Introduction

Adolescence is a period of maturity, a point of physical, emotional, social and psychological change. It is considered to be the period between ages 10 and 19. Puberty is the process of biological, psychological and physical development through which sexual reproduction becomes possible. Progression occurs through sequential changes described as Thelarche – Adrenarche – Peak growth spurt – Menarche – Ovulation.

Menstruation is described as the exclusive sign of femininity. It is well known that the terms menstruation and menses are derived from the Latin word menses (month), which in turn relates to the Greek word ‘mene’ (moon) and to the roots of the English word month reflecting the fact that the moon also takes close to 28 days to revolve around the Earth (actually 27.32 days).

The age of menarche is determined by general health, genetic, socio-economic, nutritional factors, geographic location, exposure to light and psychological state. The mean age of menarche is typically between 12 and 13 years. The initial cycles after menarche are often irregular with a particularly greater interval between first and second cycle. The early menstrual cycles are thought to be anovulatory.

Most women bleed for 2 to 7 days during their first menses. Most normal cycles range from 21 to 45 days, despite variability even in the first gynaecologic year, although short cycles of fewer than 20 days and long cycles of more than 35 days may occur. By the third year after menarche, 60% to 80% of menstrual cycles are 21 to 34 days long, as is typical of adults.

1. Padubidri V.G, Daftary S.N, Shaws Textbook of Gynaecology. 16 edition. Elsevier India Private Limited, 2011; 55-56.
2. Berek S. J, Berek & Novak’s Gynaecology. 16 edition. Lippincott Williams & Wilkins. 2015; 998-999.
3. McPherson M and Korfine L. Menstruation across time: menarche, menstrual attitudes, experiences, and behaviors. Womens Health Issues; 2004:  (14):193-200.
4. Critchley H, Lumsden M, Campbell-Brown M, Douglas A, and Murray G. Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data. Am J Obstet Gynecol. 2004; 190:1216 –1223.
5. Hickey M, Balen A. Menstrual disorders in adolescence: investigation and management. Hum Reprod Update. 2003; (9) :493 –504
6. Fujiwara T. The discrepancy between BMI and self-recognition ofadequate body weight may cause insufficient food intake and habits in young women in Japan. Bulletin of Ashiya College.  2005; 27: 75-80.
7. Alam T , Jiwane R , Choudhary A K , Kishanrao S S. Relationship of Body Mass Index & the age at Menarche among Young Girls. Journal of Dental & Medical Sciences. 2015; 14: 79-83.
8. Park k, Park’s Textbook of Preventive & Social Medicine, Jaypee Brothers, 2011; 367-368.
9. Mumby H. S, Elks C. E, Li S, Sharp S. J, Kaw K. T, Luben R. N, et al. . Mendelian randomisation study of childhood BMI and early menarche. Journal of Obesity.2011; 1-6.
10. Anderson S. E, Dallal G. E, Must A. Relative weight and race influence average age at menarche: results from two nationally representative surveys of U.S. girls studied 25 years apart. American Academy of Pediatrics. 2003; 3(4), 844-850.
11. Parent A. S, Teilmann G, Juul A, Skakkebaek N. E, Toppari J, Bourguignon P. The timing of normal puberty and the age limits of sexual precocity: Variations around the world, secular trends, and changes after migration. Endocrine Reviews. 2003; 24(5), 668-693.
12. Kosti R.I, Panagiotakos D.B. The epidemic of obesity in children and adolescents in the world.Cent Eur J Public Health. 2006; 14:151–9. 
13. Hedley A.A, Ogden C.L, Johnson C.L, Carroll M.D, Curtin L.R, Flegal K.M. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004; 291:2847–50.
14. Wang L, Kong L, Wu F, Bai Y, Burton R. Preventing chronic diseases in China.Lancet. 2005; 366:1821–4.

Dr Neena Agrawal

Assistant Professor, Department of Obstetrics & Gynaecology, NMCH, Patna, Bihar, India

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