Ramifications of adolescent menstrual cycles ≥42 days in young adults

Abstract

Objective To determine to what degree annual reports from ages 14 to 19 years of menstrual cycles ≥42 days would be associated with increased body mass index (BMI), waist circumference, glucose, insulin, and homeostasis model assessment insulin resistance (HOMA-IR) at ages 14–25 years. Design Prospective 11-year follow-up from ages 14 to 25 years. Setting Urban-suburban schools, post–high school. Patient(s) A total of 370 schoolgirls. Intervention(s) None. Main Outcome Measure(s) BMI, waist, insulin, glucose, HOMA-IR. Result(s) From ages 14 to 19 years, 269 girls had 0/6 annual reports of menstrual cycles ≥42 days, 74 had 1, 19 had 2, and 8 had ≥3. Among these four categories, girls with ≥3 annual reports had highest free T and DHEAS at age 14, highest BMI and waist at ages 14, 19, and 25, highest insulin at age 25, and highest glucose and HOMA-IR at age 24 years. The number of annual reports of menstrual cycles ≥42 days was positively related to change in BMI and waist and inversely with change in high-density lipoprotein cholesterol from ages 14 to 25 years. Conclusion(s) Three or more annual reports of menstrual cycles ≥42 days during ages 14–19 are associated with high BMI, waist circumference, insulin, glucose, and HOMA-IR at ages 14–25 years. (Fertil Steril® 2011;96: 236–40).

High prevalence of hirsutism and menstrual disorders in obese adolescent girls and adolescent girls with type 1 diabetes mellitus despite different hormonal profiles

“…This finding is at variance with the results of our study because the obese girls with hirsutism, despite their hyperandrogenism that correlated with their waist circumference, did not have a greater degree of obesity, higher plasma insulin levels or lower serum SHBG levels than the obese girls without hirsutism. In accordance with our findings, menstrual disorders in obese women have been associated with a high degree and early onset of obesity, centrally distributed body fat (12,14,43,47) and a high 30 min insulin peak in the OGTT (48). We found no significant differences in the serum androgen levels of the obese adolescent girls with a menstrual disorder than those without a menstrual disorder.…”

Determinants of ApoB, ApoA1, and the ApoB/ApoA1 ratio in healthy schoolgirls, prospectively studied from mean ages 10 to 19 years: the Cincinnati National Growth and Health Study

“…The first novel finding in our study was that menstrual cyclicity ≥42 days, associated with hyperandrogenism [36], ascertained yearly in post-menarchal girls from ages 14 through 19, was independently associated with increasing ApoB/ApoA1 ratios. In our study, 90% of girls were post-menarchal by age 14, the same as reported in the third NHANES study [37] where 90% of US girls were menstruating by 13.75 years.…”

“…There was no association ( p = 0.96) between age at menarche and the number of annual reports of menstrual cycles ≥42 days from ages 14 to 19. In our current and recent [21, 22] studies of the relationships of delayed cyclicity to CVD risk, metabolic syndrome, obesity, and polycystic ovary syndrome (PCOS), annual reports of menstrual cycles ≥42 days from ages 14 to 19 were used to identify girls with unequivocal menstrual delay. The ≥42 day cutpoint for menstrual delay was based on the reports of Van Hooff et al [23,24] and Chiazze et al [18], and, in the current analysis sample, was found in 8% of reports of menstrual cycle length from age 14 to 19.…”

“…In post-menarchal girls, the nurse practitioner recorded the number of days since the previous menstrual cycle and whether the participant was pregnant [13,14,17,20]. As previously described [20–22], in post-menarchal girls, we used previously reported cutpoints for menstrual delay(≥42 days since the last menses cycle [18,23,24]), assessing 6 annual reports from ages 14 to 19 years. We based our cutpoint for delayed menstrual cyclicity on the reports of Van Hooff et al [23,24] and Chiazze et al [18].…”

Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women's Health Initiative

“…A history of bilateral oophorectomy, which would result in a shortened reproductive period, and earlier menopause, have also been associated with less favorable glucose and insulin levels, 14,15 and increased risk of type 2 diabetes in some, 13,16 but not all, 12,17–20 studies. Menstrual cycle characteristics such as length and regularity of menstrual cycle have also been associated with gestational diabetes and glucose intolerance in some, 21–23 but not all, 13,24 studies.…”