Decreasing Age of Menarche

HEALTH COLUMN

Menarche defines the onset of mensturation which is a normal process that occurs at regular monthly intervals. It is the most commonly remembered milestone of puberty for most women. From both social and medical perspectives it is often considered the central event of female puberty as it signals the possibility of fertility.

The timing of menarche is determined by female biology, geographical region, race, ethnicity as well as genetic and environment factors especially nutritional factors. The average age of menarche is 12. 4 years. The mean age of menarche has declined over the last century but the magnitude of the decline and the factors responsible remain subjects of contention.

Factors responsible for early menarche are

Being Non white

Not Breast fed

Eclampsia in the womb

Exposure to smoking

Stress

Lack of physical exercise

History of childhood obesity .

It has also been suggested that decrease in age of menarche until the mid 1960s resulted from positive changes like better nutrition whereas decreases since that time are related to negative changes like overeating, decreased physical activity and possibly even exposure to chemical pollution.

It is abnormal for menarche to appear before the appearance of secondary sexual characteristics.Most girls likely menstruate within two to three years of breast development. Menarche Is considered early if it occurs before 9 years of age and late if it occurs after 15 years of age or at 15 years of age. Menarche occurs during a time of puberty that is associated with rapid growth.

Early menarche is associated with physical and psycho social problems like anxiety and depression. It can also cause early fusion of the epiphyseal growth plates, therefore the young womans final adult height may be shorter than her potential genetic height. Early menarche is one of the most important factors for breast carcinoma and other health hazards like hypertension, Type 2 Diabetes Melbitus and Asthma .

Early maturing girls may affiliate with older adolescents hence engage in risk behaviors linked to their appearance rather than their maturity

Nowadays it is not unusual to find girls having their menstrual period as early as nine years of age. As mothers and guardians we need to be vigilant about the dietary and fluid intake of out children. A comprehensive and easily understood psychosocial and sexual health education programme should be developed to educate adolescents with early menarche.

In addition lifestyle changes will be critical in preventing obesity and metabolic syndromes. Most importantly as we cannot control everything we need to initiate conversations about mensturation, its hygiene protocols and a gamut of subjects and concerns revolving around mensturation with young adolescent girls in a friendly and non intimidating manner.

It is very important to support the girls during the phase of their transition.

Consultant ObGyn at Marwari Hospitals with special interest in High Risk pregnancy and Adolescent Health.

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