J Korean Med Sci.  2020 Dec;35(49):e406. 10.3346/jkms.2020.35.e406.

Trend of Menarcheal Age among Korean Girls

Affiliations
  • 1Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
  • 2Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

Abstract

Background
Menarcheal age has been decreasing worldwide. However, few recent studies have observed trends in menarcheal age in larger populations, and the cutoff age for early menarche remains unclear. Therefore, we aimed to analyze recent trends of menarcheal age and to determine the cutoff age of early menarche based on nationally representative data.
Methods
We conducted a cross-sectional study of 351,006 Korean girls aged 12–18 years who were born in 1988–2003 based on the data of the 2006–2015 Korea Youth Risk Behavior Survey. We identified the distribution of age at menarche using the complex sample Cox regression model. Trends in the prevalence of early menarche were determined using the complex sample linear model.
Results
Ninety-five percent of all the participants reported they had experienced menarche. The mean menarcheal age was 13.0 years (95% confidence intervals [CIs], 12.92–13.04) for girls born in 1988 and decreased to 12.6 years (95% CI, 12.54–12.61) for girls born in 2003. The cutoff age (the 3rd percentile value) for early menarche was 10.5 years during the study period. The prevalence of early menarche significantly increased from 1.8% in 2006 to 3.2% in 2015 (P-for-trend < 0.001). Downward trends of menarcheal age were noted across all body mass index groups, and this trend was most prominent in the obese group.
Conclusion
We reported an ongoing downward trend in menarcheal age in Korean girls born in 1988–2003, decreasing by 0.4 years over the 15 years.

Keyword

Menarche; Trends; Korea

Figure

  • Fig. 1 Trends in the age of menarche stratified by birth year in Korean girls. The graph shows the mean ages of menarche (95% confidence intervals) by birth year.

  • Fig. 2 Trends in prevalence of early menarche. (A) The graphs show annual trends in the prevalence of early menarche and (B) the trend of prevalence of early menarche stratified by body mass index status (B) in Korean pubertal girls.


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Reference

1. Charalampopoulos D, McLoughlin A, Elks CE, Ong KK. Age at menarche and risks of all-cause and cardiovascular death: a systematic review and meta-analysis. Am J Epidemiol. 2014; 180(1):29–40. PMID: 24920784.
Article
2. Karapanou O, Papadimitriou A. Determinants of menarche. Reprod Biol Endocrinol. 2010; 8(1):115. PMID: 20920296.
Article
3. Tanner JM. Trend towards earlier menarche in London, Olso, Copenhagen, the Netherlands and Hungary. Nature. 1973; 243(5402):95–96. PMID: 4706636.
4. Sørensen K, Mouritsen A, Aksglaede L, Hagen CP, Mogensen SS, Juul A. Recent secular trends in pubertal timing: implications for evaluation and diagnosis of precocious puberty. Horm Res Paediatr. 2012; 77(3):137–145. PMID: 22508036.
Article
5. Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV, Koch GG, et al. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. Pediatrics. 1997; 99(4):505–512. PMID: 9093289.
Article
6. Cabrera SM, Bright GM, Frane JW, Blethen SL, Lee PA. Age of thelarche and menarche in contemporary US females: a cross-sectional analysis. J Pediatr Endocrinol Metab. 2014; 27(1-2):47–51. PMID: 23959659.
Article
7. Ahn JH, Lim SW, Song BS, Seo J, Lee JA, Kim DH, et al. Age at menarche in the Korean female: secular trends and relationship to adulthood body mass index. Ann Pediatr Endocrinol Metab. 2013; 18(2):60–64. PMID: 24904853.
Article
8. Cho GJ, Park HT, Shin JH, Hur JY, Kim YT, Kim SH, et al. Age at menarche in a Korean population: secular trends and influencing factors. Eur J Pediatr. 2010; 169(1):89–94. PMID: 19504269.
Article
9. Lee MH, Kim SH, Oh M, Lee KW, Park MJ. Age at menarche in Korean adolescents: trends and influencing factors. Reprod Health. 2016; 13(1):121. PMID: 27662834.
Article
10. Kim SH, Huh K, Won S, Lee KW, Park MJ. A significant increase in the incidence of central precocious puberty among Korean girls from 2004 to 2010. PLoS One. 2015; 10(11):e0141844. PMID: 26539988.
Article
11. Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean J Pediatr. 2018; 61(5):135–149. PMID: 29853938.
Article
12. Okasha M, McCarron P, McEwen J, Smith GD. Age at menarche: secular trends and association with adult anthropometric measures. Ann Hum Biol. 2001; 28(1):68–78. PMID: 11201332.
13. Chumlea WC, Schubert CM, Roche AF, Kulin HE, Lee PA, Himes JH, et al. Age at menarche and racial comparisons in US girls. Pediatrics. 2003; 111(1):110–113. PMID: 12509562.
Article
14. Hwang JY, Shin C, Frongillo EA, Shin KR, Jo I. Secular trend in age at menarche for South Korean women born between 1920 and 1986: the Ansan Study. Ann Hum Biol. 2003; 30(4):434–442. PMID: 12881142.
Article
15. Christensen KY, Maisonet M, Rubin C, Holmes A, Flanders WD, Heron J, et al. Progression through puberty in girls enrolled in a contemporary British cohort. J Adolesc Health. 2010; 47(3):282–289. PMID: 20708568.
Article
16. Papadimitriou A, Fytanidis G, Douros K, Bakoula C, Nicolaidou P, Fretzayas A. Age at menarche in contemporary Greek girls: evidence for levelling-off of the secular trend. Acta Paediatr. 2008; 97(6):812–815. PMID: 18460111.
Article
17. Rigon F, Bianchin L, Bernasconi S, Bona G, Bozzola M, Buzi F, et al. Update on age at menarche in Italy: toward the leveling off of the secular trend. J Adolesc Health. 2010; 46(3):238–244. PMID: 20159500.
Article
18. Roelants M, Hauspie R, Hoppenbrouwers K. References for growth and pubertal development from birth to 21 years in Flanders, Belgium. Ann Hum Biol. 2009; 36(6):680–694. PMID: 19919503.
Article
19. Aksglaede L, Sørensen K, Petersen JH, Skakkebaek NE, Juul A. Recent decline in age at breast development: the Copenhagen Puberty Study. Pediatrics. 2009; 123(5):e932–e939. PMID: 19403485.
Article
20. Talma H, Schönbeck Y, van Dommelen P, Bakker B, van Buuren S, Hirasing RA. Trends in menarcheal age between 1955 and 2009 in the Netherlands. PLoS One. 2013; 8(4):e60056. PMID: 23579990.
Article
21. Jansen EC, Herrán OF, Villamor E. Trends and correlates of age at menarche in Colombia: results from a nationally representative survey. Econ Hum Biol. 2015; 19:138–144. PMID: 26398849.
Article
22. Song Y, Ma J, Wang HJ, Wang Z, Hu P, Zhang B, et al. Trends of age at menarche and association with body mass index in Chinese school-aged girls, 1985-2010. J Pediatr. 2014; 165(6):1172–1177.e1. PMID: 25241174.
23. Park MJ, Lee IS, Shin EK, Joung H, Cho SI. The timing of sexual maturation and secular trends of menarchial age in Korean adolescents. Korean J Pediatr. 2006; 49(6):610–616.
Article
24. Sperling M. Pediatric Endocrinology. 4th ed. Philadelphia, PA: Elsevier/Saunders;2014.
25. Melmed S, Polonsky KS, Larsen PR, Kronenberg HM. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier Health Sciences;2015.
26. Hwang E, Lee KW, Cho Y, Chung HK, Shin MJ. Association between age at menarche and diabetes in Korean post-menopausal women: results from the Korea National Health and Nutrition Examination Survey (2007-2009). Endocr J. 2015; 62(10):897–905. PMID: 26194132.
Article
27. Yi KH, Hwang JS, Lim SW, Lee JA, Kim DH, Lim JS. Early menarche is associated with non-alcoholic fatty liver disease in adulthood. Pediatr Int. 2017; 59(12):1270–1275. PMID: 28892211.
Article
28. Lee HS, Leem S, Oh B, Park T. Effect of interaction between early menarche and genetic polymorphisms on triglyceride. Oxid Med Cell Longev. 2019; 2019:9148920. PMID: 30931082.
Article
29. Kim SH, Park MJ. Childhood obesity and pubertal development. Pediatr Gastroenterol Hepatol Nutr. 2012; 15(3):151–159.
Article
30. Rosenfield RL, Lipton RB, Drum ML. Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index. Pediatrics. 2009; 123(1):84–88. PMID: 19117864.
Article
31. Bau AM, Ernert A, Schenk L, Wiegand S, Martus P, Grüters A, et al. Is there a further acceleration in the age at onset of menarche? A cross-sectional study in 1840 school children focusing on age and bodyweight at the onset of menarche. Eur J Endocrinol. 2009; 160(1):107–113. PMID: 18974233.
Article
32. Juul F, Chang VW, Brar P, Parekh N. Birth weight, early life weight gain and age at menarche: a systematic review of longitudinal studies. Obes Rev. 2017; 18(11):1272–1288. PMID: 28872224.
Article
33. Anderson SE, Dallal GE, Must A. Relative weight and race influence average age at menarche: results from two nationally representative surveys of US girls studied 25 years apart. Pediatrics. 2003; 111(4 Pt 1):844–850. PMID: 12671122.
Article
34. Gavela-Pérez T, Navarro P, Soriano-Guillén L, Garcés C. High prepubertal leptin levels are associated with earlier menarcheal age. J Adolesc Health. 2016; 59(2):177–181. PMID: 27297138.
Article
35. Aksglaede L, Juul A, Olsen LW, Sørensen TI. Age at puberty and the emerging obesity epidemic. PLoS One. 2009; 4(12):e8450. PMID: 20041184.
Article
36. Popovic V, Casanueva FF. Leptin, nutrition and reproduction: new insights. Hormones (Athens). 2002; 1(4):204–217. PMID: 17018449.
Article
37. Buttke DE, Sircar K, Martin C. Exposures to endocrine-disrupting chemicals and age of menarche in adolescent girls in NHANES (2003-2008). Environ Health Perspect. 2012; 120(11):1613–1618. PMID: 23124194.
Article
38. Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, Bourguignon JP. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev. 2003; 24(5):668–693. PMID: 14570750.
Article
39. Adgent MA, Daniels JL, Rogan WJ, Adair L, Edwards LJ, Westreich D, et al. Early-life soy exposure and age at menarche. Paediatr Perinat Epidemiol. 2012; 26(2):163–175. PMID: 22324503.
Article
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