Keywords: Delayed menarche, Pre-teen motherhood, Negative impact on mother and child

Pre-teen and teen pregnancies are immense problematic for the individuals, societies, countries, both health wise and financially. Children born to preteen and teen mothers are not very healthy and have a short life span. Pre-teen and teen mother’s reproductive health is ruined, during labor many of them die or are, prematurely aborted, or babies are taken out surgically. There are cases of stillborn. Majority of them are malnourished. The cascade of reproductive endocrine glands start working after the onset of menarche, hormone-activated target tissues and the organs which are independent of steroid hormone action and are required in up-keeping of development of embryo, are not ready to contribute fully towards tender age during pre-teen pregnancy. Thus early reproductive maturation may not prepare an ideal environment for the pregnancy and subsequent nurturing of the baby.

Menarche is the event that signals for onset of female reproductive cycle signifying the releasing of the oocyte, and continue to do so until menopause. Even about half a century back menarcheal age was 15/16 years but now it has come down to even 9 years. Earlier in many societies child marriages were in vogue but because of late menarche the couple was not able to produce a child. Though it may be exception, a 5 year old Peruvian girl produced a child; examples of 6 to 10 years old girls became pregnant are many. This is all happening due to lowering of the menarcheal age.

Recently, we have enquired (1182 female subjects, age ranging from 9-60 years and above) in Chennai, (Metropolitan city in southern part of India) on age at which menarcheal event took place and found that in early 50’s girls never had menarche before 14 years. However in late 90s, it has come down to 11 years (11.45%) and majority will have (55.65%) at the age between 11 and 13 years, and beyond comprises only 32.9.1%.

Many factors influence menarcheal age. Since menarche is directly linked  to  sexual maturity which in turn is influenced by a wide variety of factors such as, geographical connotations, socioeconomic status, diet, exercise, environment, religion, genetic and hereditary factors, ethnicity, psychological stress, migration and chronic illnesses. In addition to these factors we believe that circadian regulatory mechanism in the pineal-hypothalamic-pituitary-gonadal axis is also operative and has a pivotal role in the lowering of the menarcheal age [1].

The ideal menarcheal age will pave the way for the best output by the cooperation and contribution of associated reproductive glands with their secretions during gestation. However, some of the factors responsible for lowering the menarcheal age cannot be controlled and the only remedial measure is not to get pregnant until proper maturity.

1.       Pushkala K, Gupta PD, Geetha R (2018) Differential drift in menarcheal age in blind and sighted girls. Gynecol Perinatol 2: 333-339.