Your age at your first period signals health events ahead

Over the last 100-200 years, the average age at which girls enter puberty and have their first period (menarche) has slowly decreased. While 16.5 was the average age of menarche in 1840, this fell to age 13-14 in the earlier half of the 20th century, and today the more typical range of menarche is ages 10-16. Now some girls are even getting their first period as young as 8 or 9. Some mothers – many of whom track their daughter’s periods – are alarmed by them entering puberty so young, and feel frustrated by the lack of explanations for this phenomenon.

Unfortunately, the causes for this overall decrease in age are still unclear – yet many women feel intuitively that something with earlier menarche is “off.” The suspected causes are complex, ranging from environmental factors like chemical compounds in food and plastics, to psychosocial factors or even trauma, such as a history of sexual abuse. What is clear is that more conversations must be had with girls, starting at an earlier age, to best prepare them not only for this major milestone and early entry into adulthood, but also for the implications of their age at menarche and what it could mean for their future health.

It turns out that age matters. The impact of the age of menarche on a girl’s health later in life is significant. Getting a period “earlier” than most (below the age of 12) – or in some cases, later (age 15 or above) – is actually correlated with various health events that play out in a girl’s daily life and across her lifetime. One study found that girls experiencing early puberty below the age of 12 had a significantly higher risk of depressive symptoms than girls who entered puberty at 15 or above. Another found that early puberty puts girls more at risk for anxiety or other disorders such as depression or OCD (obsessive compulsive disorder). Rather than being issues young women can easily “grow out of” later, adolescence is such a foundational time that developing problems during puberty can easily lead to entrapping young women in “snares” –as one study aptly described it – from which it can be difficult to escape or simply “age out.”

Another study from The American Journal of Psychiatry made similar conclusions that early puberty was highly associated with depression in girls, and that often these difficulties persist for young women nearly a decade later. The changes and potentially stressful situations that young girls experience due to early menarche  should be discussed with care and consideration for their whole well-being and mental health, beyond just an explanatory lecture of reproduction or how to use sanitary protection.

Hormone changes from menstruation, including early ovulation, are related to common health conditions such as depression, diabetes, heart disease, epilepsy, cancer, strokes, and obesity. Awareness of these associations makes it important to track a girl’s age at menarche, to help monitor the potential events that can affect her health down the road.

Studies have shown a relationship between early menarche and the risk of developing type 2 diabetes and also heart disease. In one study, “early” was considered ages 8 - 11 for girls, and yet this early onset is fast becoming the norm. Entering puberty younger is associated with higher BMIs in adult women, and therefore an increased risk of diabetes, regardless of family history, physical activity levels, or other factors that might affect BMI in general. The risk of diabetes, obesity, and increased BMI actually decreased the higher the age of the girl at her first period.

Age at menarche is also correlated to cardiovascular health. Several studies have shown that getting her first period before the age of 12 means a woman will develop a higher risk of experiencing a cardiovascular event later in life, including but not limited to heart disease, heart attacks, and strokes. Alarmingly, researchers found a correlation not just between getting a first period early and heart issues, but an increased risk of dying overall, linked to many other health events, including cancer and breast cancer. The reasons for this remain unclear, as weight (defined in the study as “adiposity,” or the amount of fatty tissue in the body) and BMI are only partly correlated with these health events in women who had early menarche.

Other studies have shown a similar increased risk of cardiovascular events, connected not only to early menarche but also to late menarche as well (defined as older than age 15). This points to a connection between these negative health effects and the complex interplay of women’s hormones overall.

Other medical conditions may begin to present in girls at the onset of puberty, no matter when they get their first period. Epilepsy, in particular, relates to the year in which young women get their first period, as significantly more women experienced their first seizure in the year of menarche as compared to any other year. Again, the reasons for this are unclear, but are thought to be due to the changes in brain active sex steroid hormones, including estrogen and progesterone that occur at menarche.  Clearly, changes in a woman’s reproductive system can be highly correlated to medical changes beyond just reproduction. Women with epilepsy that experience their first seizures later in life will also often find that their condition is tied to their menstrual cycle. For example, some women may notice an increase in seizures coinciding with the start of menstruation and/or ovulation each month.

The younger a girl is at menarche, the more important it is for her to understand the risk of pregnancy and potential health risks down the road. Mitigating these risks will empower her to better manage her life. Ages 8 or 9 may seem shockingly early to discuss getting her first period, but the reality is that the more we can teach girls about their bodies and what’s to come, the more empowered they can be throughout their lives. It’s imperative that we conduct more research into women’s health, to understand not only why the age of menarche is trending younger and younger, but also the implications of that on girls’ and women’s health over our lifetimes.

References

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7. Lakshman, R et al. “Association between age at menarche and risk of diabetes in adults: results from the EPIC-Norfolk cohort study.” Diabetologia, vol. 51, 5 Mar. 2008, pp. 781–86. doi: 10.1007/s00125-008-0948-5.
8. Lakshman, R. et al. “Early Age at Menarche Associated with Cardiovascular Disease and Mortality.” Journal of Clinical Endocrinology and Metabolism, vol. 94 no. 12, 1 Dec. 2009, pp. 4953– 60. Oxford Academic OUP, doi:10.1210/jc.2009-1789.
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10. Herzog, Andrew et al. “Does the age of seizure onset relate to menarche and does it matter?” Seizure: European Journal of Epilepsy, vol. 69, 26 Mar. 2019, pp. 1-6. doi: 10.1016/j.seizure.2019.03.018.

This information in this article is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed provider.