Factors Influencing Age at Menarche, a School-Based Cross-Sectional Study





Menarche, nutritional status, economy, pornography, genetics


The last few years have seen the increasingly young age of menarche in teenagers. The average age of the national menarche from year to year is declining. The more children experience early menarche, the greater the risk of negative implications such as lack of personal hygiene, breast cancer, and early pregnancy. Menarche's age is influenced by nutritional, economic, pornographic, and genetic status. The purpose of this study was to determine the factors that affect menarche in adolescents aged 10-12 years. The research conducted is descriptive-analytic with a cross-sectional design. The population of MIN 3 Magetan students aged 10-12 years who have menstruated and have met the inclusion and exclusion criteria. The study sample was 87 respondents with a purposive sampling technique. Data collection using questionnaires. Statistical calculations are carried out by statistical and descriptive analysis with binary logistic regression tests. The average age of menarche is 11 years with the youngest age being 9 years and the oldest at 12 years, most female students experience early menarche (65.5%). There is an effect of nutritional status on menarche (p =0.048, Exp (B)= 4.3), there is an economic influence on menarche (p=0.000, Exp (B)= 11.3), there is an influence of pornographic exposure on menarche (p=0.001, Exp (B)= 12.1), and there is no genetic or age influence maternal menarche against menarche (0.388). Nutritional status, economic status, and exposure to pornographic media increase the incidence of early menarche. The highest risk factors for exposure to pornography resulted in  12.1 times the incidence of early menarche, economic status by 11.3 times, and nutritional status by 4.2 times. Strict supervision of mass media access and maintaining nutritional intake are necessary to prevent early menarche.


Download data is not yet available.


B. de S. Barros, M. C. M. C. Kuschnir, K. V. Bloch, and T. L. N. da Silva, “ERICA: age at menarche and its association with nutritional status,” Jornal de Pediatria, vol. 95, no. 1, pp. 106–111, Jan. 2019, doi: 10.1016/j.jped.2017.12.004.

M. Sommer, C. Sutherland, and V. C. Mouli, “ Putting menarche and girls into the global population health agenda,” Reprod. Health, vol. 12, no. 24, Mar. 2015.

G. Saffa, A. M. Kubicka, M. Hromada, and K. L. Kramer, “Is the timing of menarche correlated with mortality and fertility rates?” PLoS ONE, vol. 14, Apr. 2019.

M. Żegleń et al., “The relationship among the age at menarche, anthropometric characteristics, and socio-economic factors in Bengali girls from Kolkata, India,” American Journal of Human Biology, vol. 32, no. 4, Jul. 2020, DOI: 10.1002/ajhb.23380.

A. Wahab, S. A. Wilopo, M. Hakimi, and D. Ismail, “Declining age at menarche in Indonesia: A systematic review and meta-analysis,” International Journal of Adolescent Medicine and Health, vol. 32, no. 6, Dec. 2020, doi: 10.1515/ijamh-2018-0021.

F. R. Tehrani, P. Mirmiran, R. Gholami, N. Moslehi, and F. Azizi, “Factors influencing menarcheal age: Results from the cohort of Tehran Lipid and glucose study,” International Journal of Endocrinology and Metabolism, vol. 12, no. 3, 2014, doi: 10.5812/ijem.16130.

I. M. Idris et al., “Factors associated with early age at menarche among female secondary school students in Asmara: a cross-sectional study,” Global Reproductive Health, vol. 6, no. 2, pp. e51–e51, 2021, doi: 10.1097/grh.0000000000000051.

Deswita, R. Refnandes, and M. G. Putri, “The Association of Pornographic Media Exposure and Nutritional Status with Early Menarche,” Jurnal Ners, vol. 13, no. 2, pp. 190–193, Oct. 2018.

M.-S. Lye, I. Krishnarajah, and S. Jahanfar, “Genetic and environmental effects on age at menarche, and its relationship with reproductive health in twins,” Indian Journal of Human Genetics, vol. 19, no. 2, p. 245, 2013, doi: 10.4103/0971-6866.116127.

S. Bhattarai, S. Subedi, and S. R. Acharya, “Factors Associated With Early Menarche among Adolescents Girls: A Study from Nepal,” SM Journal of Community Medicine, vol. 4, no. 1, pp. 1–11, Mar. 2018.

S. Bubach, B. L. Horta, H. Goncalves, and M. C. F. Assuncao, “Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood”.

Guntarto and N. Sevrina, “The Role of Parents in the Use of Media for Early Childhood in Suburban Jakarta,” Atlantis Press, vol. 249, pp. 78–86, 2018.

M. S. Setia, “Methodology Series Module 3: Cross-sectional Studies,” Indian J Dermatol, vol. 61, no. 3, pp. 261–264, May 2016.

W. Wahyuningsih and N. A. Setyaningtyas, “Nutrition status as dominant factors related to the age of menarche in teenagers,” Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics), vol. 6, no. 2, p. 58, Mar. 2019, doi: 10.21927/ijnd.2018.6(2).58-63.

A. Makarimah and L. Muniroh, “Nutritional Status and Body Fat Percentage Correlate with Menarche’s Age among Students at Muhammadiyah GKB 1 Elementary School.”

A. Wawrzeńczyk et al., “Relationship of serum leptin with parameters of nutritional status and body composition among patients with stable course of cardiovascular disorders,” Medical Research Journal, vol. 3, no. 2, pp. 89–97, Jul. 2018, doi: 10.5603/mrj.2018.0015.

C. F. Elias, “Leptin action in pubertal development: Recent advances and unanswered questions,” Trends in Endocrinology and Metabolism, vol. 23, no. 1. pp. 9–15, Jan. 2012. doi: 10.1016/j.tem.2011.09.002.

A. Soliman, M. Yasin, and A. Kassem, “Leptin in pediatrics: A hormone from adipocyte that wheels several functions in children,” Indian Journal of Endocrinology and Metabolism, vol. 16, no. 9, p. 577, 2012, doi: 10.4103/2230-8210.105575.

L. H. Matsuo et al., “Age at menarche and its association with overweight including obesity and socio-economic conditions of Brazilian schoolgirls: A time-trend analysis,” Nutrition Bulletin, vol. 47, no. 1, Mar. 2022.

E. Silvestris, D. Lovero, and R. Palmirotta, “Nutrition and Female Fertility: An Interdependent Correlation,” PubMed, vol. 10, Jun. 2019.

R. H. Juliyatmi and L. Handayani, “Nutritional Status and Age at Menarche on Female Students of Junior High School,” International Journal of Evaluation and Research in Education (IJERE), vol. 4, no. 2, pp. 71–75, Jun. 2015.

R. A. Putri, “The Relationship Between Nutritional Status And Age At Menarche In The Fifth And Sixth-Grade Students Of SDN Pabean 1 Sedati, Sidoarjo,” Proceeding of Surabaya International Health Conferenc, pp. 241–246, Jul. 2017.

M. U. Barut, E. Agacayak, M. Bozkurt, T. Aksu, and T. Gul, “There is a positive correlation between socioeconomic status and ovarian reserve in women of reproductive age,” Medical Science Monitor, vol. 22, pp. 4386–4392, Nov. 2016, doi: 10.12659/MSM.897620.

A. Szwed, A. John, Z. Czapla, and M. Kosińska, “Influence of socioeconomic factors on age at menarche of Polish girls,” Pubmed, vol. 70, no. 4, pp. 455–470, Dec. 2013.

M. Saeed and A. Mohammed, “Influence of Socioeconomic Status in the Age at Menarche and Duration of Menstrual Bleeding,” Materia Socio Medica, vol. 23, no. 4, p. 195, 2011, doi: 10.5455/msm.2011.23.195-199.

H. Khalid et al., “Age of Menarche in Relation to Socioeconomic Status, BMI, Physical Activity and Stress Among High School Girls,” 2015.

N. T. K. Nguyen et al., “Nutrient intake through childhood and early menarche onset in girls: Systematic review and meta-analysis,” Nutrients, vol. 12, no. 9, pp. 1–19, Sep. 2020, doi: 10.3390/nu12092544.

A. Afkhamzadeh, K. Rahmani, A. Habibi, and O. Faraji, “Menarche Age and Its Association to Body Mass Index and Socioeconomic Status Among School Girls in Sanandaj in North-West of Iran,” Shiraz E-Medical Journal, vol. 20, no. 2, Sep. 2018.

J. I. B.-D. Adinma, R. O. Egeonu, N. D. Adinma-Obiajulu, and E. A. Emeka, “Menarcheal Age and Nutritional Status of Secondary School Adolescent Girls in Nnewi, South-East Nigeria ,” Advances in Reproductive Sciences, vol. 9, no. 2, May 2021.

L. Oelkers et al., “Socioeconomic Status Is Related to Pubertal Development in a German Cohort,” Hormone Research in Paediatrics, vol. 93, no. 9–10, pp. 548–557, Apr. 2021, doi: 10.1159/000513787.

J. Kebidanan dan Kesehatan Tradisional et al., “Pornographic And Social Economic Exposure Affect The Age Of Menarch,” no. 6, 2021, doi: 10.37341/jkkt.

J. D. Fortenberry, “Puberty and adolescent sexuality,” Hormones and Behavior, vol. 64, no. 2. pp. 280–287, Jul. 2013. doi: 10.1016/j.yhbeh.2013.03.007.

R. de Alarcón, J. I. de la Iglesia, N. M. Casado, and A. L. Montejo, “Online porn addiction: What we know and what we don’t—a systematic review,” Journal of Clinical Medicine, vol. 8, no. 1. MDPI, Jan. 01, 2019. doi: 10.3390/jcm8010091.

L. Breehl and O. Caban, Physiology, Puberty. StatPearls Publishing, 2022.

M. C. Tsai, C. Strong, W. T. Chen, C. T. Lee, and C. Y. Lin, “Longitudinal impacts of pubertal timing and weight status on adolescent internet use: Analysis from a cohort study of taiwanese youths,” PLoS ONE, vol. 13, no. 5, May 2018, doi: 10.1371/journal.pone.0197860.

S.-J. Blakemore and T. W. Robbins, “Decision-making in the adolescent brain,” nature neuroscience, vol. 15, pp. 1184–1191, Aug. 2012.

F. Fuadah, “Relationship Between Media Exposure And The Age Of Menarche,” JMCRH, vol. 3, no. 1, pp. 22–26, 2020.

S. Sørensen, N. Brix, A. Ernst, L. L. B. Lauridsen, and C. H. Ramlau-Hansen, “Maternal age at menarche and pubertal development in sons and daughters: A nationwide cohort study,” Human Reproduction, vol. 33, no. 11, pp. 2043–2050, Nov. 2018, doi: 10.1093/humrep/dey287.

F. R. Day et al., “Shared genetic aetiology of puberty timing between sexes and with health-related outcomes,” Nat Communications, vol. 6, no. 8842, Nov. 2015.

C. Wohlfahrt-Veje et al., “Pubertal onset in boys and girls is influenced by pubertal timing of both parents,” Journal of Clinical Endocrinology and Metabolism, vol. 101, no. 7, pp. 2667–2674, Jul. 2016, doi: 10.1210/jc.2016-1073.

S. Nasiri, M. Dolatian, F. R. Tehrani, A. Bagheri, H. A. Majd, and R. Pakzad, “The Correlation between the Mothers’ and their Daughters’ Ages of Menarche: A Systematic Review and Meta-analysis,” Original Article, vol. 9, no. 9, pp. 14481–14496, 2021, doi: 10.22038/ijp.2021.58319.4564.

A. Eid Al Agha, S. Alabbad, and B. ah Tatwany, “Menarche Age of Mothers and Daughters and Correlation between them in Saudi Arabia,” Reproductive System & Sexual Disorders, vol. 04, no. 03, 2015, doi: 10.4172/2161-038x.1000153.




How to Cite

N. K. Novalia, Hery Sumasto, N. . Saadah, and N. . Surtinah, “Factors Influencing Age at Menarche, a School-Based Cross-Sectional Study ”, International Journal of Advanced Health Science and Technology, vol. 2, no. 4, pp. 252–259, Aug. 2022.



Health Science

Most read articles by the same author(s)