Child Abuse Study: Effects on Age of Menarche

Journal of Adolescent Health has published a new article on childhood abuse derived from data from the  Nurses’ Health Study II.

See the abstract here. The article is available for purchase at that site as well.

Of the 68,505 participants  in the study, the abstract says “Fifty-seven percent of respondents reported some form of physical or sexual abuse in childhood. We found a positive dose–response association between severity of sexual abuse in childhood and risk for early menarche.”

Conclusion: “Severity of childhood sexual abuse was associated with risk for early onset of menarche, and physical abuse was associated with both early and late onset of menarche.”

The researcher was quoted in Study Finds Link Between Child Abuse And The Timing Of Menstruation [Common Health 7/31/12 byRachel Zimmerman]”“What we think is that different types of stress may either accelerate or delay timing of puberty because of its impact on the hormonal system in the body,” said Boynton-Jarrett, whose research focuses on the enduring health impacts of adversities in childhood, including the connections between child abuse and obesity and abuse and fibroids. “Also, it appears that the effects of abuse are more diverse than we might have expected — not homogenous at all.”

Indeed, the different types (physical or sexual) and severity (moderate or severe) of abuse were associated with unique timing problems related to first menstruation. Specifically, the study found:

– Severe physical abuse was associated with a 22 percent increase in risk for early menarche. – Sexual touching was associated with a 20 percent increase in risk; and forced sexual activity was associated with a 49 percent increase in risk for early menstruation.

The researchers found no association between sexual abuse and late menarche, but did find what looks almost like a “dose-response” association between the severity of physical abuse and risk for late menstruation, after age 15.

All of this matters because it is becoming increasingly clear that a woman’s age at the start of her reproductive cycle has all sorts of health implications. “Mounting evidence has established the significance of this once symbolic lever as both a footprint for chronic disease risk and compass for health and developmental trajectory,” the new study says.

Early menarche, for instance, has been associated with a greater risk for breast cancer, all-cause mortality, metabolic disorders, cardiovascular disease, depression and certain high-risk behavior in adolescence, researchers note. While late periods have been linked to a higher risk for depression, mood disorders, low bone mineral density and bone fractures.

And, interestingly, although the initial onset of puberty appears to be declining, as has been recently reported, the age of menarche has remained fairly stable, beginning, on average, at age 12.

A major theme in Boynton-Jarrett’s work as a pediatrician and researcher is that “child abuse is a life course social determinant of health and associated with a significant health burden.”

““We’ve thought of child abuse as this immediate insult and that there are these immediate effects of the trauma,” she says. “But what this study shows is that there can be later effects of the trauma that can impact well-being through adolescence and into adulthood. Treatment, then, should be focused in a more comprehensive way that takes into account the type and severity of exposure as well as the other unique characteristics of the person and the social context.”

She adds: “You’d think this [onset of menarche] was mainly determined by genetics but the fact that it can be determined by a social exposure should humble our response.”

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