BACKGROUND: Menarche is an important phase of female reproductive life, which with
passage of time is getting earlier worldwide. Early menarche has several psychosocial and
behavioral effects on a girl’s teenage life, besides it increases the risk of breast cancer, therefore
it is important to determine the underlying causes of this change.
OBJECTIVE: To assess the extent of and factors responsible for variation in age at menarche in
females of Sindh.
STUDY DESIGN: Cross-sectional, questionnaire based.
METHODOLOGY: The study was conducted by department of physiology on 600 sexually
healthy females, belongs to interior Sindh, Hyderabad and Karachi. Informed written consent
was obtained, data about menarcheal age and relevant factor was collected using questionnaires
containing close-ended questions. Volunteers were divided into three groups, each of
200, based upon their birth year, Group 1 included ladies who were born in 1970s or before,
Group 2 consists those who born in 1980s while volunteer from Group 3 were the youngest
generation born during 1990’s and onwards.
RESULTS: Mean age at menarche for Group 1 was 13.6 yrs (Std. Dev ± 1.3), Group 2, 13.3 yrs
(Std. Dev ± 1.0) and for Group 3 it was 12.3 yrs (Std. Dev ± 1.1). Pearson Correlation between
age at menarche and menarcheal age of sister for all three groups was significant (P = 0.01).
Twenty-three percent volunteers in Group 1, 37% in Group 2 (P = 0.01) and 48% in Group 3 (P =
0.02) had awareness about menstruation at their time of menarche.
CONCLUSION: Menarcheal age, over time is decreasing, among girls of Sindh, Pakistan. This
may be due to pre-menarcheal awareness and hereditary influence.
Menarche, early menarche, puberty, girls, breastfeeding, pre-menarcheal awareness.