Menarche

September 17, 2011

The average age of menarche, or first menstruation, in the United States is 12.88 years for Caucasian girls and 12.16 years for African American girls. A popular misconception is that menarche marks the beginning of puberty; in reality, menarche occurs later in puberty. According to the widely used “five Tanner stages” of pubertal development, the onset of puberty is identified as Stage 2 at the first signs of pubic hair and breast bud development. The interval between these first signs of puberty and the completion of sexual maturation in girls (measured by the growth of pubic hair, reproductive organs, and breast development) can be as short as a year and a half to as long as 6 years. Menarche generally occurs when girls are in Stage 3 or 4 of their development, which usually takes place somewhere between age 9 and 15 years old.

There has been some debate whether the age at menarche has changed over the last few decades. Examining the average age of menarche globally, the data indicate that the average age of menarche has decreased significantly in the last 100 years. Earlier menarche is attributed to improved nutrition, and the industrial revolution, which brought on a higher stress level due to the faster pace of life. According to a recent review, the age of menarche has remained stable over the last 50 years for Caucasian girls in the United States. Comparable longitudinal data are not available for African Americans or other minority groups, because few studies have included nonwhite girls until recently. Cross-sectional findings, however, suggest that African American girls reach menarche slightly earlier than Caucasian girls (12.16 years vs. 12.88 years), underscoring the important role of ethnicity in understanding menarche. It is notable that the age of menarche has remained relatively stable, while the age of pubertal onset has decreased over the past 30 years in the United States.

GENETIC AND ENVIRONMENTAL INFLUENCES ON TIMING OF MENARCHE

Genetic factors play an important role in the age of menarche. Early menarche tends to run in families, and studies show good correlation (statistically, an average correlation of 0.30) between mother’s and daughter’s age at menstruation. Environmental influences also affect the onset of menstruation. Delayed menarche is associated with excessive exercise, malnutrition, and significantly low weight. Sports or other activities that require intense physical activity, such as dancing and gymnastics, are associated with later ages at menarche. Such processes, however, can be reversed. One study indicated that stopping exercise for as little as 2 months initiated pubertal development and menarche. Body fat also predicts the onset of menstruation, with obesity linked to earlier onset and low weight related to later onset. Significant weight gain is seen in the years preceding menarche, with girls gaining approximately 40 lb across 4 years before their first menstruation.

Studies have also identified important psychosocial factors affecting menarche. For example, family structure and family relationships are strongly related to the timing of menstruation. Earlier age at menarche is related to the father’s absence before puberty and longer father’s absence. Moreover, approval and warmth in families, and absence of family conflict is related to later age of menarche. In fact, the quality of family relationships has been shown to influence age of menstruation over and above the effects of breast development and weight.

TIMING OF MENARCHE AND MENSTRUAL EXPERIENCE

The timing of menarche may have considerable impact on how girls remember their initial menstrual experience. Conformity seeking is high during adolescence with girls striving to be like their friends. Girls who menstruate before their peers perceive the experience more negatively than girls who menstruate at the same time or later than their peers. Narratives of women between the ages of 18 and 61 recounting their first menstrual experience indicated that most women held negative views of the sex education they received in school and at home. They reported that menstruation was either not discussed or the information provided and time spent talking about it was inadequate. Most women also complained that having to ask their questions in front of their classmates made it harder for them to voice their concerns. Particularly interesting, the narratives revealed similar experiences across the sample despite the wide age range among the women. Thus, in spite of our awareness that accurate and informative sex education fosters healthy adolescent development, schools and community resources do not appear to be meeting the needs of adolescents.

Another study offers a fascinating glimpse of how women’s perceptions of menarche vary across cultures underscoring the role of environment. In one study, American and Malaysian women reported a greater range of emotional reactions to first menstruation than women from Lithuania and the Sudan, but the former two groups reported primarily negative emotions. The most common emotions reported by Americans and Malaysians were embarrassment followed by anxiety. American women expressed worrying about whether they could play sports, but they also indicated feeling “cooler” and eager to learn about their sexuality. Malaysian women reported feeling wiser, more respected, and mature. In contrast, the Lithuanians were philosophical and more positive in their explanations by placing this experience in a context larger than their selves; they reported feeling a part of nature, knowing the “secret” of life, and appreciating themselves more. Unfortunately, this study did not describe what cultural mechanisms might explain these differences in perceptions, but the data raise important questions about the impact of culture on perceptions of menstruation.

RECOMMENDATIONS

Menarche marks an important transition to adulthood, and being prepared for the experience plays a critical role in girls’ perceptions of themselves and the significance of the event. Opportunities to talk about menarche before it occurs, have a venue for asking questions, and increasing communication about the process will diminish anxiety and enhance their understanding of the experience. Indeed, placing the onset of menarche in a positive light, such as marking it with a celebration, can significantly influence how girls
interpret and respond to the event. Families and schools can play a special role in providing support and information for young girls to assist them through the transition.

SEE ALSO: Adolescence, Genital development, Puberty

Suggested Reading

  • Coleman, L., & Coleman, J. (2002). The measurement of puberty: A review. Journal of Adolescence, 25(5), 535—550.
  • Graber, J. A., Brooks-Gunn, J., & Warren, M. P. (1995). The antecedents of menarcheal age: Heredity, family environment and stressful life events. Child Development, 66, 346—359.
  • Rierdan, J., & Koff, E. (1985). Timing of menarche and initial menstrual experience. Journal of Youth and Adolescence, 14(3), 237-244.

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