SAN FRANCISCO -- Age of menarche may provide several insights on long-term cardiometabolic and reproductive health, a Brazilian cohort study indicated.
Among 7,623 women, early age of menarche (<10 years) as well as late age at menarche (≥16 years) were both associated with a higher risk for several adverse outcomes compared with women who had their menarche at an average age (10-15 years), reported Flávia Rezende Tinano, MD, PhD, of the University of Sao Paulo in Brazil.
"These findings highlight age of menarche as a key indicator of cardiometabolic and reproductive health," said Tinano at ENDO 2025opens in a new tab or window, the annual meeting of the Endocrine Society.
"Most women can remember when they had their first period, but they might not realize that it could signal future health risks," she added in a statement. "Understanding these links can help women and their doctors be more proactive about preventing conditions like diabetes, high blood pressure, and heart disease."
Compared with normal age of menarche, those who had their menarche prior to age 10 had a significantly higher risk for obesity (OR 2.08, 95% CI 1.59-2.73, P<0.001), hypertension (OR 1.36, 95% CI 1.02-1.81, P=0.034), type 2 diabetes (HR 1.92, 95% CI 1.40-2.64, P<0.001), metabolic syndrome (OR 1.57, 95% CI 1.19-2.07, P=0.001), as well as high uric acid levels (OR 1.48, 95% CI 1.03-2.13, P=0.036).
Menarche at age 16 or later was associated with lower odds for obesity compared with normal menarche (OR 0.69, 95% CI 0.55-0.87, P=0.002).
Regarding reproductive outcomes, Tinano's group found women who had an early menarche had significantly higher odds for preeclampsia (OR 1.67, 95% CI 1.12-2.48, P=0.012), while late menarche was linked with higher odds for oligomenorrhea (OR 1.62, 95% CI 1.02-2.58, P=0.041).
Early menarche was also associated with higher risks for several cardiovascular outcomes:
- Cardiovascular risk levels ≥10% by World Health Organization category: OR 2.44, 95% CI 1.39-4.29, P=0.002
- Angina: OR 1.68, 95% CI 1.12-2.52, P=0.013
- Myocardial infarction: OR 2.59, 95% CI 1.09-6.15, P=0.031
- Heart failure: OR 2.61, 95% CI 1.17-5.82, P=0.019
Late menarche was tied with higher odds for coronary revascularization (OR 2.42, 95% CI 1.23-4.75, P=0.010).
"Our findings suggest that knowing a woman's age at her first period can help doctors identify those at higher risk for certain diseases," said Tinano. "This information could guide more personalized screening and prevention efforts. It also emphasizes the importance of early health education for young girls and women, especially in developing countries."
For the ELSA-Brasil study, 15,105 civil servants from six centers in Brazil were screened and a final cohort of 7,623 women between the ages of 35 and 74 were included in the analysis. Mean age of participants at evaluation was 55.7; mean age at menarche was 12.7. Early menarche was reported in 3.1% of participants and late menarche in 5.8%.
Baseline evaluations occurred from 2008 to 2010. Women were followed-up three times, in 2012-2014, 2017-2019, and 2022-2023. Data on metabolic outcomes were measured via clinical history, physical examinations, lab testing, and abdominal ultrasound. Reproductive outcomes were collected by clinical history and physical examinations, and cardiovascular outcomes were self-reported. All multivariable analyses were adjusted for age, race, smoking status, excessive alcohol intake, educational levels, and physical activity.
Tinano said that future research should focus on personalized prevention strategies in women's health, especially for underrepresented groups.
by Kristen Monaco, Senior Staff Writer, MedPage Today
Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.
Disclosures
The study received financial support from São Paulo Research Foundation (FAPESP) grants.
Tinano reported no disclosures.
Primary Source
ENDO 2025
Source Reference: opens in a new tab or windowTinano FR, et al "Early and late age at menarche and their distinct cardiometabolic and reproductive outcomes: the Brazilian longitudinal study of adult health" ENDO 2025; OR15-08.