Age at menarche and early menarche among healthy adolescents

Main Article Content

Annang Giri Moelyo
Anindita Wulandari
Oktania Imas
Ulfa Puspita Rahma
Nurul Hidayah
Cempaka Kesumaningtyas
Fadhilah Tia Nur
Hari Wahyu Nugroho


Background Menarche is an important indicator of female adolescents’ health and also population health. Age at menarche tends to decrease in many countries. Early menarche that defined from the lowest quartile of age at menarche, associated with some physical and psychological problems.

Objective To determine the mean age at menarche, the prevalence of early menarche among healthy adolescents in Surakarta and its association to nutritional status.

Methods This cross-sectional study was conducted in 5 schools (3 junior and 2 senior high schools) in Surakarta, Central Java, Indonesia, from September 2016 to March 2018, by consecutive sampling technique. We included menarched healthy female students whose parent provided informed consent and without consuming any routine medication. Data were derived from self-reported questionnaire and measurements of body weight; body height; and body mass index (BMI) by calculated based on weight/height2(kg/m2).

Results Of 835 eligible subjects, the mean age at menarche was 12.0 (SD 1.1) years (range 8.8-15.1 years) and the prevalence of early menarche was 11.1%. The peak of age at menarche were at 11,12, and 13 years (24.3%, 36.2%, and 23.9%, respectively) and almost 99.04% of subjects had menarche at 14 years old. The proportion of early menarche between subjects birth 1997-2001 and 2002-2007 were 8.4% and 16.1%. Early menarche associated with overweight-obese in adolescents (odd ratio 2.14; 95%CI 1.21 to 3.76).

Conclusion The mean age at menarche of healthy adolescents in Surakarta is younger than other previous studies in Indonesia. Early menarche was significantly a risk for overweight/obese in adolescents.

Article Details

How to Cite
Moelyo A, Wulandari A, Imas O, Rahma U, Hidayah N, Kesumaningtyas C, Nur F, Nugroho H. Age at menarche and early menarche among healthy adolescents. PI [Internet]. 18Feb.2019 [cited 23Apr.2021];59(1):33-. Available from:
Pediatric Endocrinology
Author Biographies

Ulfa Puspita Rahma, Department of Child Health, Universitas Sebelas Maret Medical School/Dr. Moewardi Hospital, Surakarta, Central Java



Fadhilah Tia Nur, Department of Child Health, Universitas Sebelas Maret Medical School/Dr. Moewardi Hospital, Surakarta, Central Java

Received 2018-11-27
Accepted 2019-02-18
Published 2019-02-18


1. AAP committee on adolescence, ACOG committee on adolescent health care. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics. 2006;118:2245-50. PMid:17079600
2. Delemarre-Van De Waal HA. Regulation of puberty. Best Pract Res Clin Endocrinol Metab. 2002;16:1-12. PMid:11987894
3. Sohn K. The trend in age at menarche in Indonesia: Birth cohorts 1944-1988. J Biosoc Sci. 2015;47:407-12. PMid:25977963
4. Batubara JRL, Soesanti F, van de Waal HD. Age at menarche in Indonesian girls: a national survey. Acta Med Indones. 2010;42:78-81. PMid:20513931
5. Wahab A, Wilopo SA, Hakimi M, Ismail D. Declining age at menarche in Indonesia: a systematic review and meta-analysis Abstract: Int J Adolesc Med Heal. 2018:1-9.
6. Weghofer A, Kim A, Barad DH, Gleicher N. Age at menarche: A predictor of diminished ovarian function? Fertil Steril. 2013;100:1039-43. PMid:23809497
7. Remsberg KE, Demerath EW, Schubert CM, Chumlea WC, Sun SS, Siervogel RM. Early menarche and the development of cardiovascular disease risk factors in adolescent girls: The Fels Longitudinal Study. J Clin Endocrinol Metab. 2005;90:2718-24. PMid:15728207
8. Abetew DF, Enquobahrie DA, Dishi M, Rudra CB, Miller RS, Williams MA. Age at menarche, menstrual characteristics, and risk of preeclampsia. ISRN Obstet Gynecol. 2011;2011:1-6. PMid:22263114 PMCid:PMC3255320
9. Ibitoye M, Choi C, Tai H, Lee G, Sommer M. Early menarche: A systematic review of its effect on sexual and reproductive health in low- and middle-income countries. PLoS One. 2017;12:1-24. PMid:28591132 PMCid:PMC5462398
10. Gaudineau A, Ehlinger V, Vayssiere C, Jouret B, Arnaud C, Godeau E. Factors associated with early menarche: Results from the French health behaviour in school-aged children (HBSC) study. BMC Public Health. 2010;10:175. PMid:20353570 PMCid:PMC2853511
11. Center for Disease Control and Prevention [homepage on the internet].Atlanta. About child and teen BMI. [updated 2018 Oct24; cited 2019 Feb6] Available from
12. Choudhary S, Khichar S, Dabi D, Parakh M, Dara PK, Parakh P, et al. Urban rural comparison of anthropometry and menarcheal status of adolescent school going girls of Jodhpur, Rajasthan, India. J Clin Diagnostic Res. 2016;10:SC08-SC12.
13. Chun H, Shin E. Secular trends and socioeconomic differentials in menarcheal age for South Korean women. 2018;47:1254-60.
14. Odongkara Mpora B, Piloya T, Awor S, Ngwiri T, Laigong P, Mworozi EA, et al. Age at menarche in relation to nutritional status and critical life events among rural and urban secondary school girls in post-conflict Northern Uganda. BMC Womens Health. 2014. doi:10.1186/1472-6874-14-66.
15. Almuhlafi M, Abu Jamilah K, Almutairi A, Salam M. Relationship between early menarche, obesity, and disordered eating behaviors: a school-based cross-sectional survey in Northern Saudi Arabia. Diabetes, Metab Syndr Obes. 2018;11:743-51. PMid:30532574 PMCid:PMC6244586
16. Dreyfus J, Jacobs Jr. DR, Mueller N, Schreiner PJ, Moran A, Carnethon MR, et al. Age at menarche and cardiometabolic risk in adulthood: The coronary artery risk development in young adults study. J Pediatr. 2015;167:344-52.e1. PMid:25962931 PMCid:PMC4516565
17. Meng X, Li S, Duan W, Sun Y, Jia C. Secular trend of age at menarche in Chinese adolescents born from 1973 to 2004. Pediatrics. 2017;140:e20170085. PMid:28716824 PMCid:PMC5527668
18. Prentice P, Viner RM. Pubertal timing and adult obesity and cardiometabolic risk in women and men: A systematic review and meta-analysis. Int J Obes. 2013;37:1036-43. PMid:23164700