Role of biological, social and psychological factors in determining the menarche age: a multi-centered cross-sectional study in Karachi, Pakistan
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20251360Keywords:
Biological, Menarche, Psychological, Social, Women’s healthAbstract
Background: Menarche marks the beginning of the menstrual cycle, reflecting a complex interplay of biological, environmental, nutritional and socio-economic factors that contribute to variations in age at menarche. To determine the impact of physical and psychosocial factors on the age of menarche in girls from different socioeconomic backgrounds in Karachi, Pakistan.
Methods: A cross-sectional descriptive study was conducted among 305 female students aged 9 to 15 years from four different schools in urban and rural areas of Karachi district, Pakistan in 2022. Subjects who had not yet menstruated were excluded. Bilingual questionnaires were used in the study to record the responses. Height and weight were measured using calibrated instruments. The psychological stress levels were measured using APA LEVEL 2-anxiety-child aged 11-17 (Promis emotional distress -Pediatric Item bank). SPSS version 25 was used to find a correlation between the age of menarche with different biological, social and psychological factors.
Results: The mean age of menarche was 11.9±1.09 years. The study showed a significant correlation between body mass index and the father’s occupation was found (p<0.05). Presence, education, occupation, the combined income of both parents, number of siblings and female siblings, physical activity, diet, abuse, home environment, psychological and physical effect of COVID-19 lockdown and anxiety levels did not show any significant correlation with age of menarche.
Conclusions: This study supports the significant influence of body mass index and the father’s occupation on the age of menarche.
Metrics
References
Ramezani Tehrani F, Mirmiran P, Gholami R, Moslehi N, Azizi F. Factors influencing menarcheal age: results from the cohort of Tehran lipid and glucose study. Int J Endocrinol Metabol. 2014;12(3):16130. DOI: https://doi.org/10.5812/ijem.16130
Lacroix AE, Gondal H, Shumway KR, Langaker MD. Physiology, menarche. 2017.
Padez C. Social background and age at menarche in Portuguese university students: a note on the secular changes in Portugal. American J Human Biol. 2003 May;15(3):415-27. DOI: https://doi.org/10.1002/ajhb.10159
Rees L. 58 Growth, Nutrition, and Pubertal Development. Evidence-based Nephrol. 2009:6(4):2-4.
Papadimitriou A. The evolution of the age at menarche from prehistorical to modern times. J Ped Adoles Gynecol. 2016;29(6):527-30. DOI: https://doi.org/10.1016/j.jpag.2015.12.002
Karim A, Qaisar R, Hussain MA. Growth and socio-economic status, influence on the age at menarche in school going girls. J Adol. 2021;86:40-53. DOI: https://doi.org/10.1016/j.adolescence.2020.12.001
Wronka I, Pawlińska-Chmara R. Menarcheal age and socio-economic factors in Poland. Ann Human Biol. 2005;32(5):630-8. DOI: https://doi.org/10.1080/03014460500204478
Berkey CS, Gardner JD, Lindsay Frazier A, Colditz GA. Relation of childhood diet and body size to menarche and adolescent growth in girls. Am J Epidemiol. 2000;152(5):446-52. DOI: https://doi.org/10.1093/aje/152.5.446
Carwile JL, Willett WC, Spiegelman D, Hertzmark E, Rich-Edwards J, Frazier AL, et al. Sugar-sweetened beverage consumption and age at menarche in a prospective study of US girls. Human Reproduct. 2015;30(3):675-83. DOI: https://doi.org/10.1093/humrep/deu349
Towse JN, Cowan N, Hitch GJ, Horton NJ. The recall of information from working memory. Insights from behavioural and chronometric perspectives. Experimental Psychol. 2008;55(6):371-83. DOI: https://doi.org/10.1027/1618-3169.55.6.371
Reddy PJ, Rani DU, Reddy GB, Reddy KK. Reproductive health constraints of adolescent school girls. Indian J Soc Work. 2005;66(4):431.
Chang SR, Chen KH. Age at menarche of three-generation families in Taiwan. Ann Human Biol. 2008;35(4):394-405. DOI: https://doi.org/10.1080/03014460802154777
Shirazi TN, Rosinger AY. Reproductive health disparities in the USA: self-reported race/ethnicity predicts age of menarche and live birth ratios, but not infertility. J Racial and Ethnic Health Dispar. 2021;8(1):33-46. DOI: https://doi.org/10.1007/s40615-020-00752-4
Ulijaszek SJ, Evans E, Miller DS. Age at menarche of European, Afro-Caribbean and Indo-Pakistani schoolgirls living in London. Ann Human Biol. 1991;18(2):167-75. DOI: https://doi.org/10.1080/03014469100001502
Rees M. The age of menarche. ORGYN: Organon's Magazine Women & Health. 1995(4):2-4.
Georgiadis E, Mantzoros C, Evagelopoulou C, Spentzos DJAohb. Adult height and menarcheal age of young women in Greece. 1997;24(1):55-9. DOI: https://doi.org/10.1080/03014469700004772
Van Lenthe FJ, Kemper CG, van Mechelen W. Rapid maturation in adolescence results in greater obesity in adulthood: the Amsterdam Growth and Health Study. Am J Clin Nutr. 1996;64(1):18-24. DOI: https://doi.org/10.1093/ajcn/64.1.18
Matchock RL, Susman EJ. Family composition and menarcheal age: Anti‐inbreeding strategies. J Human Biol Asso. 2006 Jul;18(4):481-91. DOI: https://doi.org/10.1002/ajhb.20508
Ekwuocha I, Pereira A, Corvalán C, Michels KB, Gaskins AJ. Dietary Iron Intake about Age at Menarche: A Prospective Cohort Study in Chilean Girls. J Nutr. 2023;153(1):253-9. DOI: https://doi.org/10.1016/j.tjnut.2022.10.002
Dreizen S, Spirakis CN, Stone RE. A comparison of skeletal growth and maturation in undernourished and well-nourished girls before and after menarche. J Pediatrics. 1967;70(2):256-63. DOI: https://doi.org/10.1016/S0022-3476(67)80420-7
Duvivier BM, Schaper NC, Bremers MA, van Crombrugge G, Menheere PP, Kars M, et al. Minimal-intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable. PloS one. 2013;8(2):55542. DOI: https://doi.org/10.1371/journal.pone.0055542
Wilson ME, Fisher J, Chikazawa K, Yoda R, Legendre A, Mook D, Gould KG. Leptin administration increases nocturnal concentrations of luteinizing hormone and growth hormone in juvenile female rhesus monkeys. J Clin Endocrinol & Metabol. 2003;88(10):4874-83. DOI: https://doi.org/10.1210/jc.2003-030782
Petersen AC, Sarigiani PA, Kennedy RE. Adolescent depression: Why more girls. J Youth Adoles. 1991;20(2):247-7124. DOI: https://doi.org/10.1007/BF01537611
Ali TS, Rizvi SN. Menstrual knowledge and practices of female adolescents in urban Karachi, Pakistan. J Adoles. 2010;33(4):531-41. DOI: https://doi.org/10.1016/j.adolescence.2009.05.013
Hiatt RA, Stewart SL, Deardorff J, Danial E, Abdiwahab E, Pinney SM, et al. Childhood Socioeconomic Status and Menarche: A Prospective Study. J Adoles Health Public Soc Adoles Med. 2021;69(1):33-40. DOI: https://doi.org/10.1016/j.jadohealth.2021.02.003
Behel A, Raje L. Age at menarche in urban school-going girls: association between socio-economic status, BMI and physical activity. Int J Comm Med Public Health. 2021;8:666. DOI: https://doi.org/10.18203/2394-6040.ijcmph20210219
Kosińska M, Liczbinska G, Gautam R, Dubey P, Ahirwar A, Chaurasia A. Father’s social and economic position has the strongest impact on age at menarche in girls from Central India. Anthropol Rev. 2019;82:357-71. DOI: https://doi.org/10.2478/anre-2019-0027
Graber JA, Brooks-Gunn J, Warren MP. The antecedents of menarcheal age: heredity, family environment and stressful life events. Child Dev. 1995;66(2):346-59. DOI: https://doi.org/10.1111/j.1467-8624.1995.tb00875.x
Belsky J, Steinberg L, Draper P. Childhood experience, interpersonal development and reproductive strategy: an evolutionary theory of socialization. Child Develop. 1991;62(4):647-70. DOI: https://doi.org/10.1111/j.1467-8624.1991.tb01558.x
Moisan JO, Meyer FR, Gingras SU. Leisure physical activity and age at menarche. Med Sci Sports and Exercise. 1991;23(10):1170-5. DOI: https://doi.org/10.1249/00005768-199110000-00010
Belsky J. Childhood experience and the development of reproductive strategies. Psicothema. 2010;22(1):28-34.
Mendle J, Leve LD, Van Ryzin M, Natsuaki MN, Ge X. Associations Between Early Life Stress, Child Maltreatment and Pubertal Development Among Girls in Foster Care. J Res Adoles. 2011;21(4):871-80. DOI: https://doi.org/10.1111/j.1532-7795.2011.00746.x
Ariza Jimenez AB, Aguilar Gomez-Cardenas FJ, de la Camara Moraño C. Likely impact of COVID-19 on referrals to pediatric endocrinology: Increased incidence of precocious puberty in a third-level hospital. Endocrinol Diabetes Nutr (Engl Ed). 2022;69(7):542-4. DOI: https://doi.org/10.1016/j.endien.2022.07.002
Kaltiala-Heino R, Kosunen E, Rimpelä M. Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. J Adoles. 2003;26(5):531-45. DOI: https://doi.org/10.1016/S0140-1971(03)00053-8
Negriff S, Susman EJ, Trickett PK. The developmental pathway from pubertal timing to delinquency and sexual activity from early to late adolescence. J Youth Adoles. 2011;40(10):1343-56. DOI: https://doi.org/10.1007/s10964-010-9621-7
Shim KS. Pubertal growth and epiphyseal fusion. Ann Ped Endocrinol Metabol. 2015;20(1):8-12. DOI: https://doi.org/10.6065/apem.2015.20.1.8
Lee HS. Why should we be concerned about early menarche. Clin and Experim Paed. 2021;64(1):26-7. DOI: https://doi.org/10.3345/cep.2020.00521
Gerdhem P, Obrant KJ. Bone mineral density in old age: the influence of age at menarche and menopause. J Bone Min Metabol. 2004;22(4):372-5. DOI: https://doi.org/10.1007/s00774-004-0497-z
Stoll BA, Vatten LJ, Kvinnsland S. Does early physical maturity influence breast cancer risk. Acta oncologica (Stockholm, Sweden). 1994;33(2):171-6. DOI: https://doi.org/10.3109/02841869409098400
Fox KM, Magaziner J, Sherwin R, Scott JC, Plato CC, Nevitt M, et al. Reproductive correlates of bone mass in elderly women. Study of osteoporotic fractures research group. J Bone Mineral Res. 1993;8(8):901-8. DOI: https://doi.org/10.1002/jbmr.5650080802
Downloads
Published
How to Cite
Issue
Section
