1.Trend of age of menarche among Chinese Han girls aged 9 to 18 years from 2010 to 2019.
Ning MA ; Di SHI ; Shan CAI ; Jia Jia DANG ; Pan Liang ZHONG ; Yun Fei LIU ; Jing LI ; Yana Hui DONG ; Pei Jin HU ; Bin DONG ; Tian Jiao CHEN ; Yi SONG ; Jun MA
Chinese Journal of Preventive Medicine 2023;57(4):486-491
		                        		
		                        			
		                        			Objective: To analyze the trends of the age of menarche among Chinese Han girls aged 9 to 18 years from 2010 to 2019. Methods: Data were extracted from the Chinese National Surveys on Students' Constitution and Health in 2010, 2014 and 2019. A total of 253 037 Han girls aged 9 to 18 years with complete data on menarche were selected in this study. They were asked one-on-one about their menstrual status, age and residence information. The median age of menarche was estimated by probability regression. U tests were used to compare the difference in median age at menarche in different years. Results: The median age at menarche (95%CI) among Chinese Han girls was 12.47 (12.09-12.83) years in 2010, 12.17 (11.95-12.38) years in 2014 and 12.05 (10.82-13.08) years in 2019, respectively. Compared with that in 2010, the median age at menarche in 2019 decreased by 0.42 years (U=-77.27, P<0.001). The annual average changes were -0.076 years from 2010 to 2014 (U=-57.19, P<0.001) and -0.023 years from 2014 to 2019 (U=-21.41, P<0.001), respectively. The average annual changes in urban areas in the periods of 2010 to 2014 and 2014 to 2019 were -0.071 years and 0.006 years, respectively, while those in rural areas were -0.082 years and -0.053 years, respectively. The average annual changes in the regions of north, northeast, east, south central, southwest and northwest were -0.064, -0.099, -0.091, -0.080, -0.096 and -0.041 years in the period of 2010 to 2014 and 0.001, -0.040, -0.002, -0.005, -0.043 and -0.081 years in the period of 2014 to 2019. Conclusion: The age of menarche among Chinese Han girls aged 9 to 18 years shows an advanced trend from 2010 to 2019, and the trends in urban and rural areas and different regions have different characteristics.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Probability
		                        			;
		                        		
		                        			East Asian People
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Adolescent
		                        			
		                        		
		                        	
2.Secular trends of age at menarche and age at menopause in women born since 1951 from a county of Shandong Province, China.
Xiao Wei WANG ; Ying Chao MU ; Zhen Yu GUO ; Yu Bo ZHOU ; Yong ZHANG ; Hong Tian LI ; Jian Meng LIU
Journal of Peking University(Health Sciences) 2023;55(3):502-510
		                        		
		                        			OBJECTIVE:
		                        			To describe the secular trends of age at menarche and age at natural menopause of women from a county of Shandong Province.
		                        		
		                        			METHODS:
		                        			Based on the data of the Premarital Medical Examination and the Cervical Cancer and Breast Cancer Screening of the county, the secular trends of age at menarche in women born in 1951 to 1998 and age at menopause in women born in 1951 to 1975 were studied. Joinpoint regression was used to identify potential inflection points regarding the trend of age at menarche. Average hazard ratios (AHR) of early menopause among women born in different generations were estimated by performing multivariate weighted Cox regression.
		                        		
		                        			RESULTS:
		                        			The average age at menarche was (16.43±1.89) years for women born in 1951 and (13.99±1.22) years for women born in 1998. The average age at menarche was lower for urban women than that for rural women, and the higher the education level, the lower the average age at menarche. Joinpoint regression analysis identified three inflection points: 1959, 1973 and 1993. The average age at menarche decreased annually by 0.03 (P < 0.001), 0.08 (P < 0.001), and 0.03 (P < 0.001) years respectively for women born during 1951-1959, 1960-1973, and 1974-1993, while it remained stable for those born during 1994-1998 (P=0.968). As for age at menopause, compared with women born during 1951-1960, those born during 1961-1965, 1966-1970 and 1971-1975 showed a gradual decrease in the risk of early menopause and a tendency to delay the age at menopause. The stratified analysis presented that the risk of early menopause gradually decreased and the age of menopause showed a significant delay among those with education level of junior high school and below, but this trend was not obvious among those with education level of senior high school and above, where the risk of early menopause decreased and then increased among those with education level of college and above, and the corresponding AHRs were 0.90 (0.66-1.22), 1.07 (0.79-1.44) and 1.14 (0.79-1.66).
		                        		
		                        			CONCLUSION
		                        			The age at menarche for women born since 1951 gradually declined until 1994 and leveled off, with a decrease of nearly 2.5 years in these years. The age at menopause for women born between 1951 and 1975 was generally delayed over time, but the trend of first increase and then decrease was observed among those with relatively higher education levels. In the context of the increasing delay in age at marriage and childbearing and the decline of fertility, this study highlights the necessity of the assessment and monitoring of women' s basic reproductive health status, especially the risk of early menopause.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Menopause
		                        			;
		                        		
		                        			Regression Analysis
		                        			;
		                        		
		                        			Fertility
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Age Factors
		                        			
		                        		
		                        	
3.Relationship of Cognitive Function With Menarche Age,Menopause Age, and Reproductive Period in Female Patients With Hypertension.
Chun-Jiao YOU ; Yan-Jie XU ; Chao YU ; Ling-Juan ZHU ; Tao WANG ; Wei ZHOU ; Hui-Hui BAO ; Xiao-Shu CHENG
Acta Academiae Medicinae Sinicae 2023;45(5):760-767
		                        		
		                        			
		                        			Objective To explore the relationship of menarche age,menopause age,and reproductive period with cognitive function in the female patients with hypertension.Methods Hypertension screening was carried out in Wuyuan county of Jiangxi province from July to August in 2018.Data were collected through a face-to-face questionnaire survey,physical measurement,and biochemical tests.The cognitive function was scored according to the mini-mental state examination(MMSE)scale.Multiple linear regression and Logistic regression were employed to analyze the effects of menarche age,menopause age,and reproductive period on cognitive function,and the penalized spline regression to fit the curves.Results A total of 4595 postmenopausal women with hypertension were included in the analysis,with the mean age of(65.1±8.4)years,mean menarche age of(16.6±2.2)years,mean menopause age of(48.2±5.0)years,mean reproductive period of(31.7±5.5)years,mean MMSE score of(19.0±6.3)points,and total cognitive impairment detection rate of 40.4%(1859/4595).The detection rates of cognitive impairment were 28.4%,39.1%,and 45.8% in the females with the menarche ages of <15,15-16,and ≥17 years,47.9%,39.7%,and 38.3% in the females with the menopausal ages of <45,45-49,and ≥50 years,and 56.0%,44.4%,40.6%,and 32.6% in the females with the reproductive periods of <25,25-29,30-34,and ≥35 years,respectively.Moreover,the detection rates of cognitive impairment among different age groups were statistically significant(all P<0.05).Compared with the group with the menarche age <15 years,the groups with the menarche ages of 15-16 years and ≥17 years showed increased detection rates of cognitive impairment(OR=1.45,95%CI=1.19-1.75,P<0.001;OR=1.65,95%CI=1.37-1.98,P<0.001).Compared with the group with the menopausal age <45 years,the groups with the menopausal ages of 45-49 years and ≥50 years showed decreased detection rates of cognitive impairment(OR=0.80,95%CI=0.66-0.95,P=0.013;OR=0.78,95%CI=0.65-0.93,P<0.001).Compared with the group with the reproductive period <25 years,the groups with the reproductive periods of 25-29,30-34,and ≥35 years showed decreased detection rates of cognitive impairment(OR=0.66,95%CI=0.52-0.84,P<0.001;OR=0.62,95%CI=0.50-0.76,P<0.001;OR=0.51,95%CI=0.41-0.63,P<0.001).Conclusion The detection rate of cognitive impairment had a positive correlation with menarche age and negative correlations with menopause age and reproductive period in the female patients with hypertension.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Menopause
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Reproduction
		                        			;
		                        		
		                        			Hypertension
		                        			;
		                        		
		                        			Cognition
		                        			;
		                        		
		                        			Age Factors
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
4.Letter to the Editor Regarding the Article: Relationship between Age at Menarche and Metabolic Syndrome in Premenopausal Women: Korea National Health and Nutrition Examination Survey 2013–2014
Anthony URTEAGA ; Miluska ROBLES ; Alonso SOTO
Korean Journal of Family Medicine 2019;40(4):284-285
		                        		
		                        			
		                        			No abstract available.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Nutrition Surveys
		                        			
		                        		
		                        	
5.Age-Group Related Cohort Effects on the Association between Age at Menarche and Metabolic Syndrome among Korean Premenopausal Women
Korean Journal of Family Medicine 2019;40(4):280-281
		                        		
		                        			
		                        			No abstract available.
		                        		
		                        		
		                        		
		                        			Cohort Effect
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Menarche
		                        			
		                        		
		                        	
6.Early-life exposure to endocrine-disrupting chemicals and pubertal development in girls
Jeong Eun LEE ; Hae Woon JUNG ; Yun Jeong LEE ; Young Ah LEE
Annals of Pediatric Endocrinology & Metabolism 2019;24(2):78-91
		                        		
		                        			
		                        			Over the last decades, the onset of puberty in girls has occurred earlier, but the tempo of pubertal progression has been relatively slower, resulting in a younger age at puberty onset without a change in age at menarche. Sufficient energy availability and adiposity contribute to early pubertal development, and environmental factors, such as endocrine-disrupting chemicals (EDCs), may affect not only the control of energy balance, but also puberty and reproduction. EDCs are hormonally active substances that can perturb puberty by acting both peripherally on target organs, such as adipose tissue or adrenal glands, and/or centrally on the hypothalamic-pituitary-gonadal (HPG) axis. Depending on whether the exposure takes place earlier during fetal and neonatal life or later during early childhood, EDCs can lead to different outcomes through different mechanisms. Evidence of associations between exposures to EDCs and altered pubertal timing makes it reasonable to support their relationship. However, human epidemiologic data are limited or inconsistent and cannot provide sufficient evidence for a causal relationship between EDC exposure and changes in pubertal timing. Further investigation is warranted to determine the overall or different effects of EDCs exposure during prenatal or childhood windows on pubertal milestones and to reveal the underlying mechanisms, including epigenetic marks, whereby early-life exposure to EDCs affect the HPG-peripheral tissue axis.
		                        		
		                        		
		                        		
		                        			Adipose Tissue
		                        			;
		                        		
		                        			Adiposity
		                        			;
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Adrenal Glands
		                        			;
		                        		
		                        			Endocrine Disruptors
		                        			;
		                        		
		                        			Epigenomics
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Puberty
		                        			;
		                        		
		                        			Reproduction
		                        			
		                        		
		                        	
7.Evaluation and management of amenorrhea related to congenital sex hormonal disorders
Ju Young YOON ; Chong Kun CHEON
Annals of Pediatric Endocrinology & Metabolism 2019;24(3):149-157
		                        		
		                        			
		                        			Primary amenorrhea is a symptom with a substantial list of underlying etiologies which presents in adolescence, although some conditions are diagnosed in childhood. Primary amenorrhea is defined as not having menarche until 15 years of age (or 13 years with secondary sex characteristics). Various etiologies of primary amenorrhea include outflow tract obstructions, gonadal dysgenesis, abnormalities of the central nervous system, various endocrine diseases, chronic illnesses, psychologic problems, and constitutional delay of puberty. The management of primary amenorrhea may vary considerably depending on the patient and the specific diagnosis. In this article, the various causes, evaluation, and management of primary amenorrhea are reviewed with special emphasis on congenital sex hormonal disorders.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Amenorrhea
		                        			;
		                        		
		                        			Central Nervous System
		                        			;
		                        		
		                        			Chronic Disease
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Endocrine System Diseases
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Gonadal Dysgenesis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Puberty
		                        			
		                        		
		                        	
8.Interaction Effect Between Breast Density and Reproductive Factors on Breast Cancer Risk in Korean Population
Se Eun LIM ; HyoJin AHN ; Eun Sook LEE ; Sun Young KONG ; So Youn JUNG ; Seeyoun LEE ; Han Sung KANG ; Eun Gyeong LEE ; Jai Hong HAN ; Boyoung PARK
Journal of Cancer Prevention 2019;24(1):26-32
		                        		
		                        			
		                        			BACKGROUND: This study was conducted to explore the effect of known risk factors, focusing on risk factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, in consideration of interaction among East-Asian women. METHODS: Case-control study with 2,123 cases and 2,121 controls with mammographic density was conducted. Using the mammographic film, breast density was measured using Breast Imaging-Reporting and Data System. To identify the association of selected reproductive factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, stratified analysis was conducted according to breast density groups and interaction effects was assessed. The results were presented with adjusted OR and 95% CIs. RESULTS: Significant interaction effect between age at first birth and breast density on breast cancer (P = 0.048) was observed. Women with age at first birth ≥ 28 years old showed increased breast cancer risk in extremely dense breast group (≥ 75%) (OR = 1.627, 95% CI = 1.190–2.226). However, women with fatty breast (< 50%) and heterogeneously dense breast (50%–75%) did not show an increased association. Age at menarche, age at menopause, number of children, and family history of breast cancer did not show significant interaction with breast cancer and similar risk patterns were observed. CONCLUSIONS: Age at first birth showed significant interaction with breast density on breast cancer risk. Further studies considering biologically plausable model between exposure, intermediate outcomes and breast cancer risk with prospective design need to be undertaken in East Asian women.
		                        		
		                        		
		                        		
		                        			Asian Continental Ancestry Group
		                        			;
		                        		
		                        			Birth Order
		                        			;
		                        		
		                        			Breast Neoplasms
		                        			;
		                        		
		                        			Breast
		                        			;
		                        		
		                        			Case-Control Studies
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Information Systems
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Menopause
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Reproductive History
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
9.Clinicopathological features of premature ovarian insufficiency associated with chromosome abnormalities
Hyen Chul JO ; Ji Kwon PARK ; Jong Chul BAEK ; Ji Eun PARK ; Min Young KANG ; In Ae CHO
Journal of Genetic Medicine 2019;16(1):10-14
		                        		
		                        			
		                        			PURPOSE: The aim of this study was to investigate the clinicopathological features of premature ovarian insufficiency (POI) associated with chromosomal abnormalities. MATERIALS AND METHODS: This was a retrospective study of POI patients with chromosomal abnormalities diagnosed between January 2009 and December 2017. The definition of POI is based on hypergonadotropinism of 40 or greater in follicle stimulating hormone (FSH) measurements at age 40 years or less. FSH was measured twice at least 4 weeks apart. Karyotyping using peripheral blood for chromosomal testing was conducted in all patients diagnosed with POI. We analyzed the clinical characteristics and genetic causes of patients who were diagnosed with POI. RESULTS: Forty patients were diagnosed with POI including 9 (22.5%) with identified chromosomal abnormalities. The mean age at diagnosis was 23.1±7.8 years (ranging between 14 and 39). Three patients did not experience menarche. The presenting complaints were short stature in one case, one case of amenorrhea with ambiguous external genitals, one case of infertility, and six related to menstruation such as oligomenorrhea or irregular rhythm. Turner syndrome was diagnosed in four cases, Xq deletion in one case, trisomy X in two cases, and 46,XY disorder of sexual development in two other patients. CONCLUSION: Patients diagnosed with POI carrying the same type of chromosomal abnormality manifest different phenotypes. The management protocol also needs to be changed depending on the diagnosis. A karyotype is indicated for accurate diagnosis and proper management of POI in patients, with or without stigmata of chromosomal abnormalities.
		                        		
		                        		
		                        		
		                        			Amenorrhea
		                        			;
		                        		
		                        			Christianity
		                        			;
		                        		
		                        			Chromosome Aberrations
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Follicle Stimulating Hormone
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infertility
		                        			;
		                        		
		                        			Karyotype
		                        			;
		                        		
		                        			Karyotyping
		                        			;
		                        		
		                        			Menarche
		                        			;
		                        		
		                        			Menstruation
		                        			;
		                        		
		                        			Oligomenorrhea
		                        			;
		                        		
		                        			Phenotype
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Sexual Development
		                        			;
		                        		
		                        			Trisomy
		                        			;
		                        		
		                        			Turner Syndrome
		                        			
		                        		
		                        	
            
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