Age at Menarche and Asthma Onset Among US Girls and Women: Findings from NHANES, 2001-2018

Background: Findings on the association between early menarche and asthma onset remain inconsistent and the evidence in the US is lacking. Furthermore, there was no clear separation of childhood- and adult-onset asthma in previous studies. Therefore, we aim at quantitatively estimating the association of age at menarche with risk of childhood- and adult-onset asthma separately in US girls and women.Methods: We conducted a retrospective cohort study of 24,282 US girls and women aged less than 80 years by using continuous NHANES data in 2001-2018. Weighted Cox proportional-hazards regression models with censoring ages of 19 and 79 were used to separately estimate hazard ratios of childhood- and adult-onset asthma associated with age at menarche. Results: Each one-year increase of age at menarche was significantly associated with a 17% (HR [95%CI]: 0.83 [0.77, 0.90]) decrease in the risk of childhood-onset asthma. Compared with age at menarche of 12-14, we observed a 60% (HR [95%CI]: 1.60 [1.22, 2.09]) increased risk of childhood-onset asthma for early menarche (age at menarche <12 years) and 41% (HR [95%CI]: 0.59 [0.32, 1.08]) decreased risk for late menarche (age at menarche ≥15 years). Race, family income, education and family history of asthma did not modify these associations. No significant association between age at menarche and adult-onset asthma.Conclusions: In this US nationally representative study, we found that early menarche was associated with increased risk of childhood-onset asthma, but not adult-onset asthma. These findings help demonstrate early menarche may be a risk factor for childhood-onset asthma in US, indicating timely and effective management of special individuals with early menarche for preventing asthma.

RISK FACTORS FOR ESTROGEN EXPOSURE IN VARIOUS GRADES OF ENDOMETRIOID CARINOMA

Background: Incidence endometrial cancer in Southeast Asia it is estimated that 41% of new cases emerge. The incidence of endometrial cancer in Dr. Soetomo General Hospital has increased every year. In 2016 there were 119 new cases of endometrial cancer and in 2017 there were 160 cases. 75%-80% is type I endometrial cancer (endometrioid carcinoma). Risk factors for estrogen exposure (early menarche, parity, obesity) are risk factors for endometrial cancer. The prognosis of endometrial cancer depends on the grade. This study aims to determine differences in risk factors for estrogen exposure in various grades of type I endometrial cancer (endometrioid carcinoma) in the Poli Onkologi Satu Atap Dr. Soetomo General Hospital Surabaya. Methods: the research method was analytic observational with cross-sectional design. Sample size of 40 medical records was taken by total sampling technique. Research variables include age of menarche, parity, BMI, and grade of endometrial cancer. The instrument used was a data collection sheet and medical records. Data analysis using chi-square test. Results: The results showed 52% patients were grade 1-2, there were 95% of menarche patients in the age range of 12-14 years, 62.5% patients had parity of 1-2 and 52% patients, BMI was underweight-normal category. Test results based on early menarche did not show significant differences between grades 1-2 and grade 3 in endometrioid carcinoma (p = 0.168). Likewise, parity in various grades of endometrial cancer type I (endometrioid carcinoma) there was no significant difference (p = 0.220) and BMI also no significant difference (p = 0.987). Conclusions: risk factors for estrogen exposure which include menarche, parity, obesity do not make a significant differences to the grades of endometrioid carcinoma.

827Early life influences on timing of menarche in racial/ethnic minority and immigrant women

Background Early life adversity and infections may theoretically affect the timing and effort of reproductive development. We examined associations of childhood adversity and exposure to tonsillitis with age at menarche in women age 40-64 years. Methods A multi-ethnic cohort of 394 women reported on exposure to parental maltreatment and maladjustment during childhood (&lt;18 years) and on any diagnosis of tonsillitis, an infection primarily acquired in early life and adolescence. We used linear and logistic regression models to examine the associations of cumulative/specific childhood adversity experience(s) and history of tonsillitis with average age at menarche and early onset of menarche (&lt;12 years of age). Results The average age at menarche was 12.6 years, and was significantly lower for women who lived with a mentally ill caregiver (M = 12.4 (95% CI: 11.7-13.0)) and those with a history of tonsillitis (M = 12.6 (95% CI: 12.0-13.2)). In adjusted multivariable models, living with a mentally ill caretaker (RR = 1.5, 95% CI: 1.0-2.1) and a having a history of tonsillitis (RR = 1.7, 95% CI: 1.3-2.4) were associated with increased risk of early menarche compared with women without these exposures. Cumulative and other specific adversities were not statistically associated with early menarche. Conclusions These findings support growing evidence that early life experiences may influence reproductive development. Key messages Early life adversity related to living with mentally ill caretakers and a history of tonsillitis is associated with earlier menarche in racial/ethnic minority and immigrant women.

The Effects Of Early Menarche On Sexual And Reproductive Health: A Scoping Review

Early menarche in adolescent girls has an effect on how quickly they come into contact with sexual life. This may have an impact on the increased incidence of unintended pregnancy, increased childbirth and abortion in adolescents. The condition of adolescents who are too young at menarche and poor reproductive health status will create problems with their menstruation, especially when the right sources of reproductive health information are not fully utilized. The aim of this scoping review is to interpret the effects of early menarche on sexual and reproductive health. The Scoping Review method was carried out using the following steps; 1) identifying research questions; 2) identifying relevant studies, through the Pubmed, Ebsco, and Wiley databases. In the search for articles, the keywords used are Effect OR Outcomes AND Menarche OR Menstruation OR Menstrua * OR menses OR "Early Menarche" AND "Reproductive Health" OR sexual reproduction * AND sexual behavior * OR "sexual debut" OR "Sexual Partners OR" unsafe sex "OR" unprotected sex ". The article criteria used are articles published from 2009 to 2019 and discussing the effects of early menarche on sexual and reproductive health; 3) the selection of articles was described using the Prisma Flow Chart where in full text search results, 18 articles were obtained and 9 articles was used for the review as these have quality assessment and according to population, methods, and results; 4) carrying out data charting; and 5) carrying out the compilation of results reports. The nine articles used as review materials discussed sexual health and early sexual reproduction in 101 respondents (21%) among sexually active students, 15 out of 89 students (16.9%) had low use of contraception, diseases of sexual health and reproduction (herpes simplex type-2, that is, women aged 14 who have experienced menarche have had sexual intercourse, HIV, which is 5.6% positive, as well as factors that affect sexual and reproductive health (45% education, 81.4% knowledge, economy due to low income, 60% sexual desire at the age of 14 years and only 11% who have not been sexually active at the age of 17 years). Early menarche and high sexual desire are health problems that have serious implications for adolescents. Provision of appropriate information and education on sexual and reproductive health for adolescents is urgently needed. It is hoped that the findings from the articles that have been reviewed can contribute to the importance of providing sex education from an early age.

When and how do adolescent girls in Japan become aware of premenstrual symptoms from menarche? A cross-sectional study among senior high school students

ObjectiveTo investigate the interval from menarche to the onset of premenstrual symptoms and its relationship with menarche age.DesignCross-sectional school-based survey.SettingUrban areas of Sendai, the largest city in northeastern Japan.Participants1422 female Japanese 10th–12th grade senior high school students participated in the survey.Main outcome measuresThe time of awareness of premenstrual symptoms, and the interval from menarche to the onset of premenstrual symptoms.Results1290 students had menstruation and completed the whole survey. The median age at menarche was 12 years (IQR: 11–13 years). The prevalence of self-reported premenstrual symptoms was 49%. The median age at which students became aware of premenstrual symptoms was 15 years (IQR: 14–16 years). The median time from the onset of menarche to awareness of premenstrual symptoms was 2 years. This time was negatively correlated with menarche age (ρ=−0.47, p<0.001). A Cox proportional hazards regression analysis revealed that early menarche was significantly associated with a lower cumulative risk of developing premenstrual symptoms (OR: 0.73 (95% CI 0.58 to 0.91)).ConclusionsHigh school students in Japan began experiencing premenstrual symptoms at around 15 years old, and within 2 years of menarche. This study suggested that social factors other than hormonal factors, such as early menarche, might be associated with the onset of premenstrual symptoms.

Longitudinal association of dietary sources of animal and plant protein throughout childhood with menarche

Background Inconsistent findings have been reported for associations between protein intake and age at menarche. We aimed to investigate the association between intake of protein and protein-containing food groups during childhood with menarche among Iranian girls. Methods Girls aged 6–18 years who did not experience menarche in the third or fourth examination cycles of the Tehran Lipid and Glucose Study were selected and were followed to the fifth examination cycle. Daily intakes of protein from different animal/plant sources and ten protein-containing food groups were assessed using a food frequency questionnaire at baseline (the third or fourth examination cycles). Occurrence of menarche and its onset age were asked during each examination cycle. Cox proportional hazards regression was used to estimating hazard ratios (HRs) and 95% confidence interval (95%CI) for the occurrence of menarche per one standard deviation (SD) of dietary intakes. Logistic regression was also used to estimate the odds of reaching menarche ≤12 years. Results During the study, 147(61%) of girls reached menarche, the median age at menarche was 12 years. The adjusted HRs (95% CI) for the occurrence of menarche per one-SD of dietary intakes were 0.68 (0.48, 0.98; p = 0.040) for plant protein and 1.36 (1.01, 1.84; p = 0.042) for animal protein after adjusting for baseline age, BMI Z-score, energy intake, and mother’s early menarche and education. Substituting 10-g animal protein with plant protein was associated with a 16% (95%CI: 5–25%; p = 0.006) lower risk of menarche. Dietary intakes of poultry (adjusted HR: 1.35; 95% CIs: 1.00–1.82; p = 0.049) and low-fat dairy (adjusted HR: 1.20; 95%CIs: 0.99–1.46; p = 0.064) were marginally associated with the increased risk of menarche. However, the odds of early menarche was significant only for plant protein (adjusted odds ratio = 0.39; 95% CI: 0.16–0.96; p = 0.040). Conclusions Our findings indicate that the risk of menarche increases by higher intakes of animal protein and decreases by plant protein. Intakes of poultry and low-fat dairy associate with a higher risk of menarche. The odds of menarche occurrence ≤12 years reduces by higher intakes of plant protein.