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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.

Background: There is a strong evidence showing that women who start menstruation early are at a greater risk of developing breast cancer. Recognizing that women will seek breast cancer screening when they have a high perceived risk, we hypothesized that women who experienced early menarche will be more likely to utilize clinical breast examination (CBE). Hence, we aimed to investigate the association between age at first menstruation and women's utilization of CBE in Côte d'Ivoire. Methods: We used data from the 2021 Côte d'Ivoire demographic and health survey. A sample of 14,685 women was used for the analysis. A descriptive analysis, as well as bivariate and multivariate logistic regression models were computed in STATA version 18. Adjusted odds ratio (AOR) and a 95% confidence interval was used to present the result. Results: CBE utilization was 17.4%. Women who had their first menstruation before attaining 15 years were significantly less likely to utilize CBE services [AOR = 0.89; 95% CI 0.81–0.99]. A significantly higher utilization of CBE was found among those with primary [AOR = 1.48, 95% CI 1.29–1.70], secondary [AOR = 2.96, 95% CI 2.59–3.38], and higher education [AOR = 4.35, 95% CI 3.50–5.40] compared to those with no formal education. Increasing likelihood of CBE utilization was observed as age increased. Rural residence was associated with lower odds of CBE utilization (AOR = 0.84, 95% CI 0.74–0.95]. Increasing wealth status was associated with higher odds of CBE utilization with those in the richest households having the highest odds compared to women in the poorest household [AOR = 2.11, 95% CI 1.69–2.64]. Conclusion: Utilization of CBE is low among women of reproductive age in Côte d'Ivoire. We conclude that even though existing literature has established early age at first menstruation as a strong risk factor for breast cancer, CBE utilization is significantly low among those who had early menarche. Going forward, it is necessary for Côte d'Ivoire's health Ministry to intensify breast cancer awareness in the country. Such awareness campaigns must emphasize age at menarche as a risk factor so as to motivate women with a history of early menstruation to utilize CBE. [ABSTRACT FROM AUTHOR]

Precocious exits from adolescence via early union formation are often argued to represent a strong risk factor for intimate partner violence (IPV) victimization. However, causal evidence for this claim is scant. This study examines the impact of teen union formation (before age 18) on experiences of IPV in Brazil and Colombia, where early family transitions are common and levels of interpersonal violence are high. Using data that allow instrumenting for teen union formation with age at menarche, results show that both Brazilian and Colombian women who start a co‐residential union before age 18 have a higher probability of experiencing psychological violence from partners. Early cohabitation is also linked to greater risk of past‐year sexual abuse among Black/Brown Brazilian women, and lifetime sexual IPV in Colombia, including among women who partnered once. Among testable potential pathways, age‐heterogamy (male partner being older) explains part of the results, but lower educational attainment among early cohabiting women emerges as a key driver in both countries. Education remains a powerful policy tool to confront both forms of gender‐based violence in South America. [ABSTRACT FROM AUTHOR]

Background: In Ethiopia, many young girls face numerous challenges in managing their menstruation. However, community-based studies on the use of menstrual sanitary pads and associated factors are limited. Therefore, this community-based study aimed to identify factors associated with utilization of menstrual sanitary pads among young girls in a rural setting. Methods: A community-based cross-sectional study was conducted in June 2018 among youths aged 15?24 years in the rural eastern zone of the Tigray region, northern Ethiopia. This study included 330 girls aged 15?24 years who had started menses. Binary logistic regression analysis was performed to identify the determinants of menstrual sanitary pad utilization. Results: In this study, 82.4% (95% CI 78.3?86.1%) of the girls utilized menstrual sanitary pads. The remaining (17.6%) used nothing or unhygienic homemade sanitary pads to maintain their menstrual hygiene. Being single (AOR?=?2.89; 95% CI 1.21?6.87), being Afar ethnicity (AOR?=?0.18; 95% CI 0.05?0.72), had road access to marketplace (AOR?=?2.46; 95% CI 1.28?4.71), and receiving pre-menarcheal information on menstruation (AOR?=?2.86; 95% CI 1.34?6.08) were the independent predictors of menstrual sanitary pad utilization. Conclusions: Our study revealed that a significant number (17.6%) of young girls used nothing or unhygienic homemade sanitary pads to maintain their menstrual hygiene. Provision of information on menstruation during the pre-menarcheal period in young girls could improve their utilization of menstrual sanitary pads. Therefore, young girls should receive appropriate information about menstruation early before menarche through formal and informal means of communication. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions The trend in declining age at menarche (AAM) largely continues while body size increases globally. The aim was to investigate trends in AAM, menstrual characteristics, and post‐menarcheal anthropometric parameters in adolescents living in an urban area in Türkiye between 1999 and 2018.Female adolescent high school students in the Manisa region were asked about menarche and socioeconomic status (SES). There were 1017 girls in the first study (1999–2001) and 1304 (2016–2018) in the second study. Height and weight were measured. Body mass index (BMI) was calculated. Adolescent girls were grouped into three socioeconomic status (SES) groups based on parental education and occupation, and all parameters were evaluated using SES.The mean ± standard deviation for AAM in the first period was 12.82 ± 1.07 years and 12.83 ± 0.9 years in the second. AAM did not differ between the two periods nor between SES groups in either period. Post‐menarcheal height, weight, and BMI increased in the second period compared to the first study and across all SES groups (p < 0.05). The whole group AAM was similar in both periods, only 3 months earlier in the second period than in the first period. However, the AAM in girls with a post‐menarcheal BMI indicating being overweight or obese was significantly earlier than that of those with a normal post‐menarcheal BMI in both periods (p < 0.05).Despite changing sociodemographic characteristics and an increasing trend in height, weight, and BMI in all socioeconomic groups, no change was observed in mean AAM in an urban region of Western Türkiye over 18 years. While the inverse relationship between BMI and postmenarcheal BMI continued in both periods, the decline in AAM became more pronounced over the years in the presence of high postmenarcheal BMI. [ABSTRACT FROM AUTHOR]

Menarche, the first event in a woman's reproductive phase, It occurs between the age of 9-16 years. This would differ with physical, hereditary and cultural base of an individual. The dietary customs emphasize the consumption of specific foods to support the hormonal balance, encourage regular menstruation and improve general well-being and the menarche has been celebrated through various cultural practices. The aim of the study is to compile the information of dietary customs and cultural practices followed at the time of menarche and its importance Method: A 6-month study was conducted in 7 districts of Kerala, involving 70 female participants aged 30-80, who were surveyed using a self-structured questionnaire. Results: In this study, 63% of them informed about special diet during menarche. 14% of them informed about certain cultural practices. Conclusion: Without being aware of the nutritional value and health advantages, the people have followed the specific diet as a custom. This study suggests that intake of a traditional diet rich in essential nutrients is paramount. A wholesome nutritious diet and practices play a crucial role in sustaining hormonal balance and support the reproductive health. [ABSTRACT FROM AUTHOR]

Background: Associations between early‐life menstrual cycle characteristics (MCC) and gestational diabetes (GDM) remain unclear. Objectives: To evaluate associations between early‐life MCCs and GDM in first pregnancy, across pregnancies and its recurrence. Methods: This analysis included participants from a US‐based digital cohort enrolled between 11/2019 and 9/2023 who provided consent, completed relevant surveys, were without diabetes and aged ≥18 at first pregnancy (n = 30,473). Age at menarche [<11 (early), 11–15 (referent), ≥16 (late) years] and time from menarche to cycle regularity [<1 (referent), 1–2, 3–4, ≥5 years, not yet regular, regular after hormones] were self‐recalled at enrolment. Additionally, the last three categories were considered prolonged time‐to‐regularity (PTTR). GDM history was recalled at enrolment for each pregnancy. We restricted to pregnancies of ≥24 weeks with a live birth. We evaluated associations of early‐life MCCs with GDM at first pregnancy using modified Poisson regression, across pregnancies using cluster‐weighted Poisson generalised estimating equation and GDM recurrence using multinomial logistic regression, adjusted for sociodemographic, early‐life factors and age at pregnancy. Missing variables were imputed with multiple imputation by chained equations. Results: Among 30,473 participants, 20,591 had eligible first pregnancies, of which 5.9% reported GDM. In 17,512 participants with ≥2 pregnancies, 8.3% had GDM once and 3.7% had recurrent GDM. Early menarche (<11 years, vs. 11–15 years) was associated with GDM in first pregnancy (RR 1.34, 95% CI 1.15, 1.57), across pregnancies (RR 1.24, 95% CI 1.10, 1.39) and recurrence (OR 1.51, 95% CI 1.21, 1.89). PTTR was associated with GDM in the first pregnancy (RR 1.22, 95% CI 1.08, 1.38), across pregnancies (RR 1.16, 95% CI 1.05, 1.27) and recurrence (OR 1.19, 95% CI 0.99, 1.43). Conclusions: Earlier menarche and prolonged time‐to‐regularity are associated with higher risk of GDM and recurrence, suggesting menstrual characteristics during childhood/adolescence as potential early‐life markers for GDM. [ABSTRACT FROM AUTHOR]

Purpose: Metabolic syndrome (MetS) is the primary cardiovascular risk factor, making it a global issue. Our objective was to assess the association between the age at menarche (AAM) and MetS and its components in different generations of women. Methods: In this cross‐sectional study, 5500 eligible women aged ≥ 20 who participated in the Tehran lipid and glucose study in 2015–2017 were selected. Participants were divided into groups by birth cohorts (BC) (born ≤ 1959, 1960–1979, and ≥ 1980) and AAM (≤ 11, 12–15, and ≥ 16 years, early, normal, and late, respectively). The status of MetS and its components were compared amongst participants using logistic regression. Results: Normal AAM (12–15 years) was considered the reference group. The adjusted model revealed that AAM ≤ 11 is associated with a higher risk of 34% (95% confidence interval (CI): 1.04, 1.71) in MetS, and the prevalence of MetS in the early menarche group was higher in BCI, and BCII (odds ratio (OR): 1.87; 95% CI: 1.04, 3.36 and OR: 1.33; 95% CI: 1.00, 1.89, respectively). Those with late menarche demonstrated a lower risk (OR:0.72; 95% CI: 0.57, 0.91) of abdominal obesity, and early menarche showed a higher risk (OR: 1.45; CI: 1.14, 1.86). This higher risk in early menarche was observed in BCI and BCII (OR: 1.76; 95% CI: 1.16, 2.66 and OR: 1.80; 95% CI: 1.23, 2.64, respectively). However, the protective effect of late menarche was observed in BC II and BC III (OR: 0.74; 95% CI: 0.54, 1.00 and OR: 0.64; 95% CI: 0.44, 0.96, respectively). Conclusions: The influential effect of AAM on metabolic disturbances varies amongst different generations. [ABSTRACT FROM AUTHOR]

Background & Objective: The routine approach to fibroadenomas in the BI-RADS 3 category consists of follow-up at brief intervals and biopsy is usually forborne. Nevertheless, there is some evidence implying a link between this benign mass and breast cancer. The present study was performed with aim to investigate the accuracy of the Gail model for assessing the risk of breast malignancy in women suffering from fibroadenoma. Materials & Methods: This diagnostic accuracy study was conducted at the Surgery Clinic of Shahid Rahimi Hospital in Khorramabad, Iran, in 2020-2021. A total of 160 women aged >35 years who had a breast fibroadenoma in the BI-RADS 3 category were included. The Gail questionnaire was utilized to estimate the risk of developing breast cancer. The patients with a Gail score ≥1.67 underwent biopsy, while those with a Gail score of <1.67 were followed up for 3 months. Then, the baseline and follow-up findings of the patients were collected and compared. Results: The mean age of the patients was 40.87 ± 6.08 years. No cases of breast cancer were found in the low-risk group who were followed up or in the high-risk group who underwent biopsy. Higher age, a positive history of breast malignancy in first-degree family members, and a personal history of breast biopsy were significantly associated with a higher Gail score (P<0.001). Conclusion: For patients with fibroadenoma in BI-RADS 3 category, a high Gail score does not justify performing a breast biopsy. Therefore, follow-up in brief intervals is safe and invasive interventions should be avoided. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of this study was to assess the impact of various factors—such as age, age at menarche, age at first childbirth, number of births, body mass index (BMI), living environment (rural vs. urban), and other factors later discussed—on the likelihood of developing breast cancer. This article's original research was based on data gathered from 687 breast biopsies, which were analyzed through comparative analysis and regression analysis to identify possible predictors for malignancy and tumor size. The comparative analysis and regression models in this study provide deeper insights into the roles of various variables, particularly positive hormonal receptor status, in malignancy. Introduction: Breast cancer has become one of the most serious and widespread public health concerns globally, affecting an increasing number of women—and, in rare cases, men—across the world. It is the most common cancer among women across all countries. In this study, we aimed to evaluate the influence of demographic factors, medical and reproductive history, diagnostic techniques, and hormone receptor status on the development and progression of breast cancer. Materials and Methods: A total of 687 female patients from Romania underwent standard breast examination techniques, including clinical breast examination, mammography, ultrasonography, and, ultimately, breast biopsy. Statistical analysis was performed using the R programming language and RStudio software. The study included a comparative analysis and a prediction analysis for malignancy and tumor size (cumulative histological dimension) through logistic and linear regression models. Results: The comparative analysis identified several variables associated with malignancy: older age (p < 0.001), non-vulnerability (p = 0.04), no daily physical activity (p = 0.002), no re-biopsy (p < 0.001), immunohistochemistry use (p < 0.001), use of larger gauge needles (p < 0.001), ultrasound-guided biopsy (p < 0.001), and vacuum biopsy (p < 0.001). The hormone receptor statuses—estrogen receptor (ER), progesterone receptor (PR), and androgen receptor (AR)—showed statistically significant differences in distribution across breast cancer B classifications. Logistic regression analysis identified ER, PR, and age as significant predictors of malignancy. Linear regression analysis revealed histopathological results, living environment, geographical region, vulnerability, prior breast examination, and the number of histological fragments as significant predictors of cumulative histological dimension. Conclusions: Our predictive models demonstrate the impact of demographic factors, medical history, diagnostic techniques, and hormone receptor status on breast cancer development and progression, accounting for a significant portion of the variance in malignancy and cumulative histological dimension. [ABSTRACT FROM AUTHOR]

Introduction: Precocious puberty is defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. Central precocious puberty (CPP) is a rare condition that is diagnosed when premature activation of the hypothalamic-pituitary-gonadal axis is detected, in association with precocious breast development or testicular growth. Idiopathic CPP is historically considered to be the most common form, but in recent years defects in a small but growing number of genes regulating the timing of puberty have been identified in an increasing proportion of cases of CPP. Delta-like non-canonical Notch ligand 1 (DLK1) is understood to be one of the key genes involved in the etiology of CPP, although its mechanistic role is not yet fully understood. Case Presentation: We identified a novel de novo variant of DLK1 (c.835C>T; p.Gln279*) in an 8-year-old girl of Bangladeshi origin. She presented with an advanced Tanner staging of B4P4A2, significantly advanced bone age (BA, 13 years), a near-adult proportioned uterus, with a history of menarche at the age of 7.4 years. Diagnosis was confirmed by raised basal luteinizing hormone concentration. She was found to have truncal obesity associated with abnormal fasting insulin levels and mildly elevated cholesterol levels. These findings are consistent with previous literature describing an association between patients with DLK1 deficiency and an impaired metabolic profile. The patient was treated for 2 years with GnRH agonists with ongoing biochemical follow-up into adolescence. Conclusion: This case illustrates the susceptibility to metabolic derangement for patients with mutations in DLK1 and the need for ongoing monitoring after puberty. Our summary of previously identified DLK1 variants and their metabolic consequences demonstrates the frequency of obesity, lipid abnormalities, and insulin dysregulation in this patient cohort in childhood and beyond. This knowledge can guide future clinical practice for patients with CPP patients due to DLK1 deficiency. [ABSTRACT FROM AUTHOR]

Objective To analyze the co-morbidity of spinal curvature abnormality and myopia and the relevant factors in primary and middle school students in Guangzhou from 2019 to 2023, so as to provide references for the establishment of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of common diseases in students. Methods From September 2019 to 2023, used stratified random cluster sampling, 4 248, 4 230, 4 266, 25 476, 25 587 primary and middle school students were selected as subjects for spinal curvature abnormality and myopia screening and questionnaire survey. The SymbolcA@2test was used for comparing the group differences and univariate analysis. The multivariable logistic regression model was used to explore the influencing factors of their co-morbidity. Results the co-morbidity rates of spinal curvature abnormality and myopia were 2.96%-6.00% from 2019 to 2023 in primary and middle school students in Guangzhou. The differences in the co-morbidity rates among students of each phases of studying and the difference of the co-morbidity rate in primary and middle school students over the past 5 years were statistically significant (P＜0.05). Multivariate logistic regression analysis showed that low BMI junior and senior high school students (OR=1.72, 1.89, 95%CI: 1.11-2.67, 1.47-2.41) were more likely to suffer these two diseases. Primary school students in grades 4 to 6 who had menarche or spermatorrhea (OR=1.77, 95%CI: 1.04-3.02), screening time 2-＜3h or≥3h per day (OR=3.06, 2.28, 95%CI: 1.41-6.68, 1.02-5.19), outdoor activities time＜2h per day (OR=2.28, 95%CI: 1.22-4.26), junior high school students with low BMI (OR=1.72, 95%CI: 1.11-2.67), whose teacher "never or occasionally" reminded reading and writing posture (OR=1.50, 95%CI: 1.06-2.12), who were not strict with requiring standing and sitting posture themselves (OR=2.51, 1.99, 95%CI: 1.29-4.86, 1.06-3.74), senior high school students with low BMI (OR=1.89, 95%CI: 1.47-2.41) who had activities in the teaching building during recess (OR=1.33, 95%CI: 1.02-1.75), distance from chest to the edge of table "never or occasionally" more than 1 fist away during reading and writing (OR=1.27, 95%CI: 1.05-1.53) had a higher risk of spinal curvature abnormality and myopiaco-morbidity (P＜0.05). Conclusion The co-morbidity of spinal curvature abnormality and myopia was associated with daytime outdoor exercise and sedentary behavior with bad posture. Early screening and early treatment of spinal curvature abnormality and myopia should be strengthened among adolescent students, especially in urban, female and emaciated students. [ABSTRACT FROM AUTHOR]

Pubertal research has primarily focused on hypothalamic–pituitary–gonadal axis (HPG) regulation of puberty, though the hypothalamic–pituitary–adrenal axis (HPA) is increasingly considered critical. Heightened HPA function proxied by increasing cortisol levels may play a role in accelerated pubertal timing. However, the extent to which cortisol varies across ages and its relation to pubertal changes in linear growth are less well substantiated. We explored relationships between age, linear growth, adiposity, C‐peptide (proxy for insulin), and cortisol across puberty, and we tested whether higher cortisol levels are associated with earlier ages at menarche and peak height velocity. We utilize longitudinal data (n = 777 urine samples) from Qom females ages 7–14 (n = 46) and test our pre‐registered analysis using Bayesian longitudinal mixed effects models and joint modeling techniques. We find limited evidence supporting the overarching hypothesis that HPA upregulation is associated with pubertal maturation or timing. We find some evidence that HPA upregulation, as proxied by cortisol, may be more clearly related to differences in relative linear growth at early‐mid puberty, as measured by height‐for‐age z‐scores. Transdisciplinary perspectives on puberty, including the assumption that stressors acting via cortisol accelerate pubertal development, are discussed. [ABSTRACT FROM AUTHOR]

Mature ovarian dermoid cysts (ODCs) are the most common benign ovarian tumors diagnosed in children. However, there is minimal data on management of ODCs in premenarchal patients. This study assesses characteristics associated with expectant (EM) vs surgical (SM) management in premenarchal patients and the growth rate of ODCs in EM patients at a single institution. Forty-four premenarchal patients, either post-surgical with pathologically-confirmed ODC or having radiologic findings consistent with ODCs, were included. Data collected included demographics, cyst characteristics, imaging findings, presence of symptoms, surgical procedure performed, and ovarian torsion occurrence. Patient age at diagnosis was similar between groups (SM: 8.8 vs EM: 8.0, P =.55). At presentation, 36 patients (82%) underwent SM and 8 (18%) underwent EM. There was a significant difference in cyst size between groups (SM: 8.9 cm vs EM: 3.6 cm, P =.004). Of SM patients, 30% underwent oophorectomy vs cystectomy, with a significant difference in ODC size between procedures (11.8 cm vs 7.7 cm, P =.016). Of EM patients, 75% had at least one and 60% had three follow-up ultrasounds, with average follow-up timeframes of 3.7 and 27 months respectively. Average yearly ODC growth rate for the latter group was 0.8 cm. The average yearly growth rate of ODCs in premenarchal patients within our institution was slower than in older cohorts, and both age and cyst size played significant roles in determining surgical procedure. Continued study on EM in premenarchal ODCs will help define parameters for recommending SM vs EM in this population. [ABSTRACT FROM AUTHOR]

The abnormal timing of pubertal development is a risk factor for addictive disorders among adolescents. However, whether the precocious or late puberty has influence on addiction in adults remains unclear. Based on the data of 336,398 European participants in the UK Biobank, we explored the associations between secondary sexual characteristics (SSCs) outset time abnormality and addiction with observational analyses. Linkage disequilibrium score regression (LDSC) was conducted to test for the genetic correlation between them. For significant genetic associations, two-sample Mendelian randomization (MR) analyses were further performed for causal inferences. The genetic instruments were derived from genome-wide association studies of early menarche (N = 165,862), late first facial hair grows (N = 141,210) and late voice broke (N = 138,461). Observational analyses detected several significant associations between SSCs outset time abnormality and addiction, such as early menarche vs addiction to any substance or behavior (OR = 1.37, PFDR = 3.31 × 10−4) and late first facial hair grows vs alcohol addiction (OR = 1.24, PFDR = 2.40 × 10−15). MR analyses found genetically predicted early menarche was causally associated with higher risk of tobacco addiction (OR = 1.35, 95% CI: 1.15–1.58, PIVW = 0.0002) and addiction to any substance or behavior (OR = 1.39, 95% CI: 1.12–1.73, PIVW = 0.003). Our findings suggest the prevention and treatment for precocious puberty might be protective factors for addiction in female adults. Early preventive interventions for addictive behaviors are needed for females at high risk. [ABSTRACT FROM AUTHOR]

Background: The average age of menarche has decreased in both developed and developing countries over the past few years. Early menarche is associated with more of cardiovascular accidents and increased incidence for cancer. Objectives: To assess the multiple factors associated with the age of menarche. Methodology: It was a cross sectional study done for a period of two months among 100 adolescent girls in a junior college, Kurnool. Results: The mean age of menarche of study participants was 12.31 years. Lower age of menarche was found in girls who had higher BMI. It was observed in this study that girls with more of junk food intake and non veg intake had early menarche. Conclusion: The mean age of menarche in this region is comparable to many Indian states. The major determinant of age at menarche in this study was body mass index, dietary patterns. [ABSTRACT FROM AUTHOR]

Objectives: The study of puberty is a well‐established area of bioarcheological research, which greatly enhances our understanding of adolescence and growth in the past. Since the publications of Shapland and Lewis' works, which have become "standards" for estimating puberty in skeletal material, no additional osteological indicators of puberty have been proposed. Nevertheless, clinical practice constantly develops skeletal maturation markers that could be useful in bioarcheology. This study aims to assess the applicability and reliability of novel puberty indicators as a complementary tool to estimate puberty in skeletal remains. Materials and Methods: Four new maturation markers including spheno‐occipital synchondrosis, humeral head ossification, calcaneal apophysis ossification, and mandibular premolar mineralization were selected and applied to a sample of 85 adolescents from pre‐Roman southern Italy (Pontecagnano, 7th–4th BCE). Results: Despite some limits in adapting the original clinical methods to osteoarcheological material, the use of these novel skeletal indicators had moderate to excellent scoring repeatability and an overall high agreement with the puberty and menarche status previously estimated with standard methods. These results encourage us to apply these markers in bioarcheology. In some cases, minor adaptations of the original scoring systems are suggested to enhance reliability. Discussion: Including the proposed indicators in routine puberty data collection allows us to refine puberty estimation and improve the ability to identify key growth milestones in poorly preserved skeletons. Further application to osteological collections with diverse chronology and geographical differences is needed to assess how and to what extent the newly proposed maturation markers perform. [ABSTRACT FROM AUTHOR]

ABSTRACT: Aims: To study the pattern of physical growth and pubertal changes in adolescent girls with Systemic Lupus Erythematosus (SLE). Methods and Material: Weight, height, BMI, waist and hip circumference among 50 adolescent SLE girls (aged 8–17 years) were cross-sectionally studied using standardized techniques and instruments. Breast development stage, presence or absence of pubic and axillary hair and age of attainment of menarche were also noted. Results: With the advancement of age, weight and height of SLE girls increased but they were lighter and shorter compared to normal Indian peers. 18.4% of study girls were short-statured while only one participant was underweight. As per mid-parental height, 34.3% were predicted to have shorter final heights. BMI demonstrated an inconsistent trend with 12.3% and 9.2% being obese and overweight, respectively. Interestingly, 10.7% of SLE girls were at risk of metabolic syndrome (waist circumference >70th centile). About 50% of study girls had attained menarche (mean age: 13.04 ± 1.38 years). Appearance of pubic and axillary hair occurred around 1 year later than attainment of menarche. 33.80% of study subjects were in prepubertal stage of breast development and rest 66.20% were in advanced stages of breast development. SLE girls who had younger age at diagnosis and longer duration of therapy had significant delay in breast development and attainment of menarche. Conclusions: SLE girls show delayed growth and pubertal attainments compared to their normal Indian and Western counterparts. The data presented will provide an understanding of the auxological dynamics and pattern of pubertal changes among adolescent girls with SLE living in north-western India. [ABSTRACT FROM AUTHOR]

Background: One of the most commonly experienced symptoms of premenstrual disorder (PMD) is anxiety, and there is a notable rise in sympathomimetic activity in this patient group. Studies have linked fluctuations in systemic autonomic tone to electrocardiography (ECG) changes. This study aims to investigate the relationship between anxiety, a common symptom of PMD, and alterations in QT dispersion (QTd) and P‐wave dispersion (Pd) in adolescent females. Methods: This cross‐sectional study included female adolescents aged 12–18 with regular menstruation for at least 3 months. Participants completed the premenstrual syndrome scale (PMSS) and were divided into two groups, PMD and control, according to the PMSS score. A standard 12‐lead body surface ECG was performed and QTd and Pd values were determined in each participant. Results: Of the 43 participants, 27 were categorized into the PMD group, with a mean age of 15.15 ± 1.43 years. Age at menarche and menstrual cycle patterns were comparable between the PMD and control groups. Statistical analysis revealed significantly higher Pmin (p = 0.010) and Pd values (p < 0.001) in the PMD group compared to controls. A positive correlation between PMSS scores and Pd (p = 0.049) was also observed. Conclusions: Changes in atrial conduction and ventricular repolarization due to the pathophysiology of PMD may increase the risk of developing atrial and ventricular tachyarrhythmias over time. Screening patients with PMD using an ECG may be useful in identifying potentially at‐risk adolescents. [ABSTRACT FROM AUTHOR]

Background: While studies have explored various aspects of menstruation, an evident gap remains in the literature concerning the perspectives of young women and female health workers. By shedding light on this unexplored terrain, the study provides novel insights that can inform targeted interventions and foster a more inclusive understanding of menstrual health. As such, this investigation stands at the forefront of academic endeavour in menstrual health research, making an original and valuable impact in the field. Objectives: The objective of this study was to explore the experiences of reproductive-aged women during menstruation in Malawi. The specific objectives were to examine the experiences of reproductive-age women related to menstrual preparation, identify factors influencing the choice of menstrual products for women in Malawi, and identify the public health implications of menstrual products. Design: This cross-sectional study employed qualitative research methods to explore the acceptance and implementation of menstrual cups as a feminine hygienic product for women in Malawi. Methods: The study involved focus group discussions and interviews with reproductive-age women aged 18–54 years and health providers at Bwaila and Mitundu family clinics and Lighthouse HIV management centres. Thematic content analysis was performed using NVivo 12. Ethical approval was obtained from the College of Medicine Research and Ethics Committee (P.08/21/3379). Results: Education on menstruation is provided as early as 10 years before menarche by sisters, friends, mothers, aunties and grandmothers. Parents remain silent on menstrual issues. Commonly used menstrual products include disposable pads, cloths, reusable pads and cotton wool. While a few mentioned using tampons, pieces of blankets and flex foam, the majority demonstrated widespread ignorance about menstrual cups. Mentors or counsellors, affordability, accessibility, comfort and disposal issues influence women's choice of products being used. Conclusion: Parents need to break the silence on menstrual issues. Messages on menstruation and menstrual products are explicit in forming female adolescents what to expect with menarche, how to manage menses including health-related impacts, and ways of mitigating menses-related misconceptions, discrimination and stigma, and could be incorporated into the primary school curriculum. Safe menstrual products are accessible free of charge or at a subsidised cost. [ABSTRACT FROM AUTHOR]

Children born small for gestational age (SGA) may be at risk for earlier puberty and adverse long-term health sequelae. This study investigates associations between SGA and age at menarche using secondary data on 1,027 female children in a population-based U.S. birth cohort that over-sampled non-marital births, which in the U.S. is a policy-relevant population. SGA was defined as <10th percentile of weight for gestational age compared to the national U.S. distribution. We estimated unadjusted and adjusted Ordinary Least Squares (OLS) models of associations between SGA and age at menarche in years, as well as unadjusted and adjusted logistic regression models of associations between SGA and early menarche (before age 11). SGA was not significantly associated with earlier age at menarche, even when adjusting for maternal sociodemographic characteristics, prenatal smoking, and maternal pre-pregnancy overweight and obesity. Similarly, SGA was not significantly associated with the odds of menarche occurring before age 11. However, maternal non-Hispanic Black race-ethnicity, Hispanic ethnicity, and pre-pregnancy obesity all had independent associations with average earlier age at menarche and menarche before age 11. Thus, maternal risk factors appear to play more influential roles in determining pubertal development. [ABSTRACT FROM AUTHOR]

This Perspectives article reflects on findings from our systematic review about adolescent dysmenorrhoea Q, drawing on sociology of diagnosis theory. We consider tensions and uncertainties between presentation with symptoms of dysmenorrhoea and processes of symptom categorisation and diagnosis in adolescents, tracing these through research and clinical guidance, considering possible implications for clinical practice. We argue that challenges in distinguishing between primary and secondary dysmenorrhoea in research translate into challenges in differentiation in clinical practice. We argue that framing this distinction as clear cut and straightforward belies the well-documented challenges in diagnosis of endometriosis, and that not recognising uncertainty and complexity inherent in this task may benefit neither clinicians nor patients. [ABSTRACT FROM AUTHOR]

Background: Women are three times more likely to be diagnosed with thyroid cancer than men, with incidence rates per 100,000 in the United States of 20.2 for women and 7.4 for men. Several reproductive and hormonal factors have been proposed as possible contributors to thyroid cancer risk, including age at menarche, parity, age at menopause, oral contraceptive use, surgical menopause, and menopausal hormone therapy. Our study aimed to investigate potential reproductive/hormonal factors in a multiethnic population. Methods: Risk factors for thyroid cancer were evaluated among female participants (n = 118,344) of the Multiethnic Cohort Study. The cohort was linked to Surveillance, Epidemiology, and End Results cancer incidence and statewide death certificate files in Hawaii and California, with 373 incident papillary thyroid cancer cases identified. Exposures investigated include age at menarche, parity, first pregnancy outcome, birth control use, and menopausal status and type. Multivariable Cox proportional hazards models were used to obtain relative risk (RR) of papillary thyroid cancer and their 95% confidence intervals (CI). Covariates included age, race and ethnicity, reproductive history, body size, smoking, and alcohol consumption. Results: We observed a statistically significant increased risk of papillary thyroid cancer for oophorectomy (adjusted RR 1.58, 95% CI: 1.26, 1.99), hysterectomy (adjusted RR 1.65, 95% CI: 1.33, 2.04), and surgical menopause (adjusted RR 1.55, 95% CI: 1.22, 1.97), and decreased risk for first live birth at ≤20 years of age versus nulliparity (adjusted RR 0.66, 95% CI: 0.46, 0.93). These associations did not vary by race and ethnicity (p het > 0.44). Conclusion: The reproductive risk factors for papillary thyroid cancer reported in the literature were largely confirmed in all racial and ethnic groups in our multiethnic population, which validates uniform obstetric and gynecological practice. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue that shed light on the politics of age in sex and sexuality education in relation to four core areas.

The age of the onset of menstruation, termed menarche, has been declining for decades worldwide. Approximately 12% of Australian girls reach menarche between eight to 11 years of age. Current health and physical education subject guidelines from the Australian Curriculum Assessment and Reporting Authority state that puberty education should be introduced to students between year levels five to six (ages 10–12) when many have already begun puberty. To explore how girls experiencing early menarche are currently supported in Australian primary schools, semi-structured telephone interviews were conducted with 15 primary school staff from separate schools, including teachers, principals, a school services officer, and a school counsellor. Thematic analysis identified three main themes, (1) the prevalence of deficit models of early menarche and children's capacity to know; (2) gendered gatekeeping of menstruation knowledge; and (3) systemic barriers and inconsistencies in menstruation education. Our analysis complements but extends recent calls for improvements to menstruation education in Australian schools. Affirmative menstrual support practices and facilities are needed in primary schools to normalise and encourage conversations with students about menarche and menstruation irrespective of age, gender, class or culture. [ABSTRACT FROM AUTHOR]

Objective: In South Asia, studies show secular trends toward slightly later women's marriage and first reproduction. However, data on related biological and social events, such as menarche and age of coresidence with husband, are often missing from these analyses. We assessed generational trends in key life events marking the transition to womanhood in rural lowland Nepal. Methods: We used data on 110 co‐resident mother‐in‐law (MIL) and daughter‐in‐law (DIL) dyads. We used paired t‐tests and chi‐squared tests to evaluate generational trends in women's education, and mean age at menarche, marriage, cohabitation with husband, and first reproduction of MIL and DIL dyads. We examined norms held by MILs and DILs on a daughter's life opportunities. Results: On average, MIL was 29 years older than DIL (60 years vs. 31 years). Both groups experienced menarche at average age 13.8 years. MIL was married at average 12.4 years, before menarche, and cohabitated with husbands at average 14.8 years. DIL was simultaneously married and cohabitated with husbands after menarche, at average 15 years. DIL was marginally more educated than MIL but had their first child on average 0.8 years earlier (95% CI −1.4, −0.1). MIL and DIL held similar norms on daughters' education and marriage. Conclusion: While social norms remain similar, the meaning of "early marriage" and use of menarche in marriage decisions has changed in rural lowland Nepal. Compared to DIL, MIL who was married earlier transitioned to womanhood more gradually. However, DIL was still married young, and had an accelerated trajectory to childbearing. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mammographic breast density (MBD) is a strong risk factor and an intermediate phenotype for breast cancer, yet there are limited studies on how environmental pollutants are associated with MBD. OBJECTIVE: We investigated associations of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonate (PFHxS) levels with measures of MBD and evaluated if early life factors modified any associations. METHODS: Metabolon performed metabolomics analysis using ultrahigh-performance liquid chromatography/tandem accurate mass spectrometry in fasting blood from 705 premenopausal women completing their annual screening mammogram in St. Louis, Missouri. We calculated least square means (LSM) of mammographic volumetric percent density (VPD), dense volume (DV), and nondense volume (NDV) by quartiles (Q) of PFOS, PFOA, and PFHxS from multivariable linear regression modeling overall and stratified by recruitment period, race, age at menarche, and body shape at age 10. Models were adjusted for age, age at menarche, body fat percentage, race, family history of breast cancer, oral contraceptive use, alcohol consumption, parity/age at first birth, and body shape at age 10. RESULTS: PFOS, PFOA, and PFHxS were not significantly associated with VPD or NDV. PFHxS was significantly positively associated with DV (Q1=67.64 cm³, Q2=69.91 cm³, Q3=69.06 cm³, Q4=75.79 cm³; 푝-trend=0.03). PFOS was positively associated with DV (Q1=65.45 cm³, Q2=70.74 cm³, Q3=73.31 cm³, Q4=73.52 cm³; 푝-trend=0.06) with DV being 8.1%, 12%, and 12.3% higher in Q2, Q3, and Q4 compared to Q1. Among women who were underweight/normal weight at age 10, PFOS was positively associated with VPD (Q1=9.02%, Q2=9.11%, Q3=9.48%, Q4=9.92%; 푝-trend=0.04) while there was an inverse association among women who were overweight/obese at age 10 (Q1=7.46%, Q2=6.94%, Q3=6.78%, Q4=5.47%; 푝-trend=0.005) (푝-interaction=0.04). DISCUSSION: We report novel associations of PFHxS and PFOS with DV in premenopausal women. PFOS, PFOA, and PFHxS were not associated with VPD and NDV. In addition, body shape at age 10 may modify the associations of PFOS with MBD. Further studies are needed to validate our findings and to evaluate the associations of other per- and polyfluoroalkyl substances (PFAS), as well as mixtures of PFAS, with MBD. [ABSTRACT FROM AUTHOR]

Early menarche has been associated with adverse health outcomes, such as depressive symptoms. Discovering effect modifiers across these conditions in the pediatric population is a constant challenge. We tested whether movement behaviours modified the effect of the association between early menarche and depression symptoms among adolescents. This cross-sectional study included 2031 females aged 15–19 years across all Brazilian geographic regions. Data were collected using a self-administered questionnaire; 30.5% (n = 620) reported having experienced menarche before age 12 years (i.e., early menarche). We used the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Accruing any moderate–vigorous physical activity during leisure time, limited recreational screen time, and having good sleep quality were the exposures investigated. Adolescents who experienced early menarche and met one (B: –4.45, 95% CI: (–5.38, –3.51)), two (B: –6.07 (–7.02, –5.12)), or three (B: –6.49 (–7.76, –5.21)), and adolescents who experienced not early menarche and met one (B: –5.33 (–6.20; –4.46)), two (B: –6.12 (–6.99; –5.24)), or three (B: –6.27 (–7.30; –5.24)) of the movement behaviour targets had lower PHQ-9 scores for depression symptoms than adolescents who experienced early menarche and did not meet any of the movement behaviours. The disparities in depressive symptoms among the adolescents (early menarche vs. not early menarche) who adhered to all three target behaviours were not statistically significant (B: 0.41 (–0.19; 1.01)). Adherence to movement behaviours modified the effect of the association between early menarche and depression symptoms. [ABSTRACT FROM AUTHOR]

Background: Across the life course, women and girls with learning disabilities and their carers report difficulties in accessing information and support with menstruation, yet their experiences are often overlooked in initiatives to improve menstrual health and wellbeing. Our aim was to collaborate with women with learning disabilities to co‐produce future research priorities in a UK context. Methods: We undertook a two‐part scoping exercise to explore what is known about this topic from a life course perspective, beginning pre‐menarche and extending to post‐menopause support. This combined a rapid scoping review of the literature since 1980 with a stakeholder consultation where people with learning disabilities, family carers, advocacy groups and staff working across education, health and social care were invited to share their experiences of menstruation support. Findings: UK and international literature provided insight across five narrative themes. Seventy stakeholders took part in our consultation, enabling the identification of five key themes. Findings across both highlight examples of supportive practice and valued resources alongside enduring health inequalities and barriers to menstruation support faced by women and girls with learning disabilities across the life course. Conclusion: Our scoping exercise identified multiple gaps in research and practice, ongoing reproductive health inequalities and a need for improved access to peer support, resources and training that take a life course approach. The scoping exercise indicates the need for further empirical research on menstruation and learning disability, with a particular focus on collating people's lived experiences. Accessible summary: We wanted to find out what support and information is available to girls and women with learning disabilities about periods (also called 'menstruation') over a lifetime.This was to help us work out what new research might be needed in the future.Our team included women with and without learning disabilities. We are based in the United Kingdom.We read lots of articles, from the United Kingdom and around the world.We spoke to lots of people who care about this issue and know about it. This included women with learning disabilities, family carers, advocacy groups and staff working in education, health and social care settings.There is not enough guidance about periods for girls and women with learning disabilities.A lot more research is needed about how to support women with learning disabilities with their periods, over their whole life.This must also include women with profound and multiple learning disabilities and women from minority ethnic communities.Our work showed that we need to hear much more from women with learning disabilities themselves. [ABSTRACT FROM AUTHOR]

This article examines the rise and fall of Eumenol, Merck's patent emmenagogue extracted from danggui (當歸), and its destined connections with China. Understood to affect the blood, danggui, one of the most prolifically used substance among Chinese materia medica, had been included in recipes for women aged from before menarche to after menopause since the twelfth century, but it was not until its production and advertisement by the German pharmaceutical company that the multi-functional material was placed on the international stage with a sharpened gendered image. For Merck customers around the world, Eumenol was a long-awaited, harmless emmenagogue made from an obscure Chinese material; for Chinese who had been using the root to treat a wide range of disorders, the branded drug was a scientific refinement of a time-honored medicine. The success of Eumenol gave advocates of Chinese medicine a concrete example with which to rejuvenate their medical traditions, but the later cessation of Chinese imports forced Merck to eventually stop marketing the emmenagogue. Within this intersection of medicinal exchanges, Eumenol emerged as an indispensable piece of the puzzle in terms of both the history of an ancient remedy and the modernization of Chinese medicine. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether there is an association between age at menarche (AAM) and the risk of gestational diabetes mellitus (GDM). Methods: A retrospective cohort study was conducted, including 5390 pregnant women who were screened for GDM at Alexandra Hospital in Athens, Greece over a 15-year period (2000–2014). Maternal age, pre-pregnancy body mass index (BMI), height, family history of type 2 diabetes mellitus, parity, educational and smoking status, and AAM were recorded. The results were expressed as odds ratios (OR) with a 95% confidence interval (95% CI). Results: Pregnant women with GDM experienced earlier menarche compared to normoglycemic women (12.9 ± 1.5 vs 13.1 ± 1.6, p < 0.001, respectively). The OR for a woman with AAM <12 years to develop GDM was 1.08 (95% CI 1.03–1.14), while the OR to be obese was 1.70 (95% CI 1.50–1.90). The multivariate logistic regression analysis showed that AAM is a risk factor for GDM. However, that effect was lost after adjusting for BMI. Conclusion: Early AAM may be associated with an increased risk of GDM. Therefore, it can be used to identify high-risk women and implement preconception interventions for GDM prevention. Future studies should be conducted to confirm these findings. [ABSTRACT FROM AUTHOR]

ABSTRACT: 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. [ABSTRACT FROM AUTHOR]

The prevalence of metabolic syndrome (MetS) as well as related social costs and efforts is increasing. The purpose of this study was to investigate the association between age at menarche and the risk of MetS, obesity, diabetes, and cardiovascular disease (CVD) in women over 30 years, using data from the Korean National Health and Nutrition Examination Survey (2010-2020). The analysis of 30 916 participants showed that early menarche (before 11 years) significantly increased the risk of obesity, diabetes, and MetS compared with the median age of 14 years. Late menarche (after 17 years) was also linked to MetS and related disorders. The relationship between age at menarche (at <10 years and >19 years) and the risk of MetS and related disorders exhibited a reversed J-shaped (し) pattern characterized by a pronounced increased risk among those who experience early menarche, whereas the increased risk associated with late menarche was less consistent. These results will help to decrease the risk of MetS and related disorders by enabling early intervention in early and late menarche age groups. [ABSTRACT FROM AUTHOR]

Menarche is a significant pubertal event influencing girls' participation in physical activity. As menarche is a sensitive matter, a non-invasive substitute is needed to help classify girls' maturity status and provide physical literacy to them in this regard. The objective of this exploratory study was to investigate the classification agreement between self-reported age of menarche and calculated maturity offset in adolescent girls from South Africa by making use of various statistical methods. Fifty-eight girls, n = 13 pre- and n = 45 post-menarche (Status Quo method) aged 13.51 ± 3.51 years at baseline, were analyzed (2010–2012). Independent t-testing, cross-tabulation, Roc Curve statistics and logistic regression were used to analyze the classification agreement between markers. All four statistical methods revealed the potential to categorize different maturity groups through the maturity offset equation, although the accuracy declined with increased age. A realized power of 0.92 was found for the group in the first year of the study, with a gradual and significant decline over time. Cross-tabs showed a significant moderate predictive effectiveness (Chi-square = 0.042) during T1, closer to PHV (13.51 years) although also declining significantly with increased age (T2, 14.51 years) beyond PHV (Chi-square = 0.459). Although positive results were found, caution must be used when using maturity offset equations in different homogenic populations due to their unique growth characteristics. [ABSTRACT FROM AUTHOR]

PurposeTo understand the status of vitamin D deficiency in girls with growth and developmental variations, as well as the impact of COVID−19 on their vitamin D levels, and to provide reference for the prevention and treatment of vitamin D deficiency in children.MethodsA retrospective analysis was conducted on 1,345 instances of girls with growth and developmental variations who visited our pediatric endocrinology department and completed vitamin D detection. A total of 279 girls with complete data were included in this study. Among them, 246 girls were classified into four groups based on different growth and developmental variations: early puberty group, menarche group, obesity group, short stature group, and 33 healthy girls served as the control group. Besides, the girls were divided into pre-epidemic and post-epidemic groups by the occurrence of the COVID-19 epidemic. Vitamin D were measured in all girls. The 25(OH)D 0.05).ConclusionGirls with early puberty, menarche, and obesity have a certain deficiency of vitamin D levels, and appropriate vitamin D treatment should be provided clinically. Girls with short stature and healthy girls also have certain levels of vitamin D deficiency, and awareness of prevention should be strengthened.

Phenylketonuria (PKU) results from a deficiency in phenylalanine hydroxylase, catalyzing the conversion of phenylalanine (Phe) to tyrosine. Premenstrual syndrome (PMS) consists of physical, behavioral, and emotional symptoms occurring during the last week of luteal phase. The aim of the study was to determine the incidence of PMS, and document menstrual cycle characteristics of PKU patients to reveal the relationship with blood Phe levels. The study was conducted on 74 patients with a mean age of 21.7 ± 5.4 years. The mean age at menarche was 12.7 ± 1.3 years and 82.4 % had regular menstrual cycles. The periods of most patients (47.2 %) lasted 4–5 days. Menstrual cycles of 21–28 days were reported by 73 %, less than 21 days by 8 %, and more than 28 days by 19 % of women. Menorrhagia and dysmenorrhea was observed in 6.7 % and 71.6 % respectively. Adherence to diet was lost in 7 patients during the menstrual period. No significant relationship was found between Phe levels and PMS symptoms (p > 0.05). According to PMSS subscales, 52.7 % of patients with PKU had depressive feelings, 16.2 % anxiety, 55.4 % fatigue, 52.7 % irritability, 28.3 % depressive thoughts, 39.1 % pain, 59.4 % changes in appetite, 28.3 % changes in sleeping habits and 43.2 % had swelling. The findings of the study revealed that PMS prevalence was 39.1 % among PKU women. Awareness about this syndrome, will improve the quality of life in women with PKU by evaluating and taking measures for PMS. Synopsis: Evaluating menstrual cycle characteristics and premenstrual syndrome in phenylketonuria patients provides valuable insights for enhancing their overall health profile and personalizing treatment and management plans.

Background: Dysmenorrhea is a very common problem and a large number of females in our society are suffering from it. This study aims to determine the prevalence of dysmenorrhea and its associated lifestyle and other factors. Methodology: This was a cross-sectional study which was conducted among females aged between 15 to 45 years in urban population of district Ghaziabad through a house-to-house survey, using a pre-designed, semi-structured questionnaire. Results: The prevalence of dysmenorrhea was 67.8%. Out of the participants having dysmenorrhea, 36.5% females were experiencing mild pain, 44.3% were experiencing moderate pain and 19.1% were experiencing severe pain. The chances of dysmenorrhea were significantly more in participants of 15 to 25 years of age, participants who had attained early menarche, those having pre-menstrual symptoms and those who had passage of clots during menstruation, participants consuming refined flour, fried food, preservatives, soda and those who were skipping meals. Participants doing physical exercises showed less chance of menstrual pain. Conclusions: The prevalence is dysmenorrhea is quite high in our society. It may be related to factors which are modifiable, such as diet and exercise. An improvement of lifestyle is recommended.

Background: Reproductive factors, such as age at menarche, are known to be associated with disease risk, but data on trends in these factors in Japan are limited. In this study, we investigated secular trends in reproductive factors and explored their potential association with socioeconomic and historical events. Methods: We conducted a retrospective analysis of 62,005 Japanese women born between 1890 and 1991 using a survey conducted over 25 years. Trends in reproductive factors were analyzed using linear and joinpoint regression models, and their associations with major historical events involving Japan were evaluated. Results: We found that the age at menarche showed a significant downward trend (P < 0.001) over the century. Three joinpoints were identified, in 1932 (15.23 years old), 1946 (13.48 years old), and 1959 (12.71 years old), which indicated that average age at menarche decreased by approximately 0.8% per year between 1932 and 1946, and then by 0.4% per year between 1946 and 1959, both of which were statistically significant. However, after 1959, age of menarche remained stable. Analyses of other reproductive factors found significant changes, including a decrease in parity and the number of babies breastfed, and an increase in age at first birth. Conclusion: Age at menarche showed a long-term downward trend in Japan, with significant change points in annual percent change. Other factors showed secular changes in trends as well. These change points were observed at the same time as historical events, namely wars and economic development, suggesting that socioeconomic and environmental changes at the population level affect reproductive factors in females.

Background: Premenopause syndrome triggers more severe physical and psychological problems and the emergence of various diseases. The limited research on the factors causing the severity of Premenopause syndrome has resulted in a lack of efforts to address the causative factors. Purpose: This study aims to explore factors that influence the severity of premenopause syndrome. Method: This is an analytic observational study with a cross-sectional design. Eighty-eight women aged 40-45 years were included in this study. The knowledge, attitude, age of menarche, use of hormonal contraceptives, and symptoms of premenopause syndrome observed in this study—data analysis using chi-square and multiple logistic regression. Results: Factors that influence the severity of premenopause syndrome are knowledge, attitude, age of menarche, and use of hormonal contraceptives (p

Background: Menstrual hygiene is an important risk factor for reproductive tract infections among adolescent girls. Unhygienic practices during menstruation have a significant impact on health. Fear of blood leaking, fatigue, dysmenorrhea, and lack of cleanliness in schools during menstruation contribute to absenteeism. Frequent episodes of absenteeism result in poor school performance. Objectives: The objectives of the study were to assess menstrual hygiene practices among the study population and estimate the proportion of school absenteeism among girls during menstruation and evaluate the associated factors. Materials and Methods: A cross-sectional study was conducted among 231 high schools (8th, 9th, and 10th standards) girls in Narayanguda, Hyderabad. A semi-structured questionnaire was used to interview the subjects after taking permission from the principal, and confidentiality was ensured for the students. Adolescent girls who have attained menarche and who were present on the day of the survey were included in the study. Adolescent girls who have not attained menarche were excluded from the study. Results: The mean age of menarche was 12.19 ± 1.17 years. The majority (93%) were using sanitary pads. Disposal of material used for menstruation was majorly (95.6%) by throwing in dustbins. Almost 92.2% of them were following good hygienic practices. The proportion of school absenteeism during menstruation was 53%, and the reasons were dysmenorrhea and fear of leaking menstrual blood while transiting. Conclusions: The majority of the girls were following good hygienic practices and used sanitary pads. About half of them remained absent from school during menstruation.

With the increasing burden of hypertension in Chinese adults, the detection rate of hypertension among children and adolescents continued to rise, drawing increasing attention to the impact of pubertal timing on blood pressure. In recent years, many scholars have evaluated the association between pubertal development and blood pressure at different stages using various methods of assessing pubertal timing. To understand the correlation between pubertal timing and blood pressure in adolescents, this study reviews the associations between pubertal timing and blood pressure and their underlying mechanisms. The relationship between earlier female pubertal development and the risk of hypertension in adulthood shows positive, negative, and U-shaped correlations, with varying results. Earlier female pubertal development may lead to a higher detection rate of hypertension during adolescence. Most of the studies focus on the correlation between pubertal timing and adult blood pressure, with less research on adolescent blood pressure, indicating a need for further research to reveal underlying patterns.

Abstract Background The burden of early sexual engagement among youth is enormous. It directly raises the risk of sexually transmitted infections(STIs) and indirectly contributes to unintended pregnancy, unsafe abortion, premature childbirth, and psychosocial issues. The aim of this paper was to estimate the timing of sexual debut and examine the factors influencing the timing of first sexual intercourse following menarche among female youth aged between 15 and 24 in Uganda. Method Self-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sub-sample of 7964 female youth from the individual woman file. Kaplan-Meier survival curves, decrement life-table analysis, and the discrete-time logit model were used to examine the timing of sexual debut and associated factors. Results 67.4% of the female youth had experienced first sexual initiation. Overall, the meantime to sexual debut was 4.4 years and the median time was 4.3 years, and all the female youth had experienced first sexual initiation by the end of the twelfth year following menarche. Significant factors found to influence the timing of sexual initiation include having higher education level (OR = 0.724: 95% CI = 0.59–0.89; p = 0.003), residing in the Northern region (OR = 0.877:95% CI = 0.79–0.97, p = 0.012), being employed (OR = 1.085: 95% CI = 1.01–1.16; p = 0.021), and being literate (OR = 1.155; 95% CI = 1.07–1.25; p

Abstract Background Dementia is associated with older adults; however, it can also affect younger individuals, known as young-onset dementia (YOD), when diagnosed before the age of 65 years. We aimed to conduct a retrospective cohort study involving middle-aged women to investigate the association between premorbid depression and YOD development. Methods We included 1.6 million women aged 40–60 years who underwent health checkups under the Korean National Health Insurance Service and investigated the association between depression and YOD. Results Women with depression had a significantly higher risk of developing YOD than women without depression. Among premenopausal women, those with depression had a 2.67-fold increased risk, whereas postmenopausal women with depression had a 2.50-fold increased risk. Late age at menarche (> 16 years) and young age at menopause (

Pubertal timing predicts a miscellany of negative mental and physical health outcomes. Prior work examining pubertal timing in youth with attention-deficit hyperactivity disorder (ADHD) has failed to investigate potential sex specificity of results. Therefore, we aim to extend past findings in a sample of female adolescents with ADHD. We compare pubertal timing (1) between females with and without carefully diagnosed ADHD and (2) between females with ADHD who do vs. do not have a history of stimulant medication use during childhood. We examine 127 adolescent females with childhood-diagnosed ADHD and 82 matched neurotypical peers (Mage: 14.2 years, range: 11.3-18.2) from the Berkeley Girls with ADHD Longitudinal Study (Wave 2). We measured pubertal timing using self-reported Tanner staging and age at menarche. Three strategies compared pubertal timing across groups: (1) [Formula: see text] tests of Tanner Stages, (2) t tests of residuals of pubertal status regressed on age, and (3) t tests of age at menarche. Pubertal timing of girls with and without ADHD did not differ significantly across methods and measures. Yet females with ADHD who had received stimulant medication during childhood menstruated later than those without a stimulant history, potentially related to differences in BMI across groups. On the other hand, no significant differences between medicated vs. non-medicated participants emerged for the two Tanner staging indicators. Our findings extend prior work, suggesting that females with ADHD are developing physically at a similar time as their peers, which parallels findings from previous mixed-sex samples that did not examine effects separately by sex.

Despite agreement that humans have evolved to be unusually fat primates, adipose patterning among hunter–gatherers has received little empirical consideration. Here we consider the development of adiposity among four contemporary groups of hunter–gatherers, the Aka, Savanna Pumé, Ju'/Hoansi and Agta using multi-level generalized additive mixed modelling to characterize the growth of tricep skinfolds from early childhood through adolescence. In contrast to references, hunter–gatherers show several consistent patterns: (i) children are lean with little fat accumulation; (ii) no adiposity rebound at 5 years is evident; (iii) girls on average have built 90% of their body size, and reach menarche when adiposity is at its maximum velocity; and (iv) a metabolic trade-off is evident in young, but not older children, such that both boys and girls prioritize skeletal growth during middle childhood, a trade-off that diminishes during adolescence when height velocity increases in pace with fat accumulation. Consistent results across hunter–gatherers living in diverse environments suggest that these patterns reflect a general forager pattern of development. The findings provide a valuable baseline for adipose development not apparent from reference populations. We emphasize both generalized trends among hunter–gatherers, and that inter-populational differences point to the plasticity with which humans organize growth and development. [ABSTRACT FROM AUTHOR]

Background: Aging is an inevitable biological process. Accelerated aging renders adults more susceptible to chronic diseases and increases their mortality rates. Previous studies have reported the relationship between lifestyle factors and phenotypic aging. However, the relationship between intrinsic factors, such as reproductive factors, and phenotypic aging remains unclear. Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES), spanning from 1999 to 2010 and 2015–2018, with 14,736 adult women. Random forest imputation was used to handle missing covariate values in the final cohort. Weighted linear regression was utilized to analyze the relationship between women-specific reproductive factors and PhenoAgeAccel. Considering the potential impact of menopausal status on the results, additional analyses were conducted on premenopausal and postmenopausal participants. Additionally, the Life's Essential 8 (LE8) was used to investigate the impact of healthy lifestyle and other factors on the relationship between women-specific reproductive factors and PhenoAgeAccel. Stratified analyses were conducted based on significant interaction p-values. Results: In the fully adjusted models, delayed menarche and gynecological surgery were associated with increased PhenoAgeAccel, whereas pregnancy history were associated with a decrease. Additionally, early or late ages of menopause, first live birth, and last live birth can all negatively impact PhenoAgeAccel. The relationship between women-specific reproductive factors and PhenoAgeAccel differs between premenopausal and postmenopausal women. High LE8 scores positively impacted the relationship between certain reproductive factors (age at menarche, age at menopause, age at first live birth, and age at last live birth) and phenotypic age acceleration. Stratified analysis showed significant interactions for the following variables: BMI with age at menarche, pregnancy history, and age at menopause; ethnicity with age at menopause, age at first live birth, and parity; smoking status with use of contraceptive pills and gynecologic surgery; hypertension with use of contraceptive pills, pregnancy history, and age at menopause. Conclusion: Delayed menarche, gynecological surgery, and early or late ages of menopause, first live birth, and last live birth are associated with accelerated phenotypic aging. High LE8 score may alleviate the adverse effects of reproductive factors on phenotypic aging. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionAssociations between age at menarche and myopia have been observed in studies that included older women. Furthermore, pregnancy-related hormone surges in young women are associated with short-term changes in refractive error, although the long-term effects are less known. This study explored associations of age at menarche and parity with refractive error and ocular biometry in young women, and the relationship between age at menarche and refractive error in middle-aged adults for comparison.Community-based young women underwent eye examinations at 20 and 28 years old. Information on age at menarche and parity were collected prospectively. The older cohort underwent an eye examination and information on age at menarche was self-reported retrospectively. Cross-sectional associations between age at menarche and myopia were explored in both cohorts. Associations between parity and 8-year longitudinal change in refractive error measures were explored in the young cohort.The cross-sectional analyses comprised 429 young (age 18–22) and 1,818 older (age 46–69) women. No associations were found between age at menarche and myopia or ocular biometry measures in either cohort. The longitudinal analysis (n = 269 women) revealed that for each pregnancy carried to full term, there rate of lens thickening increased by 0.004 mm/year (95% CI = 0.002–0.007). No other associations between parity and refractive error or ocular biometry were found.There is no association between age at menarche and myopia or its related measures. While pregnancy was associated with thicker lens in the long term, there is no lasting effect on refractive error. [ABSTRACT FROM AUTHOR]

Background: Endometriosis is a chronic inflammatory disease of women during their reproductive years. The relationship between the severity and location of endometriosis and menstruation, ovulation, reproductive function, and mode of delivery remains unclear. Methods: We explored the association between the various phenotypes of endometriosis and menstruation, ovulation, reproductive function, and mode of delivery, using two-sample Mendelian randomization (MR) and summary data on endometriosis stages and locations from the FinnGen consortium and women's menstruation, ovulation, reproductive function, and mode of delivery from OpenGWAS and ReproGen. Inverse-variance weighting was used for the primary MR analysis. In addition, a series of sensitivity analyses, confounding analyses, co-localization analyses, and multivariate MR analyses were performed. Results: MR analysis showed a negative effect of moderate to severe endometriosis on age at last live birth (OR = 0.973, 95% CI: 0.960-0.986) and normal delivery (OR = 0.999, 95% CI: 0.998-1.000; values for endpoint were excluded), ovarian endometriosis on age at last live birth (OR = 0.976, 95% CI: 0.965-0.988) and normal delivery (OR = 0.999, 95% CI: 0.998-1.000; values for endpoint were excluded), and fallopian tubal endometriosis on excessive irregular menstruation (OR = 0.966, 95% CI: 0.942-0.990). Bidirectional MR analysis showed that age at menarche had a negative causal effect on intestinal endometriosis (OR = 0.417, 95% CI: 0.216-0.804). All MR analyses were confirmed by sensitivity analyses, and only the genetic effects of moderate to severe endometriosis on normal delivery and age at last live birth were supported by co-localization evidence. Conclusion: Our findings deepen the understanding of the relationship between various types of endometriosis and menstruation, ovulation, reproductive function, and mode of delivery and clarify the important role of moderate to severe endometriosis. [ABSTRACT FROM AUTHOR]

Cross-sectional studies indicate that menstrual problems are related to poorer mental health; however, longitudinal studies are limited. This longitudinal study aimed to determine whether baseline menstrual characteristics were risk factors for incident and persistent mental health problems. The study was conducted among Chinese adolescent girls. Menstrual characteristics including menarche, menstrual cycle and menstrual pain were assessed at baseline, whereas mental health problems including PTSD, depression, anxiety, ADHD, insomnia, psychotic-like experiences, non-suicidal self-injury, suicide ideation, suicide plan, and suicide attempt were assessed at baseline (n = 1039) and at the 1-year follow-up (n = 946) by self-administered, structured questionnaires. Multiple logistic regressions were performed to examine whether menstrual characteristics were associated with incident (e.g., PTSD at follow-up but not baseline) and persistent (e.g., PTSD at both time points) mental health problems. The results demonstrated that early menarche was related to persistence of psychotic-like experiences; irregular menstruation was associated with higher rates of incident anxiety and insomnia, and persistent depression, anxiety, ADHD, insomnia, non-suicidal self-injury, suicide ideation, and suicide plan; menstrual pain was associated with elevated rates of incident PTSD and depression, and persistent depression, insomnia, psychotic-like experiences, non-suicidal self-injury, suicidal ideation, suicide plan, and suicide attempt. In conclusion, irregular menstruation and menstrual pain specifically contributed to the development of emotional problems and insomnia, and were associated with maintenance of the most mental health problems in early adolescence. The long-term effects of menstrual problems on mental health need further study. [ABSTRACT FROM AUTHOR]