De Sanctis Vincenzo, Bernasconi Sergio, Bianchin Luigi, Bona Gianni, Bozzola Mauro, Buzi Fabio, De Sanctis Carlo, Rigon Franco, Tatò Luciano, Tonini Giorgio, Perissinotto Egle
Private Accredited Hospital Quisisana, Paediatric and Adolescent Outpatients Clinic, Ferrara, Italy.
Department of Pediatrics, University of Parma, Parma, Italy.
Indian J Endocrinol Metab. 2014 Nov;18(Suppl 1):S84-92. doi: 10.4103/2230-8210.140251.
Healthcare professionals need updated information about what is the range of "normal" variation of menstrual cycle features to support young girls and their parents in managing reproductive health, and to detect diseases early.
This cross-sectional study aimed to provide an updated picture of age at menarche and main menstrual cycle characteristics and complaints in an Italian population-based sample of 3,783 adolescents attending secondary school. Girls filled in a self-administered anonymous questionnaire including questions about demography, anthropometry, smoking and drinking habits, use of contraceptive, socioeconomic status, age at menarche, menstrual pattern, and physical/psychological menstrual complaints. Mean age at menarche and prevalence of polymenorrhea (cycle length < 21 days), oligomenorrhea (cycle length > 35 days), irregularity, dysmenorrhea, and of physical/psychological complaints were computed. Factors associated with age at menarche and menstrual disturbances were explored by using multiple logistic models.
The girls' mean age was 17.1 years (SD 1.4 years) and the mean age at menarche was 12.4 years (SD 1.3 years); menarche occurred with two monthly peaks of frequency in July-September and in December-January (P < 0.0001). Age at menarche was significantly associated with geographic genetics (as expressed by parents' birth area), mother's menarcheal age, BMI, family size, and age at data collection. The prevalence of polymenorrhea was about 2.5%, oligomenorrhea was declared by 3.7%, irregular length by 8.3%, while long bleeding (>6 days) was shown in 19.6% of girls. Gynecological age was significantly associated with cycle length (P < 0.0001) with long cycles becoming more regular within the fourth year after menarche, while frequency of polymenorrhea stabilized after the second gynecological year. Oligomenorrhea and irregularity were both significantly associated with long menstrual bleeding (adjusted OR = 2.36; 95% CI = 1.55-3.60, and adjusted OR = 2.59; 95% CI = 1.95-3.44, respectively).
The findings of the study support the levelling-off of secular trend in menarche anticipation in Italy and confirm the timing in menstrual cycle regularization. The study provides updated epidemiological data on frequency of menstrual abnormalities to help reproductive health professionals in managing adolescent gynecology.
医疗保健专业人员需要有关月经周期特征“正常”变化范围的最新信息，以帮助年轻女孩及其父母管理生殖健康，并尽早发现疾病。
这项横断面研究旨在提供意大利3783名就读中学的青少年人群样本中初潮年龄以及主要月经周期特征和症状的最新情况。女孩们填写了一份自我管理的匿名问卷，包括有关人口统计学、人体测量学、吸烟和饮酒习惯、避孕药具使用、社会经济地位、初潮年龄、月经模式以及身体/心理月经症状的问题。计算了初潮的平均年龄以及月经过频（周期长度<21天）、月经过少（周期长度>35天）、月经不规律、痛经以及身体/心理症状的患病率。通过使用多重逻辑模型探讨了与初潮年龄和月经紊乱相关的因素。
女孩的平均年龄为17.1岁（标准差1.4岁），初潮的平均年龄为12.4岁（标准差1.3岁）；初潮在7月至9月和12月至1月出现两个频率高峰（P<0.0001）。初潮年龄与地理遗传学（以父母的出生地表示）、母亲的初潮年龄、体重指数、家庭规模以及数据收集时的年龄显著相关。月经过频的患病率约为2.5%，宣称月经过少的占3.7%，周期长度不规律的占8.3%，而19.6%的女孩出现经期延长（>6天）。妇科年龄与周期长度显著相关（P<0.0001），初潮后第四年内长周期变得更加规律，而月经过频的发生率在第二个妇科年后趋于稳定。月经过少和月经不规律均与经期延长显著相关（调整后的比值比分别为2.36；95%置信区间为1.55-3.60和2.59；95%置信区间为1.95-3.44）。
该研究结果支持意大利初潮提前的长期趋势趋于平稳，并证实了月经周期规律化的时间。该研究提供了有关月经异常频率的最新流行病学数据，以帮助生殖健康专业人员管理青少年妇科。
