Menarche and its relation to nutritional status in rural Bangladesh

Menarche is an important milestone in female adolescent development. We assessed the age at menarche, seasonality of its occurrence and association with age, and marital and nutritional status (using mid upper arm circumference, MUAC) among 12–19 yr old adolescents in a rural area of Bangladesh. Cross-sectional data on date of menarche using recall were collected from married nulliparous (n=439) and unmarried adolescent girls (n=2976) in the defined study area. At the time of assessment, ~ 88% of the sample had attained menarche. Among these, the mean (± SD) age of onset was 12.4 (± 1.4) years. Married adolescents had an earlier onset of menarche than unmarried girls (12.1 ± 1.3 vs 12.4 ± 1.4, p<0.01). The mean (± SD) MUAC was higher among menstruating (22.8 ± 2 cm) vs non-menstruating girls (19.5 ± 1.5 cm), after adjusting for chronological age (p<0.01). A negative linear relationship between MUAC and age at menarche was found after adjusting for chronological age and marital status (p<0.01). Above 50% of the adolescent girls had an onset of menarche during winter, with peaks in the months of December and January. In conclusion, our data suggest that, at present, the mean age of menarche in rural Bangladesh may be lower than in the past and comparable to that of developed countries, although factors associated with this declining trend remain to be elucidated. Funded by the USAID and the Bill & Melinda Gates Foundation