Search

Purpose: To describe the self-reported menstrual health, symptomatology, and perceived effects of the menstrual cycle on athletic performance for national and international Australian football (soccer) players. Methods: Players from national and domestic teams were invited to complete an online questionnaire regarding menstrual health, use of hormonal contraceptives (HCs), negative symptomatology, and perceived disruption of the menstrual cycle to performance. Descriptive statistics and binomial regressions with odds ratios (OR) were used to report the relationship of menstrual-related variables with perceived performance disruption. Results: A total of 199 players (20.9 [5.1] y) completed the questionnaire, with 18% of players reporting using HCs. One primary amenorrhea case was detected, and 26% of players reported menarche at age ≥15 years. For non-HC users, the prevalence of secondary amenorrhea was 2%, oligomenorrhea was 19%, and heavy menstrual bleeding was 11%. Ninety-seven percent of players reported experiencing physical or affective menstrual symptoms (5 [1.3] per player), and 40% of all players reported that menstrual symptoms impacted their ability to work, study, train, or compete. Furthermore, 40% of players perceived their training or performance to be disrupted by the menstrual cycle. Increasing number of menstrual symptoms (OR = 1.43; 95% CI, 1.28–1.62; P <.001), heavy menstrual bleeding (OR = 12.73; 95% CI, 3.4–82.8; P <.001), and pelvic pain (OR = 3.40; 95% CI, 1.7–7.2; P <.001) increased the likelihood of perceiving the menstrual cycle to disrupt performance. Conclusion: Heavy menstrual bleeding and HC use were low among this cohort of national and international footballers, whereas amenorrhea and oligomenorrhoea were comparable with other football populations. Nearly all players reported menstrual symptoms, and increased symptomatology was associated with greater perceived effects on performance. [ABSTRACT FROM AUTHOR]

BACKGROUND: Atopic dermatitis (AD) might delay puberty, but research is lacking. OBJECTIVE: To investigate the association between AD and puberty. METHODS: A subcohort within the Danish National Birth Cohort includes children born between 2000 and 2003, with mothers reporting doctor-diagnosed AD at 6 months, 18 months, and 7 years old. The National Patient Registry identified hospital-diagnosed AD. From 11 years, the children give half-yearly information on pubertal development. We estimated the mean age difference in months at attaining Tanner stages 1 to 5 and the development of axillary hair, acne, first ejaculation, voice break, and age at menarche, using an interval-censored regression model. RESULTS: In total, 15,534 children participated, 21.5% had self-reported doctor-diagnosed AD and 0.7% had hospital-diagnosed AD. For girls with self-reported doctor-diagnosed AD, the average age difference at reaching all pubertal milestones was 0.0 months (95% confidence interval [CI]: -0.8; 0.8), and for hospital-diagnosed AD, it was -0.3 months (95% CI: -5.4; 4.8). For boys, the average age difference was 0.1 months (95% CI: -0.6; 0.9) and -0.3 months (95% CI: -3.6; 3.0), respectively. LIMITATIONS: No information on treatment was available. Missing data on covariates (

BACKGROUND: Women who reach menarche and menopause at earlier ages have been shown to be at increased risk for numerous conditions including cardiovascular disease, cancer, depression, and obesity; however, risk factors for earlier ages of menarche and menopause are not fully understood. Therefore, we aimed to perform a retrospective investigation of the associations between a personal birthweight and/or being born preterm and the age of and menarche and menopause and related events in the Womens Health Initiative, a large, racially and ethnically diverse cohort of postmenopausal women. METHODS: At study entry, women reported their birthweight by category (

STUDY QUESTION: What is the association between reproductive health history (e.g. age at menarche, menopause, reproductive lifespan) with abdominal adiposity in postmenopausal women? SUMMARY ANSWER: Higher visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) tissue levels were observed among women with earlier menarche, earlier menopause, and greater parity. WHAT IS KNOWN ALREADY: Postmenopausal women are predisposed to accumulation of VAT and SAT. Reproductive health variables are known predictors of overall obesity status in women, defined by BMI. STUDY DESIGN, SIZE, DURATION: This study is a secondary analysis of data collected from the baseline visit of the Womens Health Initiative (WHI). The WHI is a large prospective study of postmenopausal women, including both a randomized trial and observational study. There were 10 184 women included in this analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS: Data were collected from a reproductive health history questionnaire, dual-energy x-ray absorptiometry scans, and anthropometric measures at WHI baseline. Reproductive history was measured via self-report, and included age at menarche, variables related to pregnancy, and age at menopause. Reproductive lifespan was calculated as age at menopause minus age at menarche. Statistical analyses included descriptive analyses and multivariable linear regression models to examine the association between reproductive history with VAT, SAT, total body fat, and BMI. MAIN RESULTS AND THE ROLE OF CHANCE: Women who reported early menarche (15 years had 23 cm2 less VAT (95% CI: -31.4, -14.4) and 47 cm2 less SAT (95% CI: -61.8, -33.4) than women who experienced menarche at age 10 years or earlier. A similar pattern was observed for age at menopause: compared to women who experienced menopause 3 pregnancies) was also associated with VAT and SAT. For example, adjusted beta coefficients for VAT were 8.36 (4.33, 12.4) and 17.9 (12.6, 23.2) comparing three to four pregnancies with the referent, one to two pregnancies. LIMITATIONS, REASONS FOR CAUTION: The WHI reproductive health history questionnaire may be subject to poor recall owing to a long look-back window. Residual confounding may be present given lack of data on early life characteristics, such as maternal and pre-menarche characteristics. WIDER IMPLICATIONS OF THE FINDINGS: This study contributes to our understanding of reproductive lifespan, including menarche and menopause, as an important predictor of late-life adiposity in women. Reproductive health has also been recognized as a sentinel marker for chronic disease in late life. Given established links between adiposity and cardiometabolic outcomes, this research has implications for future research, clinical practice, and public health policy that makes use of reproductive health history as an opportunity for chronic disease prevention. STUDY FUNDING/COMPETING INTEREST(S): HRB and AOO are supported by the National Institute of Health National Institute of Aging (R01AG055018-04). JWB reports royalties from ACSMS Body Composition Assessment Book and consulting fees from the WHI. The remaining authors have no competing interests to declare. TRIAL REGISTRATION NUMBER: N/A.

Pubertal timing varies considerably and is associated with later health outcomes. We performed multi-ancestry genetic analyses on ~800,000 women, identifying 1,080 signals for age at menarche. Collectively, these explained 11% of trait variance in an independent sample. Women at the top and bottom 1% of polygenic risk exhibited ~11 and ~14-fold higher risks of delayed and precocious puberty, respectively. We identified several genes harboring rare loss-of-function variants in ~200,000 women, including variants in ZNF483, which abolished the impact of polygenic risk. Variant-to-gene mapping approaches and mouse gonadotropin-releasing hormone neuron RNA sequencing implicated 665 genes, including an uncharacterized G-protein-coupled receptor, GPR83, which amplified the signaling of MC3R, a key nutritional sensor. Shared signals with menopause timing at genes involved in DNA damage response suggest that the ovarian reserve might signal centrally to trigger puberty. We also highlight body size-dependent and independent mechanisms that potentially link reproductive timing to later life disease.

Patients with intellectual and developmental disabilities (IDD) experience greater unmet medical service needs and decreased care satisfaction compared to those without these diagnoses. There are no evidence-based resources widely available to prepare children with IDD for menarche. This IRB approved embedded mixed methods study investigated the efficacy of "period kits" for patients with IDD to ease anxiety and improve preparedness for menarche. Custom kits included a colorful pouch, an original social story, a resource list, and common period management items. Nine family pairs (child/adult) were enrolled. Surveys performed before and after kit exploration queried participants' understanding of menarche, and feedback about the kit itself. Data were analyzed using thematic analysis. Surveys of the children showed limited knowledge about periods at baseline. Additional themes prior to provision of the "period kit" included limited knowledge, negative perceptions and emotional responses about menstruation and puberty and hesitancy approaching period conversations. After kit exposure, there was an improvement in period related knowledge and promotion of interhousehold discussion with continued room for conversation. Many kids with IDD have limited baseline knowledge about menstruation. Custom "period kits" may be helpful in stimulating conversation within families and promoting increased knowledge about menses to children and families. Limitations of this study are small size and qualitative nature, potentially limiting generalizability and external data validity. [ABSTRACT FROM AUTHOR]

Background: The onset age of pubertal changes varies widely among girls and has undergone changes over time around the world. This study aimed to determine the age of onset of puberty in healthy Iranian girls living in Isfahan province. Methods: This cross- sectional study was conducted among 13,886 students aged 6–18 years. They were selected by multistage random cluster sampling from urban and rural areas of Isfahan province of Iran. Pubertal stage was determined according the 5-level Tanner stages proposed by Marshall and Tanner. Trained physicians determined the breast development through both visual inspection and palpation, in addition, mothers assessed their daughter's pubic hair growth using Tanner's Sexual Maturation Scale (SMS) by comparison to standard pictures. The data were analyzed by the status quo method. Probit regression analysis was used to evaluate the median age of onset for each characteristic including menarche, breast and pubic hair. Results: A total of 13,886 healthy girls with mean age (SD) of 11.97 (2.9) were studied. Overall 6968 (50.2%) girls experienced menstruation with a median (95%CI) age of 12.05(11.88–12.21) years at its onset. The median age for onset of breast development was 9.89 (95% CI: 9.77 − 10.02) years and for onset of pubic hair development was 10.14 (95% CI: 9.88– 10.39) years. The 3rd percentile for breast stage 2 (B2) and pubic hair stage 2 (PH2) was 6.85 and 6.75 years, respectively, and the 97th percentile for B2 and PH2 was 12.94and 13.54 years, respectively. Conclusion: According to our findings, the onset of puberty before 6.85 years should be considered as precocious puberty for Iranian girls. Our study indicated the secular trend toward earlier menarche in girls. Nationally representative surveys and longitudinal studies are necessary to determine the exact age of puberty for future international comparisons. [ABSTRACT FROM AUTHOR]

Background: Menarche is an important period in a female's life; its time of onset may depend on various factors and could correlate with the development of diseases in adulthood. Our study aims to investigate the relationship between body mass index and age at onset of menarche; Methods: We used a unique standardized national dataset on adolescent girls participating in the Italian Health Behaviour in School-aged Children Study. Two independent nationally representative survey datasets: one on 15-year-olds (n = 6505, year 2017/2018) and one on 11-year-olds (n = 6548, year 2013/2014) were analysed. The survey instrument was the self-report questionnaire. Median age at menarche and 95% confidence intervals were estimated through Kaplan–Meier analysis. Hierarchical models assessed the relationship between BMI and age at menarche; Results: Region-level median age at menarche ranged between 12 years/5 months and 13 years/4 months. Region-level prevalence of overweight among 15-year-old girls ranged between 6% and 24%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta=-0.81; 95% CI, -0.92 to -0.70). Individual-level and class-level measures of BMI accounted for 215.2% of the region-level variance in age at menarche; Conclusions: The results show that girls who were overweight during childhood went through early puberty. Further investigation needs to assess a possible cause-effect relationship. [ABSTRACT FROM AUTHOR]

Age at menarche may be associated with cardiovascular disease risk factors in different ethnic groups. The purpose of this study was to identify the association of cardiovascular disease (CVD) risk factors with age at menarche (AAM) in Mashhad, the second biggest city in Iran. This was a cross- sectional study based on cohort data of 2353 women (35–65 years) from Mashhad, Iran for whom the age at menarche was reported. Baseline demographic, anthropometric data, and biochemical profiles were also collected. The levels of depression and anxiety were evaluated using a validated Persian version of the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Multiple logistic regression models were used to examine the association between age at menarche with CVD risk factors. Anthropometric parameters, short stature, prevalence of diabetes, and CVD risk were significantly higher in women who were younger at menarche (AAM) in comparison to women with an older AAM. Women with a menstruating age of 11 years had a significantly higher weight (P < 0.001), higher BMI (P < 0.001), lower waist circumference (WC) (P = 0.004), higher hip circumference (HC) (P < 0.001) and higher waist-to-thigh ratio (WTR) (P < 0.001) than women with an AAM of ≥ 15 years. University-educated women and employed women were most likely to have menarche at ≥ 15 years (P < 0.001 and P = 0.012 respectively. In girls who menstruated at age ≤ 11 years old, the odds of having a BMI > 28.7 kg/m2, WC > 96 cm, HC > 105 cm and WTR > 61.96 were higher than girls who menstruated at 13 years old. The odds of height > 155 cm was higher in girls with menarche age of ≥ 15 than 13 years and the odds of having depression scores greater than 12 was lower in menarche age group of ≥ 15 years. The girls with menstruation age of 12 years had higher odds of having diabetes mellitus and HC > 105 cm than girls with menstruation age of 13 years. The odds of demi span exceeded 74 cm and height > 155 cm were higher in girls with menarche age of 14 than 13 years. AAM may be a useful factor to identify women at greater risk of CVD to implement appropriate preventive measures. [ABSTRACT FROM AUTHOR]

Objective: Early menarche is associated with uterine fibroid risk, but the association between menarcheal timing and fibroid severity remains to be explored. Given the hormonal dependence of fibroids, earlier menarche may increase physical burden (e.g., number of fibroids) and/or symptoms (e.g., heavy menstrual bleeding), though the two are not always correlated. We hypothesized that individuals with earlier menarche are more likely to have severe fibroids. Design: We analyzed observational data using linear regression models to examine the association between earlier age at menarche and fibroid severity. Subjects: Individuals seeking hysterectomy (n = 110) for fibroid management at a hospital in Washington, D.C. from 2014 to 2021 as part of the Fibroids, Observational Research on Genes and the Environment study. Exposure: Participants recalled age at menarche during adulthood. We modeled age at menarche continuously, and we defined early menarche as menarche before 12 years in descriptive analyses. Main Outcome Measures: We evaluated three types of fibroid severity outcomes: self-reported symptoms using validated scales, clinical parameters (e.g., fibroid number and size), and age at hysterectomy. Results: In our predominantly Black sample, early menarche (i.e., <12 years) was reported by 25.5% (28/110) of participants. In adjusted linear models, earlier menarche was associated with increased symptom severity [b = −3.3 (95% CI: −6.05, −0.56)], younger age at hysterectomy [b = 0.8 (95% CI: 0.2, 1.41)], and uterine weight over 250 g (compared with ≤250 g) [b = −0.05 (95% CI: −0.11, −0.00)], but not with other measures of physical fibroid burden. Conclusion: Earlier menarche was associated with measures of fibroid severity. Prolonged exposure to estrogen via early menarche may accelerate the tumorigenesis process. Patient-reported symptoms as well as measures of physical burden should be considered when investigating the etiology of fibroid-related morbidity. [ABSTRACT FROM AUTHOR]

The evidence for an association between early menarche and depression is inconsistent. We therefore performed a meta-analysis to examine this association. The protocol for the current study was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with registration number CRD42023483591. We searched several databases up to 17 June 2024. Random effects models were used to calculate pooled effect sizes. A total of 22 studies involving 87,798 participants were included. The Newcastle–Ottawa Scale (NOS) scores of the 22 studies ranged from 4 to 8, with a median score of 6. Depression scores and depression incidence were significantly higher in the early menarche group than in the non-early menarche group (Standardized Mean Difference: 0.13, 95 % CI: 0.04, 0.21; OR: 1.37, 95 % CI: 1.23, 1.52). However, moderate heterogeneity was observed (depression scores: I2 = 54 %, p = 0.03; depression incidence: I2 = 61 %, p = 0.001). Subgroup analyses revealed that depression scores were significantly associated with study type (cohort studies: I2 = 57 %, p = 0.071; case–control studies: I2 = 61 %, p = 0.051) and study quality (≥ 6: I2 = 58 %, p = 0.065; < 6: I2 = 62 %, p = 0.052). This meta-analysis revealed that early menarche was associated with depression. Parents, schools and health care providers should monitor the emotions of girls who experience menarche at an earlier age. • 22 studies with 87,798 participants were included in the study. • We pooled the different effect sizes according to the type of outcome indicator. • The results found that girls with early menarche had greater risk of depression. • Timely interventions can support girls with early menarche in reducing their vulnerability. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background The American Cancer Society recommends physicians inform average-risk women about endometrial cancer risk on reaching menopause, but new diagnoses are rising fastest in women aged younger than 50 years. Educating these younger women about endometrial cancer risks requires knowledge of risk factors. However, endometrial cancer in young women is rare and challenging to study in single study populations. Methods We included 13 846 incident endometrial cancer patients (1639 aged younger than 50 years) and 30 569 matched control individuals from the Epidemiology of Endometrial Cancer Consortium. We used generalized linear models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for 6 risk factors and endometrial cancer risk. We created a risk score to evaluate the combined associations and population attributable fractions for these factors. Results In younger and older women, we observed positive associations with body mass index and diabetes and inverse associations with age at menarche, oral contraceptive use, and parity. Current smoking was associated with reduced risk only in women aged 50 years and older (P het <.01). Body mass index was the strongest risk factor (⁠ OR ≥ 35   vs < 25   kg / m 2 = 5.57, 95% CI = 4.33 to 7.16, for ages younger than 50 years; OR ≥ 35   vs < 25   kg / m 2 = 4.68, 95% CI = 4.30 to 5.09, for ages 50 years and older; P het =.14). Possessing at least 4 risk factors was associated with approximately ninefold increased risk in women aged younger than 50 years and approximately fourfold increased risk in women aged 50 years and older (P het <.01). Together, 59.1% of endometrial cancer in women aged younger than 50 years and 55.6% in women aged 50 years and older were attributable to these factors. Conclusions Our data confirm younger and older women share common endometrial cancer risk factors. Early educational efforts centered on these factors may help mitigate the rising endometrial cancer burden in young women. [ABSTRACT FROM AUTHOR]

Background: Premature coronary artery diseases (PCAD) is a major health concern. Finding the potential risk factors for this health issue is crucial for early detection and prevention. This study aimed to evaluate the relation between age at menarche and PCAD presence and severity. Methods: This study was performed in the framework of the Iran premature coronary disease (IPAD). IPAD is a multiethnic case–control study conducted from 2020. PCAD was defined as at least 75% obstruction in more than one coronary artery or above 50% in the left main artery in man and women under the age of 60 years and 70 years, respectively. Age at menarche is evaluate using self-reporting questionnaire. We categorized age at menarche into three groups: early (8–11 years), average (12–13 years), and late (14–17 years). Results: A total number of 1035 women participated in this study. No significant association was observed between every year increase in age at menarche and the PCAD risk after fully adjustment with odds ratio (OR) 95% confidence interval (95% CI) OR = 0.98, 95% CI 0.91–1.05, P = 0.65 Besides, no significant association was seen between number of obstructed vessels and age at menarche (OR = 1.01; 95% CI 0.94–1.08, P = 0.76). Following the subgroup analysis based on ethnicity, it was observed that only individuals of Gilak ethnicity showed a significant association between a 1-year increase in age at menarche and the risk of PCAD (OR = 0.68, 95% CI 0.49–0.95, P = 0.026). Conclusion: This study suggested that age at menarche may not be connected to PCAD risk and number of obstructed vessels. However, ethnicity may have roles in terms of the relationship between age at menarche and PCAD. More longitudinal studies are needed to evaluate this relationship. Trial registration number: IR.MUI.REC.1396.2.055. [ABSTRACT FROM AUTHOR]

This review examines the inconsistent effects of endocrine-disrupting chemicals (EDCs) and pollutants on pubertal timing, emphasizing the methodological challenges contributing to variability in findings. Data from nine key studies reveal that chemicals such as BPA, phthalates, and PFAS impact pubertal onset differently based on exposure timing, dosage, and sex. For instance, BPA is linked to earlier puberty in girls but delayed onset in boys, while other EDCs show mixed effects across populations. These discrepancies often arise from challenges in study design, such as the difficulty in establishing reliable control groups, accurately measuring exposures, and accounting for confounding factors like socioeconomic status, diet, and obesity. Sex-specific differences and environmental shifts during the COVID-19 pandemic, including increased indoor exposure and stress, further complicate the picture. These factors highlight the urgent need for more robust research methodologies, including standardized exposure assessments and longitudinal studies, to clarify the mechanisms driving these effects. Despite these challenges, the findings stress the importance of public health interventions, such as stricter EDC regulations, improved pollutant monitoring, and minimizing exposures during sensitive developmental windows. Addressing methodological gaps is crucial for producing reliable, actionable insights to protect adolescent development from the adverse effects of EDCs. [ABSTRACT FROM AUTHOR]

Introduction: Globally, there has been a decline in the age of menarche; the decline is higher in poorer countries than in richer ones. The measurement of the decline was based on the reported mean age at menarche (MAM) across the countries. There is a significant knowledge gap in investigating the generational decline in MAM in low- and median-income countries (LMC). In Nigeria, different studies have reported MAM, but none have attempted to investigate the generational shift in the reported MAM in girls residing in rural and urban areas. This review sought to understand if there is a rural-urban disparity in the MAM. Methods: Documents were searched in the relevant bibliometric database and Population intervention, comparison(s) and outcome (PICO) framework were used as eligibility criteria for extracting data from the documents based on some inclusion and exclusion criteria. The population are adolescent schoolgirls in rural and urban settlements in Nigeria. The comparator is the age of menarche of urban versus rural adolescent schoolgirls in Nigeria, while the mean age at menarche (MAM) is the outcome. Data quality assessment was done to critically appraise the included studies and enhance. Data were synthesized using narrative review, descriptive and inferential statistics. Results: Ten articles were included in the study, following the PRISMA framework. The overall mean evaluation of the risk of bias in the individual studies included in the review was computed to be 88%. Generally, there seems to be a decline in the age at menarche from 1976 to 2023. The rural MAM is higher than the urban MAM, and the gap between the two appears to be narrowing. The t-test showed no statistically significant mean differences between the rural and urban mean age at menarche (T = 2.1009, p value = 0.4679). The mean menarcheal age for girls in rural and urban areas is 13.44 and 13.04, respectively. There is a strong positive correlation between the rural and urban MAMs (Pearson = 0.93, p < 0.001). The Gaussian kernel estimated a bimodal distribution for rural girls, where they are most likely to experience menarche at 11 and 13 years, respectively, while urban girls are most likely to experience menarche at 13 years. In both locations, the incidence of menarche decreases just after the peak at 13 years. Conclusion: Although rural girls have delayed menarche, there is no statistically significant mean difference between the age at menarche reported for rural and urban areas in Nigeria. Interventions in the form of counseling and reproductive education are recommended. The review provides a strong foundation for further research and policy development aimed at improving the health and well-being of adolescent girls in Nigeria and other similar settings. PROSPERO Registration: CRD42024529497 [ABSTRACT FROM AUTHOR]

Background: Although endogenous estrogen exposure, influenced by reproductive factors (RFs), is negatively associated with fracture risk, there is limited and conflicting information on the association between these factors and the incidence of fractures. This study aimed to evaluate the association between RFs and fracture incidence (FXI) separately. Methods: This longitudinal study commenced in 1999 and concluded in 2021. It is performed on women without previous fractures and adjusted for confounders. RFs, including age at menarche, parity, abortion, duration of breastfeeding (BF), hormonal contraceptive use, and age at menopause, were exposure variables. The incidence of fractures was the primary outcome. A Cox proportional hazards regression model was used to estimate the associations between RFs and FXI outcomes. Results: The median (interquartile range) of follow-up time was 15.0 (12.1–17.0) years. A total of 19.9% (1324/6653)of the women were menopausal at baseline, and 13% (865/6653) of the remaining participants reached menopause at the end of follow-up. At the end of the follow-up, 222 (3.3%) participants had fractures. The mean age of participants at the initiation of the study and last follow-up were 35.8 (15.5) and 50.0 (15.3) years, respectively. After adjusting for potential confounders, the HR of FXI increased by 10% per one extra delivery (HR: 1.10,95% CI: (1.03, 1.18); p = 0.01), and by 12% per one-year increase in age at menarche (HR: 1.12, 95% CI: (1.02, 1.23); p = 0.02). The HR of FXI decreased by 3% per month extra exclusive BF (HR: 0.97,95% CI: (0.94, 0.99); p = 0.04). Conclusions: The results elucidate that a longer duration of exclusive BF has a protective effect on FXI. In contrast, increasing age at menarche and the number of parities increase the risk of FXI. [ABSTRACT FROM AUTHOR]

Introduction: Premature adrenarche in girls is defined biochemically by an increase in adrenal androgen (DHEAS) levels above the age-specific reference range before age 8 years. Recently, increased levels of 11-oxyandrogens have also been reported in girls with premature adrenarche. Epigenetic modifications, specifically CpG methylation, may affect gene expression and/or activity of steroidogenic enzymes during developmental changes in adrenal androgen secretion. Objective: The aim of the study was to determine whether circulating 11-oxyandrogen levels in post-menarcheal girls are associated with the methylation status of genes involved in 11-oxyandrogen steroidogenesis. Methods: Ninety-seven healthy girls followed since the age of 3 years were classified, according to DHEAS serum concentration at age 6–7 years, as normal DHEAS (<42 μg/dL [75th percentile for population]) or high DHEAS (≥42 μg/dL). At Tanner stage 2, the methylation status of CpG sites located in CYP11B1 and HSD11B2 genes was analyzed in genomic DNA from peripheral blood leukocytes by the melting curve analysis methylation assay. Eleven-oxyandrogen concentrations were assessed at 4 years post menarche. Results: Significantly lower methylation levels were detected in the CYP11B1 gene in girls with high versus normal serum DHEAS levels, with no differences found in HSD11B2 gene. Additionally, CYP11B1 methylation status correlated inversely with 11β-hydroxy-androstenedione and 11-ketotestosterone levels. Furthermore, CYP11B1 methylation in the full cohort correlated inversely with insulin concentration at Tanner 1 and with body mass index at Tanner stage 1 and 2. Conclusion: This pilot study proposes the hypothesis that a lower methylation of CYP11B1 may be a mechanism contributing to increased concentrations of 11-oxyandrogens in premature adrenarche and its associated metabolic risk. [ABSTRACT FROM AUTHOR]

This study aims to address the overlooked effect of bilateral asymmetry for sex estimation in non‐adult paired bone structures. Using a recently developed method, disparities between right and left iliac auricular surfaces (AuSs) were quantified, also verifying the effectiveness between sides regarding the percentages of cases correctly assigned. A sample of 418 AuSs belonging to 209 individuals aged 5 gestational months to 18 years (113 males and 96 females) from the Coimbra, Lisbon, and Granada Identified skeletal collections, were studied. They were grouped into two large age cohorts (≤12 y.o. and 12.1–18 y.o.) based on the onset of menarche. The significant and distinct hormonal fluctuations between sexes in ≤2 y.o. individuals compelled an additional separation. Locomotion issues also imposed grouping individuals for comparison in non‐bipedal (≤1 y.o.) and those who were still achieving emerging gait milestones (1.1–6 y.o.). Overall agreements between sides, sexes, age cohorts, and morphometric variables were compared using Cohen's κ and intraclass correlation coefficients, while chi‐square and Kolmogorov–Smirnov tests were applied for statistically significant evaluation. Asymmetry directionality was calculated through standardized directional and total asymmetry scores. Slight asymmetries between sides were identified, becoming the pre‐pubertal left AuS more useful for non‐adult female sexing. Metric variables work better in males, possibly due to the higher variability found in females. Both sexes display a marked age‐related change in asymmetry during puberty (12.1–18 y.o.), with a predominance of the right side in females and of the left side in males. Possible explanations for the identified pubertal abrupt shifts are discussed considering the various developmental biomechanical milestones. This pioneering study reinforces the complexity of somatic growth and development that characterizes non‐adult phenotype, calling for further refinement of sexing methods considering bilateral asymmetry, and for complementary studies that deepen the study of dextralization and its repercussions in adults. [ABSTRACT FROM AUTHOR]

Background: The challenges of safe menstrual hygiene management practices in low-income settings, including the study areas are pressing. However, Studies specifically focusing on barriers that schoolgirls face in managing monthly menstruation in schools of Bahir Dar are inadequate and scarce. Method: To ensure the robustness of the findings, a comprehensive study was conducted among schoolgirls and boy students aged 12–20 in three schools. This study employed focus group discussions and in-depth interviews with students and leaders of the school gender club. A word cloud generator was used to visually represent frequently mentioned keywords, and the data generated from interviews were analyzed using the Open Code 4.03 tool. Results: The findings, derived from focus group discussions and in-depth interviews, revealed several significant barriers that schoolgirls face in practicing safe menstrual hygiene management. These barriers, including sociocultural factors (133), inadequate use of menstrual hygiene management facilities (73), inadequate knowledge before menarche (59), and a general lack of support (35), underscore the multifaceted nature of the issues. Importantly, these findings emphasize the urgent need for targeted interventions to address these barriers and improve menstrual hygiene management among schoolgirls. Conclusion: Schoolgirls in Bahir Dar encounter numerous challenges in maintaining safe menstrual hygiene practices. Addressing the identified modifiable barriers represents crucial areas for intervention, requiring collaborative efforts from school communities and other relevant stakeholders to create an environment conducive to promoting and enhancing safe menstrual hygiene practices. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions This research aimed to understand the long‐term trends in the age of menarche among girls and spermarche among boys, and to analyze the factors that may influence the onset of menarche and first spermarche.The study was based on data from 49 566 students in Henan Province collected from the Chinese National Surveys on Students' Constitution and Health (CNSSCH) conducted between 2000 and 2019. Median age at menarche and spermarche was estimated by probit analysis. t‐Tests were used to analyze the influence of menarche and first spermarche on physical examination indexes of adolescent children, and the chi‐squared test was used to compare whether the differences in physical activity were statistically significant.The age at menarche has decreased from 12.33 years in 2000 to 12.00 years in 2019, and the age at first spermarche has decreased from 14.01 years in 2000 to 13.99 years in 2019. The age at first spermarche in urban boys (13.61 years in 2000; 12.94 years in 2014) was consistently younger than that in rural boys (14.43 years in 2000; aged 13.08 in 2014), except in 2019. The age of menarche in urban girls (12.23 years in 2000; 11.89 years in 2019) was always earlier than that in rural girls (12.44 years in 2000; 12.05 years in 2019).The age at menarche and spermarche for children in Henan Province generally showed a decreasing trend from 2000 to 2019. The status of BMI is significantly associated with the early onset of puberty in children. [ABSTRACT FROM AUTHOR]

Background: Menstruation is a universal and normal phenomenon during the reproductive age of females; adolescence is an essential period where females are preparing and adjusting themselves to manage their menstrual bleeding safely and cleanly. Menstrual hygiene management (MHM) is an issue that is insufficiently acknowledged and has not received adequate attention among visually impaired adolescent girls (VIAGs). Objectives: The purpose of this study was to determine the knowledge and practice of MHM and associated factors among VIAGs of selected institutions in Rwanda. Design: This study consisted of a cross-sectional study design using a quantitative approach. Methods: A cross-sectional study was conducted in April and May 2021 on 92 VIAGs. They were recruited from educational institutions in two Provinces in Rwanda. Voluntary participation and confidentiality were assured. Socioeconomic and demographic data, menstruation, and menstrual hygiene questionnaires were used to obtain the required information. Statistical Packages for the Social Sciences (SPSS) for Windows version 25 was used. Descriptive statistics, Chi-square test, and logistic regressions were used for data analysis. Results: The study reached 92 respondents. The majority of the respondents, 67.4% had a poor level of menstruation and menstrual hygiene knowledge while only 32.6% had a good level of menstruation and menstrual hygiene knowledge. Also, it is confirmed that the majority of respondents, 52.1% had a good level of practice, while 47.8% had a poor level of menstrual hygiene practice. The multivariable analysis revealed that factors associated with the menstrual hygiene practice were as follows: the mother's education (odds ratio (OR): 5.979; 95% CI: [1.700–21.032]; p value: 0.005) and level of knowledge of menstruation and menstrual hygiene (OR: 0.132; 95% CI: [0.028–0.622]; p value: 0.010). Conclusion: The knowledge and practice of MHM among VIAGs were poor. Recommendations included the need for mothers to assist their daughters in improving learning and practice of menstrual hygiene, as well as the integration of MHM into school curricula. Further research is suggested to better understand MHM among Rwandan adolescent girls, both visually impaired and non-blind. [ABSTRACT FROM AUTHOR]

AbstractA cross-sectional study describing aspects of menstrual poverty was analyzed with 201 female lower-secondary students in Mexico. The 15.5% indicated having a lot of knowledge about menstruation before experiencing it, increasing to 36.5% once menstruation began. Nearly 80% expressed negative or erroneous ideas about menstruation. Adolescents whose mothers have a basic educational level or lack formal education are twice as likely to not have information at the time of menarche (OR = 2.08, 95% CI 1.00, 4.33). Promoting educational initiatives would help that new generations of adolescents can live a menstruation in a dignified, safe and positive way. [ABSTRACT FROM AUTHOR]

Introduction: Aromatase excess syndrome (AEXS) is a rare, autosomal dominant disorder, characterized by enhanced aromatization of androgens and estrogen excess. In males it is characterized by pre-/peripubertal gynecomastia, hypogonadotropic hypogonadism, advanced bone age and short adult height. Only a few female patients have been described so far. Methods: We report on a family with four members with AEXS and present the long-term effects of aromatase inhibitor use in three of them. Genetic analysis showed a monoallelic 0.3-Mb deletion in 15q21, involving parts of CYP19A1 , GLDN and DMXL2 in all four patients with AEXS. Results: The index patient (male, 8 years old) presented with gynecomastia and accelerated growth and bone age. With start of puberty, estradiol levels increased, while testosterone levels remained low. Gynecomastia progressed and a mastectomy was performed twice. Presuming AEXS, a therapy with letrozole was initiated at the age of 19 years. Low-dose letrozole treatment was associated with an increase in testicular volume, increase in virilization and improvement in physical strength and libido. His brother (age 3 years) presented with accelerated growth and bone age. Treatment with letrozole, which was started at the age of 7 years, resulted in achieving an adult height of 179 cm and prevented the appearance of gynecomastia. His sister (age 6 years), who presented with premature thelarche and accelerated growth and bone age, was treated with an estrogen receptor modulator and a GnRH analog followed by letrozole treatment. Menarche occurred at age 13.5 years and adult height was 158 cm. Their father had an early, accelerated growth with an adult height of 171 cm, a delayed puberty and no gynecomastia. In vitro studies provided evidence for involvement of aromatase induction in atypical cells and an increased range of potential mechanisms regulating aromatase activity due to the presence of the mutated allele. Discussion: In conclusion, we observed a phenotypic variability within family members with AEXS carrying the same CYP19A1 microdeletion. When started early, treatment with letrozole was found to prevent the development of gynecomastia and increase adult height in one patient. In adult life, low-dose letrozole treatment resulted in improved physical strength and libido in the index patient. [ABSTRACT FROM AUTHOR]

Age at the onset of menarche is affected by several factors. However, the characterization of such factors in the United Arab Emirates (UAE) remains partly elusive. We investigated the factors influencing the mean menarcheal age in schoolgirls from Sharjah, UAE. We also evaluated the menstrual knowledge and hygiene practices in the study population. We recruited 410 schoolgirls aged 8–17 years in this cross-sectional study. Data were obtained via a self-administered questionnaire. The mean age at menarche was 11.5 years (±1.17 SD) in the study population. A significant correlation was found between lower household income and delayed age at menarche (p = 0.005). Students who were less than 12 years old attained menarche earlier than older students (p = 0.001). Among the participants, 57.7% had good knowledge about menstruation and 54.7% adopted adequate hygiene practices. The mean age at menarche in the UAE is lower than in other Gulf regions. Earlier implementation of menstrual education programmes at schools is recommended. [ABSTRACT FROM AUTHOR]

Alcohol consumption is an established cause of female breast cancer. This systematic review examines in detail the association between alcohol and female breast cancer overall and among the described subgroups, using all of the evidence to date. A systematic review of PubMed and Embase was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The search included articles published up to November 15, 2023. Meta‐analyses and regressions were performed for alcohol consumption of less than 1 standard drink (10 g of ethanol) per day and for a range of alcohol consumption categories in relation to breast cancer. Analyses by menopausal status, hormone receptor status, human epidermal growth factor receptor 2 status, and molecular subtype were performed. The search yielded 5645 publications, of which 23 publications of individual and pooled studies examined the association between overall alcohol consumption and breast cancer incidence. The meta‐regression showed a positive association; relative risks (RR) of breast cancer were 1.05 (95% CI: 1.04, 1.06), 1.10 (95% CI: 1.08, 1.12), 1.18 (95% CI: 1.15, 1.21), and 1.22 (95% CI: 1.19, 1.25) for 0.5, 1, 2, and 3 standard drinks per day compared with nondrinking, respectively. A meta‐analysis of nine studies indicated that for consumption of less than one standard drink per day, the RR estimate of breast cancer was 1.04 (95% CI: 1.01, 1.07) compared with nondrinking. Consumption of an additional 1 standard drink per day was associated with a higher risk of premenopausal (RR: 1.03 (95% CI: 1.01, 1.06)) and postmenopausal (RR: 1.10 (95% CI: 1.08, 1.12)) breast cancer. Alcohol consumption increases female breast cancer risk, even for women who consume one drink per day. Furthermore, alcohol consumption is associated with both pre‐ and postmenopausal breast cancer risk. These findings support evidence‐based cancer prevention guidelines to reduce alcohol‐related risks. [ABSTRACT FROM AUTHOR]

Objective: To analyze differences in the menstrual pattern, age at menarche, and body mass index (BMI) in adolescents with Hypothalamic-Pituitary-Ovarian (HPO) axis immaturity and Polycystic Ovary Syndrome (PCOS) through a systematic review and meta-analysis. Methods: The PubMed, EMBASE, Web of Science, Virtual Health Library, Scopus databases were searched using combinations of descriptors. Study quality was assessed using the Newcastle-Ottawa Scale. For data analysis, the results were grouped into PCOS group and NPCOS group (HPO axis immaturity). We performed a meta-analysis of raw data and the inverse variance method, employing the standardized mean difference, of the age at menarche and BMI of adolescents. Results: Participants totaled 1,718 from nine selected studies. The meta-analysis showed that the PCOS group had a higher BMI than the NPCOS group (SMD 0.334; CI95% 0.073 − 0.595; p =.012). The degree of heterogeneity of the studies was approximately 40%. No significant difference in age at menarche (SMD − 0.027; CI95% −0.227 − 0.172; p = 0.790) and menstrual patterns was found, but amenorrhea was described only in adolescents with PCOS. Conclusions: The main characteristic in menstrual pattern that differentiated PCOS patients from girls with HPO axis immaturity was amenorrhea. Also, the BMI of PCOS patients was nearly one third higher than that of adolescents with HPO axis immaturity. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the impact of growth hormone (GH) therapy on the onset and progression of puberty in girls with idiopathic short stature. Methods: This study included 541 girls aged between 4.5 and 10.6 years who were receiving GH treatment, monitored over a 22-year follow-up period. Of these, 126 girls have been followed up to the onset of menarche. The participants were divided into two groups: a ISS control group (n = 66) and a group receiving daily GH treatment at a dose of 0.15 iu/kg (n = 60). We assessed the pubertal development and GH usage of these girls every three months. Results: (1) There was no significant difference in the onset of puberty between the growth hormone (GH) treatment group and the control group; however, the average duration of puberty was longer in the treatment group compared to the control group. (2) During puberty, there were no significant differences in height growth between the treated and untreated groups. (3) The duration of GH treatment showed a significant negative correlation with the age at onset of gonadal development and the age at menarche in females within the treatment group. Conclusion: GH treatment does not seem to accelerate the onset of puberty but may extend its duration, without significantly impacting height growth during puberty. Additionally, longer GH treatment duration is linked to earlier gonadal development and menarche in females. [ABSTRACT FROM AUTHOR]

This paper explores menstruation as a domain of kinship within and across three generations of women in central Kerala, India. Based on fieldwork, it shows that certain gendered practices of intimacy and care work in the context of menstruation produce kinship bonds among them, which the authors enunciate as 'menstrual kinship.' In the past, it was shared chiefly among consanguineal and affinal kinswomen and same-caste women, and became conspicuous only during public menarche rites and the separation of menstruating women. Presently, menstrual kinship extends to women outside the natal and marital family, often overturns the traditional perspectives of menstruation and actively contributes to maintaining the contemporary 'invisibility' of menstrual phenomena. The paper posits that regardless of its gendered nature and time-tethered transformations, 'menstrual kinship' has always existed as a realm that can release menstruation from conventional discourses of patriarchy and caste and aid in retrieving women's phenomenological experiences and voices. [ABSTRACT FROM AUTHOR]

Introduction: We aim to investigate the relationship between individuals' perceptions of their neighbourhood environment and early menarche. Methods: This was a retrospective cohort study of 7,486 girls of Ethiopia, India, South Korea, the United Kingdom (UK), and the United States (US), born in 1997–2011 was analysed. Early menarche was defined as being below the 10th to 20th percentiles in each cohort, considering the varying distributions across countries. Perceived neighbourhood environments were assessed based on the responses for neighbourhood pollution, safety, and recreational facilities. We calculated the relative risk (RR) of early menarche for unfavourable environment. Results: The mean age at menarche was lowest in South Korea (10.6 years) and highest in Ethiopia (13.7 years). Unfavourable environment was associated with higher risk of early menarche overall (RR = 1.34, 95% confidence interval [CI]:1.09–1.65) and each country (3.03, 95% CI: 1.15–7.96 in Ethiopia; 1.99, 95% CI: 0.97–4.10 in India, 1.23, 95% CI: 0.67–2.27 in Korea; 1.26, 95% CI: 0.96–1.64 in the UK). Specifically, pollution (1.29, 95% CI: 1.03–1.62) and low safety (1.19, 95% CI: 1.60–1.88) were associated with early menarche. Conclusions: Our finding highlights the potential role of perceived neighbourhood environment in the timing of puberty. SHORT CONDENSATION: Unfavourable neighbourhood environments, specifically pollution and low safety, were associated with early menarche among girls of five countries. This finding highlights the impact of the built environment on the timing of puberty. [ABSTRACT FROM AUTHOR]

To assess the knowledge of ovulation and menstruation of adolescent females in Western Australia. A validated adolescent ovulatory menstrual health literacy questionnaire was used in a cross-sectional study, which included an open-response question inviting participants' reflections. Participants (n = 297) were from two single sex and seven coeducational schools of varied socio-educational advantage. Mean chronological age was 15 years and mean gynecological age was two years. The prevalence of dysmenorrhea was 69%. Primary sources of information included mothers (91%), friends (61%), and for postmenarchel participants (n = 274), mobile applications (52%). Most adolescents enjoyed finding out information about ovulatory menstrual health, and understood the information given to them. However, participants' knowledge of ovulation, menstruation and their occurrence in the cycle were low. Attendance at a single sex or Catholic school or use of mobile applications did not confer a knowledge advantage overall (P <.05), except for knowing the meaning of cervical mucus. Thematic content analysis of open-ended responses resulted in five themes, including normality, menstrual flow, charting, ovulation, and dysmenorrhea. Inadequate functional ovulatory menstrual health literacy hampers progression to acquiring complete health literacy. This has negative implications for progressing towards the interactive and critical ovulatory menstrual health literacy domains, which include providing an accurate menstrual history when engaging with healthcare providers. [ABSTRACT FROM AUTHOR]

To evaluate changes in the age at menarche in Asian populations. Retrospective cohort study. We included 548,830 women from six countries in Asia. The data were sourced from 20 cohorts participating in the Asia Cohort Consortium (ACC) and two additional cohort studies: Japan Multi-institutional Collaborative Cohorts (J-MICC), and Japan Nurse Health Study (JNHS) with data on age at menarche. Joinpoint regression was used to evaluate changes in age at menarche by birth year and by country. The study includes data from cohorts in six Asian countries namely, China, Iran, Japan, Korea, Malaysia and Singapore. Birth cohorts ranged from 1873 to 1995. The mean age of menarche was 14.0 years with a standard deviation (SD) of 1.4 years, ranged from 12.6 to 15.5 years. Over 100 years age at menarche showed an overall decrease in all six countries. China showed a mixed pattern of decrease, increase, and subsequent decrease from 1926 to 1960. Iran and Malaysia experienced a sharp decline between about 1985 and 1990, with APC values of −4.48 and −1.24, respectively, while Japan, South Korea, and Singapore exhibited a nearly linear decline since the 1980s, notably with an APC of −3.41 in Singapore from 1993 to 1995. Overall, we observed a declining age at menarche, while the pace of the change differed by country. Additional long-term observation is needed to examine the contributing factors of differences in trend across Asian countries. The study could serve as a tool to strengthen global health campaigns. [ABSTRACT FROM AUTHOR]

Purpose: We compared the age at menarche and standard deviation score (SDS) of final height (FH) in permanent congenital hypothyroidism (CH) patients with those of healthy female adolescents and assessed their associations with CH screeningrelated variables or demographic factors. Methods: In this cross-sectional study, we included 207 female CH patients and 598 healthy age-matched female adolescents. Ages at puberty onset and menarche, height at puberty and menarche, and the FH and its SDS were evaluated in the 2 groups and compared. Associations between screening variables and anthropometric data with age at menarche and SDS of FH were also assessed in CH patients. Results: In the included population, 113 patients with CH and 453 healthy girls attained their FH. The mean ages at puberty onset and menarche in CH patients were higher than those in the healthy population (P<0.05). The mean height at menarche and the FH and its SDS were not different between the 2 groups (P>0.05). There was no significant association between FH SDS in CH patients and age of treatment (P=0.30). Age at menarche was significantly higher in CH patients with delayed age at treatment initiation (P=0.04). The difference between FH and target height was not significantly different among CH patients (P=0.83). Conclusion: While CH patients had a significantly higher age at menarche compared to the healthy population, appropriate treatment changed this age to be similar to that in the healthy group. However, CH patients who experienced delayed treatment had a higher age at menarche. Age at treatment initiation was the only screening-related variable related to age at onset of menarche and puberty. [ABSTRACT FROM AUTHOR]

Adolescence is a period of social, psychological, and physiological change, including the onset of puberty. Differential pubertal onset has been linked to a myriad of problems, including mental health problems. Therefore, we aim to investigate deviating pubertal development in autism, and whether this is more pronounced in girls than in boys. A total of 68 individuals (nASC = 34, nCOM (comparisons) = 34) aged 12 to 16 years were administered test concerning pubertal development and mental health (i.e., sensory sensitivity, autistic traits, depression, anxiety, and externalizing problems). Frequentist and Bayesian ANOVA was used to examine deviations in pubertal development in ASC and possible sex effects. Regression analyses was used to test whether this asynchronicity was linked to mental health problems. Our (frequentist and Bayesian) analyses revealed earlier onset and slower development of pubertal development in ASC but we did not find any sex differences. Maturation disparity was linked to higher mental health problems in ASC, but not in COM. No sex differences in the relation with mental health outcomes was found. We found evidence for a slower development of "true" puberty in those with ASC compared to those without. Moreover, we show that disparities in pubertal development are related to mental health in ASC, suggesting a greater impact on mental health in autistic than in non-autistic teens. Longitudinal studies are necessary to elucidate important developmental trajectories in puberty in neurodiverse populations. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between physical activity accumulated from early (age 22–27 y) to mid (age 40–45 y) adulthood and resting heart rate at age 41–46 years in women. Methods: Data were from 479 participants in the 1973–1978 cohort of the Australian Longitudinal Study on Women's Health. Participants reported physical activity every 3 years from age 22–27 years to 40–45 years. Linear regression models were used to investigate the associations of a cumulative physical activity score (average physical activity across 18 y; up to 7 surveys) and changes in physical activity from age 22–33 years to 34–45 years with resting heart rate at age 41–46 years. Results: Average resting heart rate at age 41–46 years was 75 (SD: 11) beats per minute. An inverse nonlinear dose–response association between cumulative physical activity and resting heart rate was observed. Overall, accumulation of physical activity was associated with lower resting heart rate regardless of the age when physical activity was accumulated. Women in the highest tertile of physical activity at both age 22–33 years and 34–45 years had a resting heart rate, on average, 8 beats per minute lower (95% confidence interval, −11.42 to −4.69) than those consistently in the lowest tertile of physical activity. Conclusion: Accumulating physical activity, irrespective of timing, appears to provide cardiovascular health benefits for women before the transition to menopause. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate a series of prospective life course models testing whether the timing of pubertal development is a pathway through which prepubertal risk factors may influence adulthood cardiometabolic health. METHODS: Subjects were 655 female participants in the NICHD Study of Early Child Care and Youth Development (SECCYD) and recent SECCYD 30-year follow-up, the Study of Health in Early and Adult Life (SHINE). Prepubertal risk factors included maternal menarcheal age, child race/ethnicity, child health status indicators, and child adversity indicators. Pubertal timing was indexed by breast development onset (Tanner stage [TS] II), pubic hair onset (TS II) and menarcheal age. Adulthood cardiometabolic risk (CMR) was indexed by a composite of waist circumference, systolic blood pressure, diastolic blood pressure, hemoglobin A1c, C-reactive protein, and high-density lipoprotein. RESULTS: Inspection of paths between the prepubertal risk factors, pubertal timing indicators, and adulthood CMR composite showed later breast development onset (-0.173, p < .01), later pubic hair onset (-0.182, p < .01), and later menarche (-0.145, p < .01) each predicted lower adulthood CMR, and each pubertal timing indicator mediated effects of prepubertal risk factors on adulthood CMR. Specifically, the timing of breast development onset and menarche mediated effects of maternal menarcheal age, Black (vs. White), Asian/PI (vs. White), child BMI percentile, and child SES on adulthood CMR (all ps < .05), and the timing of pubic hair onset mediated effects of maternal menarcheal age, Black (vs. White), and child BMI percentile on adulthood CMR (all ps < .10). CONCLUSION: Findings in the current study contribute to the broader literature by identifying pubertal development and its timing as a potentially important pathway through which early life exposures may shape adulthood cardiometabolic health and disease. These findings have important implications for novel opportunities for increased surveillance and potential intervention focusing on pubertal development as a target to improve health more broadly.

BackgroundThe current study examined if early adversity was associated with accelerated biological aging, and if effects were mediated by the timing of puberty.MethodsIn early mid-life, 187 Black and 198 White (Mage = 39.4, s.d.age = 1.2) women reported on early abuse and age at first menstruation (menarche). Women provided saliva and blood to assess epigenetic aging, telomere length, and C-reactive protein. Using structural equation modeling, we created a latent variable of biological aging using epigenetic aging, telomere length, and C-reactive protein as indicators, and a latent variable of early abuse using indicators of abuse/threat events before age 13, physical abuse, and sexual abuse. We estimated the indirect effects of early abuse and of race on accelerated aging through age at menarche. Race was used as a proxy for adversity in the form of systemic racism.ResultsThere was an indirect effect of early adversity on accelerated aging through age at menarche (b = 0.19, 95% CI 0.03-0.44), in that women who experienced more adversity were younger at menarche, which was associated with greater accelerated aging. There was also an indirect effect of race on accelerated aging through age at menarche (b = 0.25, 95% CI 0.04-0.52), in that Black women were younger at menarche, which led to greater accelerated aging.ConclusionsEarly abuse and being Black in the USA may both induce a phenotype of accelerated aging. Early adversity may begin to accelerate aging during childhood, in the form of early pubertal timing.

Abstract Introduction Adolescence is marked by hormonal, physical, neural, and behavioral changes, including in sleep patterns and, in females, the onset of menarche. Menstrual problems, such as painful menses, are common and contribute to school absences, and could indicate gynecological conditions impacting reproductive health. While studies in adults have shown associations between sleep disturbances and menstrual problems, this relationship is less understood in adolescents. Our study explores the association between sleep, menstrual problems, and menarche in a diverse sample of early adolescent girls in the U.S. Methods We used linear mixed-effect models to analyze associations between sleep behavior (self- and caregiver-reported) and menstrual problems (self-reported cycle irregularity, premenstrual symptom and menstrual pain severity and their impact on daily life) and menstrual characteristics (menstrual flow) in 3,037 post-menarcheal adolescent girls (Mean age:13.03 years) from the ABCD Study®. Covariates included years since menarche, race, ethnicity, parental education, and body mass index. We also used longitudinal data to explore changes in sleep behavior as a function of menarche. Results Of the sample, 26.2% reported moderate-severe premenstrual symptoms and 20.8% reported moderate-severe menstrual pain. 23.3% reported irregular menstrual cycles, 15.9% reported heavy menstrual flow. Shorter sleep duration was associated with greater menstrual pain intensity (β =—0.19) and impact on daily activities (β = -0.15), irregular cycles (β = -0.17), and severe premenstrual symptoms (β = -0.04). Higher sleep disturbance scores correlated with greater menstrual pain (β = 0.18) and premenstrual symptom severity (β = 0.03). Later wake-up times were linked to greater menstrual pain intensity (β = 0.14). Shorter time since menarche was associated with lower menstrual flow (β = 0.07) and pain intensity (β = 0.51) and less severe premenstrual symptoms (β = 0.07). Being post-menarche was associated with later bedtimes and shorter sleep duration. Conclusion Findings of links between sleep behavior and menstrual problems in early adolescence underscore the importance of addressing sleep and menstrual issues in healthcare screenings and educational initiatives for adolescents. Future research should focus on longitudinal and intervention studies to clarify these relationships.

Helalah Alenizy,1 Nouran Aleyeidi,2 Reema Almutairi,3 Leen Khosyfan,3 Raghad Bedaiwi,3 Leen Alowaidah,3 Hissah Alrushud,3 Khawla Alfadda,3 Lujain A Alshamekh,3 Najd Al Anazi,3 Shuruq Alshammari,3 Amal Alzahrani,3 Hanin Alomar3 1Obstetrics and Gynecology, Department of Obstetrics and Gynecology, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 2Community Medicine, Department of Family and Community Medicine, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 3College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Nouran Aleyeidi, Department of Family and Community Medicine, College of Medicine, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia, Tel +966 504304577, Email naaleyeidi@pnu.edu.saBackground: Menstruation is a natural process that occurs monthly in women. Although menstruation is a fundamental aspect of women’s lives, their readiness for and beliefs about menstruation vary. Moreover, their practices during menstruation can be influenced by various factors, including age, education level, mother’s education, and field of specialty. This study aimed to explore menstruation-related readiness, beliefs, and practices among women who had experienced menstruation in Saudi Arabia. In addition, the study aimed to evaluate the factors affecting these women’s readiness, beliefs, and practices regarding menstruation.Patients and Methods: This cross-sectional online questionnaire-based study included 3471 women of different ages who had experienced menstruation. The participants were selected using convenience sampling from all regions of Saudi Arabia. The questionnaire was distributed between late December 2022 and March 2023 and included questions on demographics and menstruation-related readiness, beliefs, and practices.Results: Of the 3471 participants, 1627 (46.8%) were well prepared for menstruation. In addition, most of the study participants (80.2%) had positive beliefs about menstruation. However, the participants’ menstrual practices varied. Over half of the participants (63%) used painkillers and approximately half (54.4%) used herbal medicine during menstruation.Conclusion: This study found that less than half of the participants were ready for menarche. In contrast, most participants displayed positive beliefs concerning menstruation. In terms of practices, the women exhibited certain dietary restrictions during their menstrual period and predominantly favored herbal remedies for pain relief over conventional painkillers. Implementing awareness campaigns and incorporating school education on menstrual readiness and hygiene is needed.Keywords: women’s health, gynecology, menarche, hygiene, herbal medicine, menstrual pain

Abstract Background Women who reach menarche and menopause at earlier ages have been shown to be at increased risk for numerous conditions including cardiovascular disease, cancer, depression, and obesity; however, risk factors for earlier ages of menarche and menopause are not fully understood. Therefore, we aimed to perform a retrospective investigation of the associations between a personal birthweight and/or being born preterm and the age of and menarche and menopause and related events in the Women’s Health Initiative, a large, racially and ethnically diverse cohort of postmenopausal women. Methods At study entry, women reported their birthweight by category (