Menarche is the culmination of a series of physiological and anatomic processes of puberty :
- Attainment of a sufficient body mass (typically 17% body fat). [12]
- Disinhibition of the GnRH pulse generator in the arcuate nucleus of the hypothalamus. [13]
- Secretion of estrogen by the ovaries in response to pituitary hormones.
What is menarche and why does it happen?
Menarche happens during a time of physical and sexual maturation in adolescence known as puberty. It is common for menarche to occur and then for a young girl not to get another period for a few months. This is because it can take a while for the hormone cascade that is responsible for ovulation and regular menstruation to mature.
Why is menarche the most important event in female puberty?
From both social and medical perspectives, it is often considered the central event of female puberty, as it signals the possibility of fertility . Girls experience menarche at different ages. Having menarche occur between the ages of 9–16 is considered normal.
How long does it take for menarche to appear?
The onset of menarche is sort of predictable. Typically menarche will occur about 2 ½ to 3 years after the first appearance of breast buds. The time between breast buds and menarche is when girls may start to have problems with skin breakouts.
What are the signs and symptoms of menarche?
The initial flow of menarche is usually brighter than mature menstrual flow. It is often scanty in amount and may be very brief, even a single instance of "spotting". Like other menses, menarche may be accompanied by abdominal cramping.
What happens in the female body during menarche?
Starting earlier in puberty, ovaries and female sex accessory structures (oviducts, uterus, vagina) grow and mature (Figure 6.2). The first external change during female puberty is usually growth of breast tissue; the onset of breast growth is called thelarche or breast budding.
What changes occur during menarche?
The onset of female puberty is marked by thelarche (breast budding), which typically occurs after eight years of age. Thelarche is followed by pubarche (pubic hair development), growth spurt, and finally, menarche. Menarche occurs 2-3 years after thelarche and six months after peak height velocity (PHV) is achieved.
What are the symptoms of menarche?
What are the symptoms of menstruation?Abdominal or pelvic cramping.Lower back pain.Bloating and sore breasts.Food cravings.Mood swings and irritability.Headache.Fatigue.
What girls expect on their first period?
Your first period should last anywhere from 2 to 7 days. It may be very light, with just a few spots of brownish blood. Or it may start and end more brownish, but be brighter red on heavier flow days.
How long does menarche last?
Normal Menstrual Cycles in Adolescent GirlsMenarche (median age):12.43 yearsMean cycle interval:32.2 days in first gynecologic yearMenstrual cycle interval:Typically 21–45 daysMenstrual flow length:7 days or lessMenstrual product use:Three to six pads or tampons per day
What age do boys start liking girls?
In terms of an 'average' age, it seems to be 11 for girls and 12 for boys. But don't worry about averages… who wants to be average, anyway! Furthermore, even if his body says he is ready, intellectually, his mind might not be on the same wavelength just yet.
What is the Colour of a menarche?
When a woman experiences menarche, the blood flow can vary from a slow and spotty discharge to a consistent blood flow for 3-7 days. While the color of the blood does range from a brown to bright red color, this is normal; some women have light periods while others have heavy ones; everyone is different.
Why is my daughters first period Brown?
Lots of girls expect their blood to be bright red during their periods. But it's completely normal for menstrual blood to be brownish. It's also perfectly normal for some girls to have their first period for just 2 or 3 days.
What should I do when my daughter gets her first period?
It's important to remind her that it is natural and that every woman goes through. You can also give her tips on how to prepare for her period ahead of time, so she's not taken by surprise when it shows up. For example, you can give her pads and panty liners to carry with her in her backpack or purse.
How long after a girl gets pubic hair does her period start?
Pubic hair – Once her pubic hair starts growing, you can expect her period to develop in one to two years. It may begin soft and thin but it will become courser and thicker towards the end of puberty.
How does a girl feel on her period?
PMS (premenstrual syndrome) is when a girl has emotional and physical symptoms that happen before or during her period. These symptoms can include moodiness, sadness, anxiety, bloating, and acne. The symptoms go away after the first few days of a period.
Are first periods heavy?
The first period often is very heavy and painful. Ovulation, or the process of making an egg, helps make a “normal” period. Unfortunately, many girls do not ovulate in the beginning, resulting in heavy bleeding.
What is menarche Class 8?
Menarche is the first menstrual cycle, or first menstrual bleeding, in female humans. From both social and medical perspectives, it is often considered the central event of female puberty, as it signals the possibility of fertility. Girls experience menarche at different ages.
What is menarche Class 10?
Menarche:- It is the stage of initiation of menstruation in the life of a female girl. it generally occurs at an age of 11-13 years. It refers to the beginning of the reproductive phase in girls.
Which of the following is a physical change in females during puberty?
Physical changes for girls around puberty Body shape - Your hips will widen and your body will get curvier. Height - You will grow taller. Acne - You may develop acne. This is a condition of the skin that shows up as bumps – most commonly on the face, neck, shoulders, upper back and chest.
What is the best explanation for why the age of menarche differs across countries?
However, several factors have been found to significantly influence menarcheal age and they include genetics, environmental conditions, body stature, family size, body mass index, socioeconomic status, and the level of education [1], [5], [6], [7], [8], [9], [10].
What is menarche in girls?
Menarche is a normal process of maturation in girls along with the other changes that happen to a girl’s body during puberty. The timing of menarche is important. If a young girl has her first period before the age of 8 she likely has a condition known as precocious puberty.
When does menarche start?
on April 20, 2020. Menarche defines the onset of menstruation, which is a normal physiologic process that occurs at regular monthly intervals. Menarche typically occurs around age 12 but a few years earlier or later is completely normal.
Why is menarche delayed?
Delay of Menarche. Most likely the cause of this delay in menarche is due to continued interference with the hormonal cascade needed for menstruation to occur. This can happen in very athletic teen girls including ballet dancers and in girls suffering from eating disorders especially anorexia nervosa.
Why do women pass menarche?
This is because it can take a while for the hormone cascade that is responsible for ovulation and regular menstruation to mature. Even if a girl’s menstrual cycles are not regular, they have still passed menarche because they have had their first period. 1 . Alys Tomlinson / Getty Images.
What is the period of a woman?
In most women, it marks the beginning of regular monthly periods that will last until around the age of 52 which is typically when menopause is reached . Also Known As: the first period, first menstrual cycle.
How long does it take for a woman to get menarche?
The onset of menarche is sort of predictable. Typically menarche will occur about 2 ½ to 3 years after the first appearance of breast buds. 2 The time between breast buds and menarche is when girls may start to have problems with skin breakouts. It is also a time when girls can become moodier and start to talk back to their parents.
Can a girl have a congenital absence of her uterus?
Very rarely a girl could have a congenital absence of her uterus a condition called Mayer-Rokitansky-Kuster-Hauer Syndrome. 4 . The onset of menarche marks the beginning of the reproductive years of a woman’s life. Actually beginning just before the first menstrual period a girl has had her first ovulation.
What is menarche?
Pronounced “MEH-nar-kee,” menarche is not a widely known term for the first menstrual period, and is sometimes misspelled as menarch or menarchy.
Why do we have early menarche?
Some scientists speculate that increases in body weight during childhood account for the early onset of menarche. Early menarche is a symptom of precocious puberty, which could be the result of: Ethnic background and predisposition (i.e., certain groups are more prone to early menarche)
What causes menarche to be delayed?
Other possible causes of delayed menarche include: 1 Genetic predisposition (e.g., delayed menarche often runs in the family) 2 Health issues such as inflammatory bowel diseases (IBD), anemia, diabetes mellitus, kidney disease, and cystic fibrosis 3 Radiation or chemotherapy treatment 4 Autoimmune disorders (e.g., Addison’s disease and Hashimoto’s thyroiditis) 5 Tumors of the pituitary gland or hypothalamus, which affect hormone production
Why is my period delayed?
Causes of delayed menarche. In contrast, delayed menarche is often attributed to a lack of body fat. Your body requires adequate amounts of fat to enter the phase of puberty and trigger your first menstrual period. That’s why hard-core athletes, such as swimmers, dancers, and gymnasts, who tend to carry less body fat, ...
How old is a woman when she is menarche?
On average, the menarche age for girls in the U.S. is around 12 or 13 years. The standard age range for menarche is between 11 and 15. However, young women can also experience early menarche (i.e., before 11 years) or delayed menarche (i.e., after 16 years).
How do you know if your daughter is in puberty?
Lastly, before her first period, your daughter will notice thick, liquid-like vaginal discharge that’s white, clear, or yellowish in color.
What does it mean when you get your period?
Getting your period basically means that you are not pregnant. Throughout the monthly menstrual cycle, your body uses two hormones (estrogen and progesterone) to thicken your uterine lining. Composed of blood and tissue, it is crucial in assisting with the process of egg fertilization.
What is menarche in women?
It is a marker of normal female reproductive health and wellness. Most females recognize menarche as their body’s critical declaration of fertility. The absence of normal menstrual periods, not related to pregnancy, is called amenorrhea. Primary amenorrhea is the complete absence of any menstruation by 15 years of age. Secondary amenorrhea is the cessation of menstruation for 3 months or more after it has started. In the first 2 to 3 years after the initial onset of menses, it is common for irregular cycles to occur, with adolescents often having several months of missed menses. Many of these irregular cycles may be nonovulatory due to poor early regulation of the hormonal interactions between hypothalamic, pituitary, and gonadal hormones. Tracking menstruation on a paper calendar or using a smartphone app can help determine if menstrual periods are becoming more regular for adolescents and for predicting when ovulation is most likely to occur. The information can be useful for both pregnancy planning and pregnancy prevention. [4][5][6][7]
What hormones affect menarche?
It also can be affected by the thyroid, adrenal, and pancreatic hormones. Thyroid hormones are necessary for normal menses, and their deficiency or excess can inhibit menarche or lead to abnormalities in existing menstrual patterns. Abnormally elevated adrenal androgens or insulin can affect normal ovarian estrogen production and decrease the normal pituitary production of luteinizing hormone. Low adiposity can inhibit normal menarche, and it is estimated that a minimum body fat of 17% is necessary for menarche, with 22% body fat necessary for maintaining normal menses. The hormone leptin appears to have a role in the maintenance of normal menstrual cycles as well. Stress and obesity appear to be predictors of early menarche.
What hormones are produced during puberty?
Pulsatile hypothalamic production of gonadotropin-releasing hormone (GnRH) at puberty stimulates the pituitary production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This pulsatile secretion pattern appears to be necessary as continuous secretion of GnRH, or its synthetic analogs, inhibits pituitary production of FSH and LH and delays menarche. This can be used medically to delay puberty in children with precocious puberty. FSH and LH, in turn, stimulate an increase in ovarian production of estrogens, primarily estradiol and androgens. Estradiol promotes maturation of ovarian follicles, with one follicle gaining dominance during each menstrual cycle. Increasing estrogen levels stimulate uterine endometrial proliferation and eventually cause a surge of LH production by the pituitary. This LH surge causes ovulation or rupture of the dominant ovarian follicle.
How to diagnose amenorrhea?
Anatomical problems leading to amenorrhea usually can be diagnosed by a thorough history and careful visual exam of the external genitalia and manual exam of the reproductive organs of the adolescent female patient . By law, clinicians must take a history in private and maintain confidentiality whenever possible. It is also important to explain the exam in detail and provide a chaperone during the exam, especially when the practitioner is male. Menarche can be delayed in adolescents with very low body mass due to starvation, malabsorption, or an eating disorder such as anorexia nervosa. Menarche can be delayed in normally developing females due to abnormalities of the female genitourinary tract. Females with an imperforate hymen may present with delayed menarche and often have a history of recurrent cyclic abdominal or pelvic pain. On exam, they often have a bulging, bluish-colored hymen. A manual exam of the reproductive organs may reveal a blind vaginal pouch in patients with Mullerian agenesis. Ultrasound imaging can be used to confirm anatomic problems, or ultrasound can be used in patients who are unwilling to have a manual exam of their internal reproductive organs. Treatment for persistent amenorrhea depends on the etiology. [12]
How often does a woman have a period?
It occurs approximately every 28 days, with a range from every 21 to every 45 days. The average age of onset of menarche is 12.4 years. Most menstrual periods last between 3 and 7 days, and menses that last more than 10 days is considered abnormal. Menarche signals maturation of the adolescent female body. It is commonly associated with the ability to ovulate and reproduce. However, the appearance of menarche does not guarantee either ovulation or fertility. [1][2][3]
What happens when a woman has menarche?
When menarche occurs, it confirms that the girl has had a gradual estrogen -induced growth of the uterus, especially the endometrium , and that the "outflow tract" from the uterus, through the cervix to the vagina, is open.
When do women reach menarche?
Most sources agree that the average age of menarche in girls in modern societies has declined, though the reasons and the degree remain subjects of controversy. From the sixth to the fifteenth centuries in Europe, most women reached menarche on average at about 14, between the ages of 12 and 15. A large North American survey reported only a 2–3 month decline from the mid-1970s to the mid-1990s. A 2011 study found that each 1 kg/m 2 increase in childhood body-mass index (BMI) can be expected to result in a 6.5% higher absolute risk of early menarche (before age 12 years).
Why is menstruation important?
Menstruation is a cultural as well as scientific phenomenon as many societies have specific rituals and cultural norms associated with it. These rituals typically begin at menarche and some are enacted during each menstruation cycle. The rituals are important in determining a status change for girls. Upon menarche and completion of the ritual, they have become a woman as defined by their culture.
What causes menarche to be delayed?
Certain systemic or chronic illness can delay menarche, such as undiagnosed and untreated celiac disease (which often occurs without gastrointestinal symptoms), asthma, diabetes mellitus type 1, cystic fibrosis and inflammatory diseases, among others. In some cases, because biochemical tests are not always discriminatory, underlying pathologies are not identified and the girl is classified as constitutional growth delay. Short stature, delayed growth in height and weight, and/or delayed menarche may be the only clinical manifestations of celiac disease, in absence of any other symptoms. According to a review article, there may also be an association between early age at menarche and breast cancer risk.
What is the culmination of a series of physiological and anatomic processes of puberty?
Puberty. Menarche is the culmination of a series of physiological and anatomic processes of puberty : Attainment of a sufficient body mass (typically 17% body fat). Disinhibition of the GnRH pulse generator in the arcuate nucleus of the hypothalamus.
How old are women when they start menstruating?
Fewer than 10% of U.S. girls start to menstruate before 11 years of age, and 90% of all U.S. girls are menstruating by 13.8 years of age, with a median age of 12.4 years. This age at menarche is not much different (0.3 years earlier) than that reported for U.S. girls in 1973.
How old is the average menarche?
Various estimates have placed it at 13. There is a later age of onset in Asian populations compared to the West.
What are the physical changes that occur after menarche?
Such increase in estrogenic activity elicits a series of physical changes that prepare the body for potential reproduction. Among these are the widening of the pelvis and hips and an increase in body fat deposition particularly in hips and tights. Linear growth after menarche is limited.
When does menarche occur?
Menarche, the first occurrence of menstruation, is a relatively late indicator of pubertal development that marks the beginning of menstrual cycling and is considered the start of a woman’s reproductive span. In most girls, however, regular and/or hormonally robust ovulatory cycles are not well established until after a variable period (ranging from 1 to 5 years) of subfertility ( Apter, 1980; Vihko and Apter, 1984 ). Recent estimates of the median age of menarche vary between 13 and 16 years ( Adams Hillard, 2008 ). The first menstrual period typically occurs approximately two years after the onset of postnatal breast development (thelarche) and following the peak in pubertal growth spurt.
What is the age at menarche?
Age at menarche is defined as the age of first menstrual cycle in females and has been linked with increased risk of breast cancer development for each year earlier than average (12.77 years in the United States) at which it occurs. It is estimated that for each 2-year increase in age at menarche, there is a 10% reduction in breast cancer risk. Studies have shown that both AA women and Hispanic women are more likely to have earlier onset of menarche compared to NHW women (Ambrosone et al., 2014; Carwile et al., 2015; Cui et al., 2014; Deardorff et al., 2014; Ramnitz & Lodish, 2013; Reagan et al., 2012 ). Age at menarche was shown to occur earlier in populations associated with increased poverty levels, and as discussed earlier poverty levels are higher in AA populations ( Reagan et al., 2012 ). NHW women who experienced a later menarche were shown to have a decreased risk for the development of solely ER positive (ER +) breast cancer when compared to AA women, which showed a decreased risk of both ER +/− breast cancer when menarche was later ( Ambrosone et al., 2014; Cui et al., 2014 ). A plethora of factors are thought to cause changes in menarche onset, such as: social economic status (lower family education level and lower family income), obesity during childhood, physical inactivity, and diet ( Carwile et al., 2015; Cui et al., 2014; Deardorff et al., 2014; Mervish et al., 2017; Mueller et al., 2015; Ramnitz & Lodish, 2013; Reagan et al., 2012; Vani et al., 2013; Villamor & Jansen, 2016 ).
What hormones are involved in menarche?
The endocrine signal linking age, body weight, fat reserves, and puberty onset is the hormone leptin. The hormone leptin is a protein produced in the adipocytes [29], which communicates the levels of peripheral energy stores to the central nervous system (CNS) and hence, regulates satiety, energy homeostasis, and fat metabolism but also other functions like reproduction [99]. Specifically, the onset of puberty is related to increases in body fat and thus in leptin secretion by the adipocytes. Obese adolescent girls, due to the increased amount of body fat and the increased secretion of leptin, may display a precocious onset of ovulatory cyclic activity (menarche) when compared to normal-weight adolescents [100].
How long does it take for menarche to occur?
Menarche will usually occur within 2–3 years after the onset of breast development. As previously mentioned genetics appears to play a large role in determining the onset of menarche, but better social conditions and increased weight are also involved ( Zacharias and Wurtman, 1969 ). Table 1.
How does age at menarche affect reproductive health?
From a life history perspective, variation in age at menarche in response to conditions experienced during childhood may help maximize reproductive fitness by adjusting an individual’s reproductive schedule and the degree of investment to the available energetic and social resources. Furthermore, the trade-offs associated with each of the resulting strategies are likely to underlie the epidemiological association between age at menarche and adult health and reproductive outcomes ( Eaton et al., 1994; Kuh and Hardy, 2002 ).
Why is menarche delayed?
Menarche may be delayed by poor nutrition, high levels of exercise (athletes or dancers), and several medical conditions, such as diabetes mellitus, congenital heart disease, and ulcerative colitis. Early menarche may occur with other conditions, such as hypothyroidism, CNS tumors, and head trauma.
What is the term for the onset of menstruation?
Menarche refers to the onset of menstruation during puberty. Less than 10% of US girls start to menstruate before 11 years, and 90% of all US girls are menstruating by 13.75 years of age, with a median age of 12.43 years. Ethnic differences remained even after adjustment for current body mass index and several social and economic variables (Chumlea et al., 2003). Irregular menstrual cycles occur most frequently within the first 2–3 years after menarche and are often anovulatory. By the third gynecological year, 60–80% of cycles are 21–34 days long, as is typical of adults, and within the sixth gynecological year most of the cycles are ovulatory (Adams Hillard, 2002 ). Approximately 4–5% of children aged under 12 suffer from migraine, with little apparent difference between boys and girls until the time around puberty ( Mortimer et al., 1992b). After menarche , the incidence diverges and amongst girls there is a rapid increase which continues throughout early adult life (Stewart et al., 1992). Age- and sex-specific incidence rates for the onset of migraine headache with and without visual aura have been clearly described. Among both males and females, the incidence rate for migraine with visual aura appears to have peaked as much as 3–5 years earlier than the age peak for migraine without aura. For males, the age-specific incidence for migraine with visual aura appears to have peaked on or before 5 years of age, while the highest incidence for migraine without aura occurred between 10 and 11 years of age. By contrast, in girls experiencing migraine with aura the peak incidence was 12–13 years of age, while in those experiencing migraine without aura it was 14–17 years of age (Stewart et al, 1991). Notwithstanding, it is likely that the erratic estrogen secretion occurring in postmenarcheal anovulatory cycles may have a role in the onset of migraine with aura, while the establishment of the ovulatory menstrual cycle is significantly relevant to the onset of migraine without aura.
What are the symptoms of a period?
Symptoms reported in the period just prior to menstruation included breast swelling and pain, headaches, abdominal bloating, depression, anxiety, poor concentration, irritability, and lethargy. While this collection of symptoms is now referred to as premenstrual syndrome (PMS) and is recognized as a diagnostic entity, there can be a wide variety of symptoms, and diagnosis is from self-report ( Richardson, 1995 ). There is little information to indicate how many women with Down syndrome experience PMS, how it might be expressed, and how it should be diagnosed in this population.
How does progesterone affect women?
Women between menarche and menopause are affected by progesterone level changes during their menstrual cycle. A respiratory stimulant, its influence in the postovulatory phase may drive P aCO 2 levels down as far as 25% below normal ( Damas-Mora et al 1980) and lower during pregnancy ( Novy & Edwards 1967 ). Patients with premenstrual syndrome (PMS) benefit from awareness of breathing rate changes and breathing retraining to prevent excessive CO 2 depletion and consequent HVS symptoms. Perimenopausal and menopausal hormone levels may fluctuate dramatically and women unable or unwilling to take hormone replacement therapies (HRT) have benefited from breathing retraining to reduce hot flashes and improve sleep ( Freedman & Woodward 1992 ).
Does anxiety affect the menstrual cycle?
From studies in the typical population, there is evidence that there are individual differences in reactivity to the menstrual cycle. Women who had high anxiety and women with panic disorder reported higher levels of physical and psychological distress during the premenstrual phase ( Sigmon, Dorhofer, Rohan, & Boulard, 2000 ). In addition, when these women were in psychological distress associated with the menstrual cycle, they were more likely to have maladaptive coping strategies, such as mental or behavioral disengagement and denial ( Sigmon, Whitcomb-Smith, Rohan, & Kendrew, 2004 ). If these findings are extrapolated to adolescents with Down syndrome, it may be that prior high levels of anxiety may lead to behavioral decompensation and regression soon after menarche in some adolescent females with Down syndrome.
Does mitosis occur during menstrual cycle?
This information was forthcoming in the early 1980s in a series of studies showing that mitotic activity of breast epithelium varies markedly during the normal menstrual cycle, with peak activity occurring in the luteal phase ( Fig. 40.4) ( 13,14). This shows that regular ovulatory cycling is positively correlated with mitotic activity and explains why a more rapid establishment of regular cycles after menarche will be associated with the greatest increase in breast cancer risk. The mitotic activity during the luteal phase is roughly double the level in the follicular phase. Based on the fit shown in Fig. 40.2, we calculate that the mitotic rate in the postmenopausal period is approximately one-fifth the mitotic rate during the follicular phase of the cycle: data on this are sparse, but this is completely in line with what has been found ( 15 ).
Who menstruates?
The median age at which menstruation begins worldwide is 14, according to research. This is called menarche, and Asian girls are generally later with starting menstruation than girls in other parts of the world. In the United States, many girls will start menstruating during the year they turn 12, but menarche can also occur at 10 or even earlier. Girls who reach 16 without menstruating are considered to be late, and may have medical problems. Menstruation is not, by itself, a sign that a girl is fertile ovulation often follows a few years after menarche, and a sign that a girl has become fertile and is able to get pregnant is having regular menstrual periods. Menstruation is interrupted during pregnancy and often while a woman is breastfeeding, and finally stops when she enters the menopause. The menopause, preceded by a transitional period with many menopause symptoms, is officially reached when a woman hasn't had a menstrual period for a year. This generally happens during a woman's early 50s.
How long does a woman's period last?
The average menstrual cycle lasts between 28 and 32 days, and may last between three and seven days. During menstruation, a portion the lining of the uterus is expelled from the body.
How many follicles are lost during a period?
In the majority of cases, one mature egg will be released, enabling pregnancy if the egg is fertilized. Scientists estimate that as many as 400 follicles can be "lost" in some way during a menstrual cycle, however. Ovulation, like menstruation, comes at different times for different women. Many will ovulate around 14 days before their next period is due, but this can vary. Women who ovulate less than 10 days before their next period is due have a Luteal Phase Defect, meaning there is not enough usually time between ovulation and menstruation for a fertilized egg to implant. This makes pregnancy very difficult.
What is the lining of the womb called?
The endometrium which is what that lining is called is soft tissue that covers the inside of the womb during the fertile stages of the cycle, to give any potential fertilized egg a place to nestle. When that doesn't happen, and the woman doesn't become pregnant during that cycle, a significant part of the endometrium leaves the body and the uterus is totally cleaned out for the next cycle. The part that is not expelled is absorbed (broken down) by the body. This is menstruation.
