Community Med. 2016;7(5):417-20.

Iyer P, Modi JN. Menstrual cycle characteristics and associated physical problems among school going adolescent girls. Int J Reprod, Contracep, Obstet Gynecol. 2017;4(4):1076-8.

Sinha S, Srivastava JP, Sachan B, Singh RB. A study of menstrual pattern and prevalence of dysmenorrhea during menstruation among school going adolescent girls in Lucknow district, Uttar Pradesh, India. Int J Comm Med Public Health. 2017;3(5):1200-3.

Noipayak P, Rawdaree P, Supawattanabodee B, Manusirivitthaya S. Factors associated with early age at menarche among Thai adolescents in Bangkok: A cross-sectional study. BMC women's health. 2017;17(1):16.

Mpora BO, Piloya T, Awor S, Ngwiri T, Laigong P, Mworozi EA, Hochberg ZE. Age at menarche in relation to nutritional status and critical life events among rural and urban secondary school girls in post-conflict Northern Uganda. BMC women's health. 2014;14(1):66.

Anderson SE, Must A. Interpreting the continued decline in the average age at menarche: results from two nationally representative surveys of US girls studied 10 years apart. J Pediatr. 2005;147(6):753-60.

Ulijaszek SJ, Evans E, Miller DS. Age at menarche of European, Afro-Caribbean and Indo-Pakistani schoolgirls living in London. Annals Human Biol. 1991;18(2):167-75.

Lakshman R, Forouhi NG, Sharp SJ, Luben R, Bingham SA, Khaw KT, Wareham NJ, Ong KK. Early age at menarche associated with cardiovascular disease and mortality. J Clin Endocrinol Metab. 2009;94(12):4953-60.

Chevalley T, Bonjour JP, Ferrari S, Rizzoli R. The influence of pubertal timing on bone mass acquisition: a predetermined trajectory detectable five years before menarche. J Clin Endocrinol Metab. 2009;94(9):3424-31.

Gerdhem P, Obrant KJ. Bone mineral density in old age: the influence of age at menarche and menopause. J Bone Mineral Metabolism. 2004;22(4):372-5.

Dunger DB, Ahmed ML, Ong KK. Effects of obesity on growth and puberty. Best Pract Res Clin Endocrinol Metab. 2005;19(3):375-90.

Gluckman PD, Hanson MA. Evolution, development and timing of puberty. Trends Endocrinol Metab. 2006;17(1):7-12.

Graber JA, Brooks-Gunn J, Warren MP. The antecedents of menarcheal age: Heredity, family environment, and stressful life events. Child Development. 1995:346-59.

Meyer JM, Eaves LJ, Heath AC, Martin NG. Estimating genetic influences on the age‐at‐menarche: a survival analysis approach. Am J Med Genetics. 1991;39(2):148-54.

Towne B, Czerwinski SA, Demerath EW, Blangero J, Roche AF, Siervogel RM. Heritability of age at menarche in girls from the Fels Longitudinal Study. Am J Physical Anthropol. 2005;128(1):210-9.

Susman EJ, Dorn LD. Its role in development. handbook of adolescent psychology. Individual Bases Adoles Dev. 2009;1:116.

Yermachenko A, Dvornyk V. Nongenetic determinants of age at menarche: a systematic review. BioMed Res Int. 2014:23;2014.

Dvornyk V. Genetics of age at menarche: a systematic review. Human Reprod Update. 2012:dmr050.

Raveendran RC, Jacob AM, Ismail J. Does birth weight influence the age of menarche? A cross sectional study in rural Kerala. JEMDS. 2017;6(1):10-3

Castilho SD, Nucci LB. Age at menarche in schoolgirls with and without excess weight. Jornal de Pediatria (Versão em Português). 2015;91(1):75-80.

Günther AL, Karaolis-Danckert N, Kroke A, Remer T, Buyken AE. Dietary protein intake throughout childhood is associated with the timing of puberty. J Nutri. 2010;140(3):565-71.

Carwile JL, Willett WC, Wang M, Rich-Edwards J, Frazier AL, Michels KB. Milk consumption after age 9 years does not predict age at menarche. J Nutri. 2015;145(8):1900-8.

Hoppe C, Mølgaard C, Juul A, Michaelsen KF. High intakes of skimmed milk, but not meat, increase serum IGF-I and IGFBP-3 in eight-year-old boys. Eur J Clin Nutri. 2004;58(9):1211-6.

Chevalley T, Rizzoli R, Hans D, Ferrari S, Bonjour JP. Interaction between calcium intake and menarcheal age on bone mass gain: an eight-year follow-up study from prepuberty to postmenarche. J Clini Endocrinol Metab. 2005;90(1):44-51.

Rao S, Joshi S, Kanade A. Height velocity, body fat and menarcheal age of Indian girls. Indian Pediatr 1998;35:619-28.

XiaoYan GU, ChengYe JI. Earlier menarche can be an indicator of more body fat: study of sexual development and waist circumference in Chinese girls. Biomed Environment Sci. 2011;24(5):451-8.

He Q, Karlberg J. BMI in childhood and its association with height gain, timing of puberty, and final height. Pediatric Res. 2001;49(2):244-51.

Lassek WD, Gaulin SJ. Brief communication: menarche is related to fat distribution. Am J Phys Anthropol. 2007;133(4):1147-51.

Grumbach MM, Styne DM. Puberty: ontogeny, neuroendocrinology, physiology, and disorders. Williams Textbook Endocrinol. 1998;9:1509-625.

Meulenijzer E, Vyncke K, Labayen I, Meirhaeghe A, Béghin L, Breidenassel C, et al. Associations of early life and sociodemographic factors with menarcheal age in European adolescents. Eur J Pediatr. 2015;174(2):271-8.

Ellis BJ, Garber J. Psychosocial antecedents of variation in girls' pubertal timing: maternal depression, stepfather presence, and marital and family stress. Child Dev. 2000;71(2):485-501.

Jorm AF, Christensen H, Rodgers B, Jacomb PA, Easteal S. Association of adverse childhood experiences, age of menarche, and adult reproductive behavior: does the androgen receptor gene play a role?. Am J Med Genetics Part B: Neuropsychiatric Genetics. 2004;125(1):105-11.

Boynton-Jarrett R, Harville EW. A prospective study of childhood social hardships and age at menarche. Annal Epidemol. 2012;22(10):731-7.