What is early menarche, symptoms and main causes

Menarche corresponds to the girl's first menstruation, which usually occurs in adolescence, between 9 and 15 years of age, but which can vary according to lifestyle, hormonal factors, presence of obesity and history of menstruation of women of the same family. It is classified as:

• Early menarche: when it appears before the age of 8,
• Late menarche: when it appears after the age of 14.

More than half of Brazilian girls have their first period until they are 13 years old, and at 14 years of age more than 90% of girls already menstruate. However, when the girl menstruates before the age of 8, parents should take the girl to the pediatrician to investigate what is happening, as there may be diseases involved.

Signs and symptoms of early menarche

The first signs and symptoms of early menarche are the appearance, before the age of 8, of:

• Vaginal bleeding;
• Slight body swelling;
• Pubic hair;
• Breast augmentation;
• Increased hips;
• Pain in the abdominal region and
• Psychological signs, such as sadness, irritation or increased sensitivity.

The girl may also notice the discharge of whitish or yellowish secretion from the vagina a few months before menarche.

Causes of early menarche

The first menstruation has come earlier and earlier. Before the 70s, the first menstruation was between 16-17 years old, but lately girls have menstruated much earlier, from 9 years of age in several countries, and the causes are not always clear. Some possible causes of the first menstruation very early are:

• No definite cause (80% of cases);
• Mild to moderate childhood obesity;
• There is a suspicion of exposure to plastic containing bisphenol A since birth;
• Central nervous system injuries, such as meningitis, encephalitis, cerebral cyst or paralysis, for example;
• After radiation in the central nervous system;
• McCune-Albright syndrome;
• Ovarian lesions such as follicular cysts or neoplasia;
• Estrogen-producing adrenal tumors;
• Severe primary hypothyroidism.

In addition, when the girl is exposed to estrogen hormones at an early age, the chances of early menarche can be increased. Some situations in which the girl may be exposed to estrogens include taking the birth control pill by the mother during pregnancy and / or breastfeeding, and using the ointment to separate the small lips, in case of female phimosis, for example.

Necessary exams

When the girl has her first menstruation before the age of 8, the pediatrician may be suspicious of any change in her health, and for this reason she normally assesses the girl's body by observing the growth of the breasts, hair in the armpits and groin. In addition, the doctor may order tests such as LH, estrogen, TSH and T4, bone age, pelvic and adrenal ultrasound.

When your first period comes before you are 6 years old, you can also order tests such as magnetic resonance imaging of the central nervous system to check for serious changes that may be causing menstruation so soon.

Treatment for early menarche

The main consequences of early menarche are psychological and behavioral disorders; increased risk of sexual abuse; short stature as an adult; increased risk of obesity, hypertension, type 2 diabetes, cardiovascular disease, stroke and certain types of cancer, such as breast cancer, due to early exposure to the hormone estrogen.

Thus, the pediatrician may suggest that the parents carry out the treatment, delaying the girl's menarche until the age of 12, using monthly or quarterly injections of a hormone that makes puberty regress. When the first menstruation comes too early and is caused by some disease, it must be treated, and the menstruation disappears, returning when the treatment is stopped.

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Bibliography

• BORDALLO, Ana Paula. Puberty Disorders. 2014. Available at:.