Original article
Childhood Abuse and Age at Menarche

https://doi.org/10.1016/j.jadohealth.2012.06.006Get rights and content

Abstract

Purpose

Physical and sexual abuse are prevalent social hazards. We sought to examine the association between childhood physical and sexual abuse and age at menarche.

Methods

Among 68,505 participants enrolled in the Nurses' Health Study II, we investigated the association between childhood physical abuse and sexual abuse and menarche before age 11 years (early) or after age 15 years (late) using multivariate logistic regression analysis, mutually adjusting for both types of abuse.

Results

Fifty-seven percent of respondents reported some form of physical or sexual abuse in childhood. We found a positive dose–response association between severity of sexual abuse in childhood and risk for early menarche. Compared with women who reported no childhood sexual abuse, the adjusted odds ratio (AOR) for early menarche in women who reported childhood sexual abuse was 1.20 (95% confidence interval [CI]: 1.10, 1.37) for sexual touching and 1.49 (95% CI: 1.34, 1.66) for forced sexual activity. Severe physical abuse predicted early menarche (AOR = 1.22, 95% CI: 1.10, 1.37). Childhood physical abuse had a dose–response association with late age at menarche: AOR 1.17 (95% CI: 1.04, 1.32) for mild, 1.20 (95% CI: 1.08, 1.33) for moderate, and 1.50 (95% CI: 1.27, 1.77) for severe physical abuse. Sexual abuse was not associated with late menarche.

Conclusions

Childhood abuse was prevalent in this large cohort of U.S. women. Severity of childhood sexual abuse was associated with risk for early onset of menarche, and physical abuse was associated with both early and late onset of menarche.

Section snippets

Study population

The NHS II is an ongoing prospective cohort study designed to explore factors that influence morbidity and mortality among women. The NHS II began in 1989 with a representative sample of 116,678 registered female nurses, aged 25–44 years at baseline, and residents of 14 states in the United States. A biennial follow-up is sent to participants who respond to questionnaires regarding health behaviors and disease occurrence. A supplemental questionnaire on lifetime exposure to violence and

Results

Overall, 57% of women in the cohort reported a history of physical or sexual abuse in childhood. Specifically, 8% reported sexual abuse only, 36% physical abuse only, and 13% both physical and sexual abuse in childhood. Paternal educational status was inversely associated with abuse. The frequency of abuse also varied by race/ethnicity (Table 1). As has been previously reported, age 5 somatogram had a weak association with childhood sexual abuse, and no association with childhood physical abuse

Discussion

In a longitudinal cohort of female nurses, we found a strong association between reported sexual abuse and early menarche, which was consistent with previous studies [8], [17], [18], [19], [20], [21], [22]. Although there is a clear association between sexual abuse and early age at menarche, we cannot assess causality. As our measure of sexual abuse (up to age 11 years) was coincident with the time frame for early menarche (before age 11 years), we cannot distinguish whether the sexual abuse

Conclusions

In summary, both childhood sexual and physical abuse were associated with increased risk for early menarche, whereas physical abuse in childhood was associated with late menarche. The nature of the association between different forms of childhood adversities and reproductive life span may vary. Type of abuse may be associated with different biological or behavioral pathways to timing of menarche. If replicated, these findings support the hypothesis that the impact of child abuse on health is

Acknowledgments

The authors acknowledge the nurse participants in the study and their mothers who participated. The William T. Grant Foundation, the Charles Hood Foundation, and the Building Interdisciplinary Research Careers in Women's Health K12 HD043444 NIH Office of Women's Health Research funded data analysis and manuscript preparation. The Nurses' Health Study II is supported by Public Health Service grant CA50385 from the National Cancer Institute, National Institutes of Health, U.S. Department of

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