Population Studies Unit, Faculty of Economics and Administration,University of Malaya,Kuala Lumpur,Malaysia.
J Biosoc Sci. 2019 Jan;51(1):77-94. doi: 10.1017/S0021932017000682. Epub 2018 Jan 21.
There has been a secular decline in age at menarche since the 19th century. Early-maturing women are more likely to have their sexual debut at a younger age, which in turn gives rise to a host of reproductive health and social problems. This study used data from five waves of National Demographic and Health Surveys conducted in the Philippines between 1993 and 2013 to examine the trends and socioeconomic differentials in age at menarche and sexual debut. The changing trend in age at menarche and sexual debut was examined across birth cohorts, and logistic regressions were used to identify the determinants of early sexual debut. In the Philippines, the mean and median ages at menarche declined from 13.2 years and 12.6 years, respectively, among young women born in 1973-1977, to 12.9 years and 12.3 years, respectively, among those born in 1993-1997. The proportion who had their sexual debut by age 20 increased from 41.2% for the 1968-1972 birth cohort to 53.4% for the 1988-1992 birth cohort. Filipino women with low education, from poor families and living in rural areas were more likely to have earlier sexual debut despite attaining menarche at a later age as compared with their higher educated counterparts, and those from wealthier families and urban areas. Logistic regression analysis showed that, besides marital status, women's education and age at menarche were important determinants of early sexual debut. However, ethnicity, place of residence and family wealth had no significant effects on age at menarche. An increasing proportion of young women were found to be having unprotected sexual debut and at a younger age, with health and social ramifications. Hence, apart from increasing the enrolment of girls in schools and discouraging teenage marriage, there is a need for social and health agencies to implement appropriate adolescent sexual and reproductive health programmes such as counselling and educational campaigns, as well as support services, to address sexual problems among the youth.
自 19 世纪以来，月经初潮的年龄呈下降趋势。性成熟早的女性更有可能在更年轻的时候开始性行为，这反过来又引发了一系列生殖健康和社会问题。本研究使用了菲律宾 1993 年至 2013 年期间进行的五次全国人口和健康调查的数据，以研究月经初潮和性开始年龄的趋势和社会经济差异。通过出生队列检查月经初潮和性开始的变化趋势，并使用逻辑回归确定早期性开始的决定因素。在菲律宾，1973-1977 年出生的年轻女性的平均和中位数月经初潮年龄分别从 13.2 岁和 12.6 岁下降到 1993-1997 年出生的女性的 12.9 岁和 12.3 岁。在 1968-1972 年出生的队列中，有 41.2%的人在 20 岁之前有过性行为，而在 1988-1992 年出生的队列中，这一比例上升到 53.4%。与受教育程度较高的同龄人相比，受教育程度较低、来自贫困家庭、居住在农村地区的菲律宾女性，尽管月经初潮较晚，但她们更有可能较早开始性行为。逻辑回归分析表明，除了婚姻状况外，妇女的教育程度和月经初潮年龄是早期性行为的重要决定因素。然而，种族、居住地和家庭财富对月经初潮没有显著影响。研究发现，越来越多的年轻女性开始无保护的性行为，而且年龄更小，这对健康和社会都有影响。因此，除了增加女孩入学率和劝阻少女结婚外，社会和卫生机构还需要实施适当的青少年性健康和生殖健康方案，如咨询和教育活动，以及支持服务，以解决青年中的性问题。
