Early Life's Impact on Menarche & Menopause

The circumstances of our early lives can predict certain things later in our lives, so for example, early periods and later menopause are both – independently – linked with a higher risk of breast cancer.

Those who start periods earlier are also at greater risks of endometrial cancer, menstrual problems, and adult obesity. Early menstruation is not thought to have any impact on cardiovascular risks, although premature menopause is associated with a greater risk of heart disease.

The start of bleeding – menarche

This is the beginning of the end of childhood, and the beginning of a woman’s fertile years. There is evidence to suggest that we are menstruating earlier than ever, with some records from the 1800s and 1900s in developed countries, up until the ’50s, reporting average age of menarche being between 15 and 17 years old.

It plateaued around 1950, but more changes, albeit smaller, have been noted. Presently, periods are estimated to start between 13 and 16 years of age.

What matters in menarche

Three elements appear to be the most important factors when determining time of menarche – body size, social circumstance, and exposure to unfavourable psychological circumstances.

Twin studies and reviews of families shows that genetics play a role in determining menarche too.

Theories on the timing of menarche

Energetics theory suggests that energy available during one’s childhood impacts menarcheal timing. If a girl was exposed to poor nutrition, she will grow more slowly, reach puberty later, and reach relatively small adult size (compared with other children exposed to more food). This ties in with the minimum fat composition of a girl before menarche can occur, due to fat cells intrinsic enzymatic connection with oestrogen. More fat cells would mean better fed, and therefore a girl would – theoretically – reach puberty faster.
Psychosocial acceleration theory suggests that high stress levels in a young girl’s family can lead her to menarche earlier so she can leave her family faster.
Parental-investment theory hypothesises a special role of a girl’s father and other men in influencing menarche.
Stress-suppression theory supposes that early adversity in one’s life – physical or social conditions or stress – cause a delay in pubertal development until a ‘better’ time comes along.
Child-development theory suggests that the age at menarche is an ‘end-point’ of a development strategy that determines the length of childhood in response to the family environment.

Birthweight and growth rates – the research

Research has found that, after adjustments were made for childhood growth, infant weight did not impact age of menarche.

Early life and its impact on menarcheal timing – the research

Rapid prepubertal weight gain and childhood obesity often mean earlier menarche, but some studies have not found a link between childhood obesity and earlier onset on menarche.

Rich kid, poor kid

Studies from many countries, both developed and undeveloped, have found that urban kids, those with dads of higher occupational class, and those with more educated parents, had earlier menarche.

Just a couple of studies have found no association of menarche timing and the place kids live. A theory for rural kids menstruating later was greater levels of physical activity compared with city kids, with family size and pubertal timing study results proving inconsistent.

Because how much money a family has ties into almost every aspect of those children’s lives – experience in the womb, time spent breastfeeding, quality and quantity of food, energy output, family structure, healthcare – separating out the reasons why socioeconomics change the timing of menarche.

Again, this supports the energetics theory.

Childhood experiences and how they impact menarcheal timing Family structure and relationships – impact on menarche

The mother’s age at menarche is more accurate at predicting her daughter’s menarche than any other external factor, but family structure also matters. That is, how affectionate a girl’s father is, positive family relationships, and the father’s role in childrearing, all of which point to a later start of menarche.

Increased conflict, divorce, and paternal absence correlate more with earlier menarche. Stepfathering is also a great predictor of menarcheal age compared to the absence of a biological father, with the longer the stepfather has been around coinciding with earlier menarche.

Stress and trauma – impact on menarche

Trauma is associated with earlier menarche, and earlier sexual development (precocious puberty), particularly in adopted girls. Adopted girls were 15-20 times more likely to develop precocious puberty compared to the reference group of children, whereas children migrating with their families had no such increase.

Sexual abuse, lack of fatherly investment, childhood adversities, and an absent father all correlate with earlier onset of menarche. In periods of war, menarche has been found to be delayed, with the Dutch Famine Study putting this down to food rationing.

Another study author concluded that psychological trauma, physical injury and low socioeconomic conditions due to war may have been to blame. A Croatian study found an increased timing of menarche of about three months between 1985 and 1996, with three studies – one in 1981, 1985, and 1996.

This was dependent on stressors experienced, and those with personal tragedy stemming from the Balkan war, the increase was almost 11 months.

So why the disparity between trauma early in life and trauma later in childhood?

It turns out that early childhood trauma and adversity cause earlier onset of menarche, while anything happening in the period before or during puberty delays it. This, therefore, includes other theories – the psychosocial acceleration theory, parental investment theory, and the stress-suppression theory.

A discussion by researchers has suggested that the stress reactivity theory can account for both the delay and accelerating impacts of stress and adversity on menarche, with both protective and stressful family circumstances triggering reactivity systems. This may hinder the hypothalamic-pituitary-ovarian (HPO) axis maturation.

Age of menopause

Menopause usually occurs between the ages of 40 and 60, and in Western countries, is currently sitting at between 48 and 52 years. There is some evidence to suggest an overall increase in the age of menopause over the past century or so.

Follicular reserves are depleted to less than 1,000 – a foetus has about five million follicles at 20 weeks, which by birth is down to two million. Natural menopause is the factors that affect ovarian follicular reserves. As with menarche, a woman’s age at natural menopause is likely to be around the same as her mother’s.

There may be a genetic component to conditions that cause surgical menopause (hysterectomy) risk, including smoking and never having had children.

Some studies have found a link between socioeconomic position and the onset of natural menopause: women of lower socioeconomic position become menopausal earlier than those of a higher position, even once confounding factors have been adjusted for (smoking, parity).

The risk of surgical menopause increases with higher parity, lower socioeconomic position, and more bodyweight changes over time.

How age at menarche impacts age at menopause

Birthweight, childhood growth and nutrition

Research findings include:

There was no evidence that higher birthweight indicated later menopause
Low weight at age one was found to be associated with earlier menopause
Women who were breastfed as babies had later menopause than non-breastfed
Women who had been severely malnourished for prolonged periods (and were of a short height and low weight) went through menopause on average four years earlier than women in the same locale who had better access to nutrition
Women exposed to low caloric intake (particularly those aged between two and six), had earlier natural menopause than those not exposed
Famine exposure may be related to a higher incidence of hysterectomy
There is no evidence that childhood weight has any association with hysterectomy risk.

Rich kids and poor kids and menopause

There is a childhood socioeconomic connection with age at natural menopause compared to as an adult. Early menopause may be mediated by childhood diet.

A link has been found between socioeconomic position during childhood and those with fathers of lower occupational standing and hysterectomy, with the opposite also being true, except in the 1920s.

What this tells us is that these associations are fluid and change over time with various factors that could include healthcare, doctor attitudes, childbearing, and treatment availability.

Did your parent’s divorce cause your early menopause?

Women with early parental divorce had earlier natural menopause than other women – early emotional stress may play a role in early menopause. Parental divorce before a child’s 15th birthday has a strong impact on early menopause, but the likelihood of divorce in women who go through menopause before age 50 is doubled.

Parental divorce is also associated with bedwetting and delinquency, and less psychologically healthy adults. Stress responses in early life could upset the HPO axis balance and could influence menopausal age. The life history theory of psychosocial acceleration may be at play. An alternate pathway may relate to ovarian function with telomerase activity.

Childhood and age at menopause

A girl’s weight at age two, her mother’s reported age at menopause, and parental divorce are further strongly associated with age at menopause before the age of 50.

The stress response may connect with another factor – follicular reserves, for example – and change the age of menopause in conjunction with genetic age at menopause.

There is conflicting evidence available regarding menarche age and menopause age, and how they connect together, with studies coming back positive, negative, and with no association at all.

Discussion

Early life clearly plays a large role in both menarche and menopause. Factors influencing menarche include childhood growth rate, socioeconomic position, family conflict and divorce, the presence of a stepfather, and stress experienced during or shortly prior to menarche.

Factors influencing menopause include being breastfed, low growth rates, lower socioeconomic standing, and parental divorce. They don’t cause impacts in the same ways, however, with aspects actually shortening a woman’s fertile lifespan including poor childhood growth – it delays menarche and speeds menopause.

This discussion does not include any of the many conditions that can affect a woman during her fertile years, which are many and varied, and without doubt, impacted by foetal and childhood experiences.

References

This article has been a short summary of the literature review done by Mishra et al in 2009, published in the Journal of Biosocial Science, Early life circumstances and their impact on menarche and menopause.