Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter November 13, 2015

Pattern of teen menstruation among secondary school girls in south east Nigeria

  • Ada R.C. Nwokocha , Josephat M. Chinawa EMAIL logo , Agozie C. Ubesie , Vivian I. Onukwuli and Pius C. Manyike

Abstract

Background: Menstruation in the teenage age has assumed variable trends which is been influenced by several variables. This study is aimed at determining the pattern and trend of menstruation among teens attending secondary school in south east Nigeria and associated factors.

Methods: Menstruation patterns were investigated using a stratified random sampling method of teens from junior secondary schools in Enugu, south east Nigeria. A self-administered questionnaire was developed and data analyzed using SPSS version 19.

Results: A total of 897 female teenagers aged 9–18 years completed the questionnaire with a mean age of 13.9±1.9 years. The mean age (SD) at onset of menarche was 12.5±1.2 years. Teenage girls with higher BMI achieved menarche earlier at age 8 and 9 when compared with their counterparts with lower BMI and this is statistically significant. F=7.60, df=8, p<0.001. Teens with a 14-day cycle had a higher BMI when compared with teens with longer cycle but this is not statistically significant. F=1.05, df=4, p=0.381. There is a statistical significance difference between teens duration of menstrual flow and BMI. Those with higher BMI had longer duration(4–5 days) compared with those with lower BMI. F=3.329, df=4, p=0.01

Conclusions: This study revealed that the mean age at onset of menarche was 12.5±1.2 years showing a continuing decreasing trend. Teens with higher BMI attain menarche earlier and had longer days of periods when compared with their counterpart with lower BMI.


Corresponding author: Dr. Josephat M. Chinawa, Department of Paediatrics, University of Nigeria/University of Nigeria Teaching Hospital (UNTH), PMB 01129, Enugu, Enugu State 400001, Nigeria, Phone: +234 806 398 1403, E-mail:

Author contributions: JMC, ARC, PMC, AU, VO, EA contributed to the conception, writing and proof reading of this manuscript. JMC and ARN contributed to writing of the manuscript. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Sharma P, Malhotra C, Taneja DK, Saha R. Problems related to menstruation amongst adolescent girls. Indian J Pediatr 2008;75:125–9.10.1007/s12098-008-0018-5Search in Google Scholar PubMed

2. Abioye-Kuyeti EA. Menstrual knowledge and practices amongst secondary school girls in Nigeria. J R Soc Promot Health 200;120:23–6.10.1177/146642400012000113Search in Google Scholar PubMed

3. Fakeye O, Fagbule D. Age and anthropometric status of Nigerian girls at puberty: implication for the introduction of sex education with secondary schools. West Afr Med J 1990:3;226–31.Search in Google Scholar

4. Busari AO. Menstrual knowledge and health care behavior among adolescent girls in rural, Nigeria. International Journal of Applied Science and Technology 2012;2:149–54.Search in Google Scholar

5. Chumlea WE, Schubert CN, Roche AF, Kulin HE, Lee PA, et al. Age at menarche and racial comparison in US girls. Pediatrics 2003;111:110–3.10.1542/peds.111.1.110Search in Google Scholar PubMed

6. Shawky S, Milaat W. Early teenage marriage and subsequent pregnancy outcome. East Mediterr Health J 2000;6:46–54.10.26719/2000.6.1.46Search in Google Scholar

7. Anderson SE, Dallal GE, Must A. Relative weight and race influence average age at menarche: results from two nationally representative surveys of US girls studied 25 years apart. Pediatrics 2003;111:844–50.10.1542/peds.111.4.844Search in Google Scholar PubMed

8. Feibelmann TC, Silva AP, Resende DC, Resende EA, Scatena LM, et al. Puberty in a sample of Brazilian schoolgirls: timing and anthropometric characteristics. Arch Endocrinol Metab 2015;59:105–11.10.1590/2359-3997000000021Search in Google Scholar PubMed

9. Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV, et al. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research Office Settings Network. Pediatrics 1997;99:505–12.10.1542/peds.99.4.505Search in Google Scholar PubMed

10. Ong KK, Ahmed ML, Dunger DB. Lessons from large population studies on timing and tempo of puberty (secular trends and relation to body size): the European trend. Mol Cell Endocrinol 2006;254:8–12.10.1016/j.mce.2006.04.018Search in Google Scholar PubMed

11. Sorensen K, Mouritsen A, Aksglaede L, Hagen CP, Mogensen SS, et al. Recent secular trends in pubertal timing: implications for evaluation and diagnosis of precocious puberty. Horm Res Paediatr 2012;77:137–45.10.1159/000336325Search in Google Scholar PubMed

12. Tabassum K, Anoop KV, Reema K, Raja R, Mousami S, Andleeb R. Age at menarche and affecting Bio-Social factors among the girls of Lucknow, Uttar Pradesh. J Indian Acad Forensic Med 2011;33:221–3.Search in Google Scholar

13. ARC Nwokocha, BA Okoro. Influence of Socioeconomic class on sexual maturation and menarche of Igbo school girls. J Coll Med 1997;2:26–30.Search in Google Scholar

14. Ofuya ZM. The age at Menarche in Nigerian adolescents from two different socioeconomic classes. Online J Health Allied Science 2007;4:3.Search in Google Scholar

15. Biro F, Greenspan L, Galvez M. Puberty in girls of the 21st century. J Pediatr Adolesc Gynecol 2012;25:289–94.10.1016/j.jpag.2012.05.009Search in Google Scholar PubMed PubMed Central

16. Walvoord E. The timing of puberty: is it changing? Does it matter? J Adolesc Health 2010;47:433–9.10.1016/j.jadohealth.2010.05.018Search in Google Scholar PubMed

17. Thelarche, Pubarche, and Menarche Attainment in Children With Normal and Elevated Body Mass Index. Available from: https://www.researchgate.net/publication/23715066_Thelarche_Pubarche_and_Menarche_Attainment_in_Children_With_Normal_and_Elevated_Body_Mass_Index [accessed Jun 19, 2015].Search in Google Scholar

18. American Congress of Obstetricians and Gynecologists Committee Opinion. “Menstruation in Girls and Adolescents: using the menstrual cycle as a vital sign”. ACOG. Retrieved June 19 th 2015.Search in Google Scholar

19. Oyedeji GA. Socio-economic and cultural background of hospitalized children in llesha. Nigerian J Paediatr 1985;12:111–7.Search in Google Scholar

20. Rokade S, Mane A. A study of age at Menarche, the secular trend and factors associated with it. The Internet Journal of Biological Anthropology 2008;3:1.Search in Google Scholar

21. Nwokocha AR. Sexual maturation ages in girls. Nigerian Journal of Surgical Sciences 1999;5:1–4.Search in Google Scholar

22. Ellis RW. Age at Puberty in the Tropics. Br Med J 1950;1:85–9.10.1136/bmj.1.4645.85Search in Google Scholar PubMed PubMed Central

23. Modebe O. The effect of Sickle Cell Disease on the age of menarche in Nigerian school girls. Ann Hum Biol 1987;4: 181–5.10.1080/03014468700006902Search in Google Scholar PubMed

24. Uche GO, Okoroafor AE. The age of menarche in Nigerian school girls. Ann Hum Biol 1979;6:395–8.10.1080/03014467900003771Search in Google Scholar PubMed

25. Herman-Giddens ME. Recent data on pubertal milestones in United States children: the secular trend toward earlier development. Int J Androl 2006;29:241–6.10.1111/j.1365-2605.2005.00575.xSearch in Google Scholar PubMed

26. Cho GJ, Park HT, Shin JH, Hur JY, Kim YT, et al. Age at menarche in a Korean population: secular trends and influencing factors. Eur J Pediatr 2010;169:89–94.10.1007/s00431-009-0993-1Search in Google Scholar PubMed

27. Michie H, Setsuko I, Hideki M, Toshiro K, Kunihiko H. Secular trends in age at menarche and time to establish regular menstrual cycling in Japanese women born between 1930 and 1985. BMC Women’s Health 2012;12:19.10.1186/1472-6874-12-19Search in Google Scholar PubMed PubMed Central

28. Talma H, Schönbeck Y, van Dommelen P, Bakker B, van Buuren S, et al. Trends in Menarcheal Age between 1955 and 2009 in the Netherlands. PLoS ONE 2013;8:e60056.10.1371/journal.pone.0060056Search in Google Scholar PubMed PubMed Central

29. Goon DT, Toriola AL, Uever J, Wuam S, Toriola OM. Growth status and menarcheal age among adolescent school girls in Wannune, Benue State, Nigeria. BMC Pediatrics 2010;10:60.10.1186/1471-2431-10-60Search in Google Scholar PubMed PubMed Central

30. Abioye Kuteyi EA, Ojofeitimi EO, Aina OI, Kio F, Aluko Y, et al. The influence of socio-economic and nutritional status on menarche in Nigerian school girls. Nutr Health 1997;11:185–95.10.1177/026010609701100304Search in Google Scholar PubMed

31. Fawole AO, Babarinsa IA, Obisesan KA, Fawole OI, Cole AT, et al. Is menarcheal age rising in Nigeria? Trop J Obstet Gynaecol 2002;19:35.Search in Google Scholar

32. Tunau KA, Adamu AN, Hassan MA, Ahmed Y, Ekele BA. Age at menarche among school girls in Sokoto, Northern Nigeria. Ann Afr Med 2012;11:103–7.10.4103/1596-3519.93533Search in Google Scholar PubMed

33. Sulayman HU, Ameh N, Adesiyun AG, Ozed-Williams IC, Ojabo AO, et al. Age at menarche and prevalence of menstrual abnormalities among adolescents in Zaria, northern Nigeria. Ann Nigerian Med 2013;7:66–70.10.4103/0331-3131.133099Search in Google Scholar

34. Hillard PJ. Menstruation in adolescents: what’s normal? Medscape J Med 2008;10:295.Search in Google Scholar

35. Graham MJ, Larsen U, Xu X. Secular trend in age at menarche in China: a case study of two rural countries in Anhui Province. J Biosoc Sci 1999;31:257–67.10.1017/S0021932099002576Search in Google Scholar PubMed

36. Attallah NL, Matta WM, El-Mankoushi, M. Age at menarche of school girls in Khartoum. Ann Hum Biol 1983;10:185–199.10.1080/03014468300006321Search in Google Scholar PubMed

37. Chang-Mo O, In-Hwan O, Kyung-Sik C, Bong-Keun C, Tai-Young Y, et al. Relationship between body mass index and early menarche of adolescent girls in Seoul. J Prev Med Public Health 2012;45:227–34.10.3961/jpmph.2012.45.4.227Search in Google Scholar PubMed PubMed Central

38. Irena B, Husref T, Dubravka M, Ozren V, Stanislava S, et al. Association of early menarche age and overweight/obesity. J Pediatr Endocrinol Metab 2012;25:57–62.Search in Google Scholar

39. Mandel D, Zimlichman E, Mimouni FB, Grotto I, Kreiss Y. Age at menarche and body mass index: a population study. J Pediatr Endocrinol Metab 2004;17:1507–10.10.1515/JPEM.2004.17.11.1507Search in Google Scholar PubMed

40. Wagner IV, Sabin MA, Pfäffle RW, Hiemisch A, Sergeyev E, et al. Effects of obesity on human sexual development. Nat Rev Endocrinol 2012;8:246–54.10.1038/nrendo.2011.241Search in Google Scholar PubMed

41. Sonia IO, Janet OO, Emmanuel A. Body mass index influences the age at menarche and duration of menstrual cycle. Am J Health Res 2014;2:310–5.10.11648/j.ajhr.20140205.24Search in Google Scholar

42. Rowland AS, Baird DD, Long S, Wegienka G, Harlow DS, et al. Influence of medical conditions and lifestyle factors on the menstrual cycle. Epidemiology 2002;13:668–74.10.1097/00001648-200211000-00011Search in Google Scholar PubMed

43. Marván ML, Molina-Abolnik M. Mexican adolescents’ experience of menarche and attitudes toward menstruation: role of communication between mothers and daughters. J Pediatr Adolesc Gynecol 2012;25:358–63.10.1016/j.jpag.2012.05.003Search in Google Scholar PubMed

44. Aniebue UU, Aniebue PN, Nwankwo TO. The impact of pre-menarcheal training on menstrual practices and hygiene of Nigerian school girls. Pan Afr Med J 2009;2:1–9.Search in Google Scholar

45. Flug D, Largo RH, Prader A. Menstrual patterns in adolescent Swiss girls: a longitudinal study. Ann Hum Biol 1984;11:495–508.10.1080/03014468400007411Search in Google Scholar PubMed

46. Widhom O, Kantero RL. A statistical analysis of the menstrual patterns of 8,000 Finnish girls and their mothers. Acta Obstet Gynecol Scand Suppl 1971;14(Suppl 14):1–36.Search in Google Scholar

47. Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign. Pediatrics 2006;118:2245–50.10.1542/peds.2006-2481Search in Google Scholar PubMed

48. Painful Menstrual Periods / Dysmenorrhea - Symptom Evaluation. Obtainable from http://www.medindia.net/symptoms/painful-menstrual-periods.htm. Accecced on 19/06/2015Search in Google Scholar

49. Normal Pubertal Physiology in Females. Obtainable from http://www.springer.com/cda/content/document/cda_downloaddocument/9781493909117-c1.pdf%3FSGWID%3... Accecced 20/06/2015Search in Google Scholar

50. Guillette EA, Conard C, Lares F, Aguilar MG, McLachlan J, et al. Altered breast development in young girls from an agricultural environment. Environ Health Perspect 2006;114:471–5.10.1289/ehp.8280Search in Google Scholar PubMed PubMed Central

Received: 2015-6-26
Accepted: 2015-8-27
Published Online: 2015-11-13
Published in Print: 2016-3-1

©2016 by De Gruyter

Downloaded on 23.4.2024 from https://www.degruyter.com/document/doi/10.1515/jpem-2015-0257/html
Scroll to top button