Puberty and perimenopause: Reproductive transitions and their implications for women's health

Abstract

This scoping review synthesizes existing research on two major transitions in females’ lives: puberty and perimenopause. These two periods of vast physiological change demarcate the beginning and the end of the reproductive life cycle and are associated with major neuroendocrine reorganization across two key systems, the hypothalamic-pituitary-gonadal (HPG) axis the hypothalamus-pituitary-adrenal (HPA) axis. Despite growing evidence suggesting that the timing and experience of puberty and perimenopause are related to various physical and mental health outcomes (e.g., mood disorders, metabolism, cardiovascular health, autoimmune conditions and cancer), these two processes are rarely examined together. In this paper, we bridge these disparate literatures to highlight similarities, isolate inconsistencies, and identify important areas for future research in women’s health.

Menstrual Factors and Stroke Incidence in Japanese Postmenopausal Women: The Ohasama Study

“…Although early menarche has been associated with adult obesity and metabolic risk factors [7,26] , the associations remained significant after adjustment for these factors in the present and previous studies [7,8] . It has been suggested that early menarche may not predict an unfavorable cardiovascular profile, but may reflect negative metabolic imprinting during pre-pubertal life [5,26] . For example, girls with their weights on the higher side tend to experience menarche at younger ages [27][28][29] .…”

“…For example, girls with their weights on the higher side tend to experience menarche at younger ages [27][28][29] . However, child or adolescent body weight has not been measured yet [5] . If elevated childhood weight contributes to early menarche, which in turn leads to the incidence of stroke as suggested [5] , then preventing childhood obesity could well become a strategy for stroke prevention in later life.…”

“…However, child or adolescent body weight has not been measured yet [5] . If elevated childhood weight contributes to early menarche, which in turn leads to the incidence of stroke as suggested [5] , then preventing childhood obesity could well become a strategy for stroke prevention in later life. As the precise biological mechanisms underlying the association between early menarche and stroke are yet to be specified, early menarche might be a cause or only a predictor for stroke.…”

“…Growing evidence suggests that the timing of menarche and menopause -that is, earlier or later than average -is associated with disease outcomes [4,5] . The association between early menarche and all-cause mortality is relatively consistent [6] .…”

Race Disparities in Pubertal Timing: Implications for Cardiovascular Disease Risk Among African American Women

“…Younger menarcheal age has also been related prospectively to a host of cardiovascular risk factors in adolescence and adulthood as well as to a worsening of these risk factors over time (Feng et al, 2008; Frontini et al, 2003; Hoyt & Falconi, 2015; Hulanicka et al, 2007; Kivimaki et al, 2008; Lakshman et al, 2009; Pierce, Kuh, & Hardy, 2010; Remsberg et al, 2005; Widén et al, 2012). For example, girls with earlier menarche, defined at the 25 th percentile or less (11.9 years), experienced greater increases in insulin, glucose, systolic blood pressure (SBP), and diastolic blood pressure (DBP) over the 13-year study period (ages 8 to 21); these changes were observed independently of correlated changes in body composition (marked by indicators: fat-free mass and percent body fat) (Remsberg et al, 2005).…”