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How age of getting a period influences woman's body later in life?

Summary of an artice comparing the age of getting first menstuation (menarche) and body composition, bone mineral density and physical activity later in life (midlife).

Who

1098 women aged 47-55 (track and field, volleyball, cross-country skiing, running, Finish baseball, gymnastics) (Finland).

Design

Retrospective cross-sectional study.

Outcome measures/tests

  • physical activity level at the ages between 13 and 16 (no exercise, regular independent physical activity, regular supervised physical activity, regular competitive sport)
  • age of first menstruation (period)
  • body composition at middle age
  • physical performance: hand grip force, maximal isometric knee extension force, countermovement jump hight and flight time, 10 m walk time, 6 minutes walking test (number of 20m laps)
  • physical activity measured by accelerometer (7 days, all waking hours)
  • self-reported physical activity

Main results

  • Those who reported competitive participation in sport at the age 13-16 years had higher proportion of competitors later in life.
  • The proportion of women in cometitive sport was the highest in 13-16 age group and deacreased steadily after.
  • Those who participated in competitive sport at the ages of 13-16, got their periods later than the ones who did no exercise. They also had more lean mass, higher lean mass index, lean mass index of the limbs (appendicular), and bone mass density (femoral neck) than those with regular physical activity or no exercise. They also performed better at all performance tests.
  • In competitive group, self-reported physical activity at midlife was higher, but accelerometer measured no difference.
  • Women got their period between 9 and 19 years of age, with mean age of 12.95 years (95%CI: 12.9-13.0).
  • The later a women got her period, the lower her weight, BMI, total fat mass, fat percetage and fat mass was likely to be.
  • 9.3% of women used oral constraception at some point of their life.
  • 16.2% of women had at least one fracture at some point of their life. 0.5% were diagnosed with anorexia nervosa (diagnosed at age 13-39 years).

Take home message

For a clinician
Girls who participated in competitive sports at the age of 13-16, had more lean mass, higher bone density and better physical performance in middle age. Women who have got their period later, had lower BMI and less fat mass. Bone mineral density was lower in women who got their periods at or after the age of 14 than those who got their period before or at the age of 12.
For a parent
Women who have got their period later, had lower BMI and less fat mass. Bone mineral density was lower in women who got their periods at or after the age of 14 than those who got their period before or at the age of 12.
For an athlete
Women who have got their period later, had lower BMI and less fat mass. Bone mineral density was lower in women who got their periods at or after the age of 14 than those who got their period before or at the age of 12.

Original article

Ravi S, Kujala UM, Tammelin TH, Hirvensalo M, Kovanen V, Valtonen M, Waller B, Aukee P, Sipilä S, Laakkonen EK. Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity. Journal of Clinical Medicine. 2020 Dec;9(12):3797.

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