Recall of Early Menstrual History and Menarcheal Body Size: After 30 Years, How Well Do Women Remember?
Abstract
The validity of recall of early menstrual characteristics is of interest because of their putative role in the etiology of breast cancer and other diseases. A retrospective follow-up of the Newton Girls Study (1965-1975) provided an opportunity to assess the accuracy and precision of recall of several early menstrual characteristics. In 1998-1999, 57 percent of the original 793 Newton Girls Study participants completed a mailed questionnaire to assess the accuracy of recall for age and body size at menarche, usual cycle length during the first 2 years, and age at regularity. Recalled and original age at menarche were highly correlated (r = 0.79, p < 0.001). The body mass index percentile at menarche was well correlated with recalled body size at menarche (r = 0.61, p < 0.001), but with some evidence of systematic bias. Overall, a woman's recall of menarcheal age and body size was better than recall of cycle length and occurrence of regularity. The failure to identify certain menstrual characteristics as exposures for subsequent disease may reflect limitations in the accuracy and precision of the recalled measures.
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Recalled age at menarche is valid.
“recalled age at menarche is valid40”
From Thirty new loci for age at menarche identified by a meta-analysis of genome-wide association studies (2010) · cites this paper as [40]
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“Other studies have yielded similar findings [26-29], indicating that these figure drawings can provide a reasonably accurate assessment of body fatness at young ages.”
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Jacobsen, B. K., Oda, K., Knutsen, S. F., & Fraser, G. E. (2009) · International Journal of Epidemiology · doi:10.1093/ije/dyn251 · Cited by 148 · see citing works
A longitudinal study of infant feeding and obesity throughout life course
Michels, K. B., Willett, W. C., Graubard, B. I., Vaidya, R. I., Cantwell, M. M., Sansbury, L. B., & Forman, M. R. (2007) · International Journal of Obesity · doi:10.1038/sj.ijo.0803622 · Cited by 144 · see citing works
The Impact of Endometriosis on Quality of Life in Adolescents
Gallagher, J. S., DiVasta, A. D., Vitonis, A. F., Sarda, V., Laufer, M. R., & Missmer, S. A. (2018) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2018.06.027 · Cited by 143 · see citing works
Farr, S. L., Cooper, G. S., Cai, J., Savitz, D. A., & Sandler, D. P. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwi006 · Cited by 142 · see citing works
Lee, Y., & Styne, D. M. (2013) · Hormones and Behavior · doi:10.1016/j.yhbeh.2013.03.014 · Cited by 141 · see citing works
“…occurs on an average 3 years after the onset of puberty and is a late marker for the onset of puberty, it is oftenused as a surrogate for the onset of puberty because it is a sentinel event that is often well remembered within 12 months of accuracy, even up to 30 years later (Must et al., 2002).”
BackgroundReproductive and hormonal factors and risk of brain tumors in adult females
Hatch, E. E., Linet, M. S., Zhang, J., Fine, H. A., Shapiro, W. R., Selker, R. G., Black, P. M., & Inskip, P. D. (2004) · International Journal of Cancer · doi:10.1002/ijc.20776 · Cited by 139 · see citing works
A large-scale candidate gene association study of age at menarche and age at natural menopause
He, C., Kraft, P., Chasman, D. I., Buring, J. E., Chen, C., Hankinson, S. E., Paré, G., Chanock, S. J., Ridker, P. M., & Hunter, D. J. (2010) · Human Genetics · doi:10.1007/s00439-010-0878-4 · Cited by 136 · see citing works
“Must et al. (2002) observed a correlation of 0.79 between contemporarily documented and recalled age at menarche after 30 years.”
InfluentialEarly Age at Menarche, Lung Function, and Adult Asthma
Macsali, F., Real, F. G., Plana, E., Sunyer, J., Antó, J. M., Dratva, J., Janson, C., Jarvis, D., Omenaas, E. R., Zemp, E., et al. (2010) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200912-1886oc · Cited by 130 · see citing works
Birth Weight, Postnatal Growth, and Age at Menarche
Terry, M. B., Ferris, J. S., Tehranifar, P., Wei, Y., & Flom, J. D. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp095 · Cited by 125 · see citing works
Genetic determinants of pubertal timing in the general population
Gajdos, Z. K. Z., Henderson, K. D., Hirschhorn, J. N., & Palmert, M. R. (2010) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2010.01.038 · Cited by 121 · see citing works
“Categorizing AAM and/or using the extremes can both improve the accuracy of recall [93,94].”
MethodResultInfluentialStöckl, D., Meisinger, C., Peters, A., Thorand, B., Huth, C., Heier, M., Rathmann, W., Kowall, B., Stöckl, H., & Döring, A. (2011) · PLoS ONE · doi:10.1371/journal.pone.0026076 · Cited by 117 · see citing works
“However, studies have shown that the actual reported mean age at menarche did not differ from the mean age at menarche recalled 33 years later [33,34].”
BackgroundUpdate on Age at Menarche in Italy: Toward the Leveling Off of the Secular Trend
Rigon, F., Bianchin, L., Bernasconi, S., Bona, G., Bozzola, M., Buzi, F., Cicognani, A., Sanctis, C. D., Sanctis, V. D., Radetti, G., et al. (2009) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2009.07.009 · Cited by 117 · see citing works
“Second, even though memory bias is possible, several studies have shown that the results from such questionnaires are reliable when the data collection is close to the menarcheal event [32–35].”
BackgroundJames-Todd, T. M., Tehranifar, P., Rich-Edwards, J. W., Titievsky, L., & Terry, M. B. (2010) · Annals of Epidemiology · doi:10.1016/j.annepidem.2010.08.006 · Cited by 116 · see citing works
Jacobsen, B. K., Heuch, I., & Kvåle, G. (2007) · American Journal of Epidemiology · doi:10.1093/aje/kwm237 · Cited by 114 · see citing works
“No study of the validity and reproducibility of the data about age at menarche was conducted within this cohort, but other studies have found that most women are able to recall the age at menarche with relatively high validity (26, 27) and reproducibility (25, 28, 29).”
BackgroundMustanski, B. S., Viken, R. J., Kaprio, J. A., Pulkkinen, L., & Rose, R. J. (2004) · Developmental Psychology · doi:10.1037/0012-1649.40.6.1188 · Cited by 109 · see citing works
Age of puberty and the risk of multiple sclerosis: a population based study
Ramagopalan, S. V., Valdar, W. S. J., Criscuoli, M. G., DeLuca, G. C., Dyment, D. A., Orton, S. M., Yee, I. M. L., Ebers, G. C., Sadovnick, A. D., & for the Canadian Collaborative Study Group (2008) · European Journal of Neurology · doi:10.1111/j.1468-1331.2008.02431.x · Cited by 107 · see citing works
“79) between age at menarche by recall during middle-age and the original childhood data [22,23], supporting the notion that the association we have observed is real and not just a reflection of bias.”
BackgroundSystematic review and meta-analysis of age at menarche and risk of type 2 diabetes
Janghorbani, M., Mansourian, M., & Hosseini, E. (2014) · Acta Diabetologica · doi:10.1007/s00592-014-0579-x · Cited by 105 · see citing works
“Age at menarche represents a distinct event in puberty, is usually well recalled into adulthood, and therefore is a convenient noninvasive measure of pubertal timing [5, 6].”
BackgroundDoes This Woman Have Osteoporosis?
Green, A. D. (2004) · JAMA · doi:10.1001/jama.292.23.2890 · Cited by 107 · see citing works
Must, A., Naumova, E. N., Phillips, S. M., Blum, M., Dawson‐Hughes, B., & Rand, W. M. (2005) · PEDIATRICS · doi:10.1542/peds.2004-1604 · Cited by 107 · see citing works
Self-citationMaternal Body Mass Index and Daughters’ Age at Menarche
Keim, S. A., Branum, A. M., Klebanoff, M. A., & Zemel, B. S. (2009) · Epidemiology · doi:10.1097/ede.0b013e3181b093ce · Cited by 105 · see citing works
“Age at menarche was based on recall in adulthood, which may be less accurate than recall closer to the event.(36,37) Maternal report of prepregnant weight may be prone to underestimation, but this would not account for the association because this bias would tend to draw the effect estimates toward the null.”
BackgroundD'hooghe, M. B., Haentjens, P., Nagels, G., D’Hooghe, T., & Keyser, J. D. (2011) · Journal of Neurology · doi:10.1007/s00415-011-6267-7 · Cited by 105 · see citing works
“Furthermore, recalled and original age at menarche were highly correlated in a cohort of women nearing menopause [29].”
BackgroundBody Mass Index, Change in Body Silhouette, and Risk of Asthma in the E3N Cohort Study
Romieu, I. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg131 · Cited by 104 · see citing works
Pubertal timing and breast cancer risk in the Sister Study cohort
Goldberg, M., D’Aloisio, A. A., O’Brien, K. M., Zhao, S., & Sandler, D. P. (2020) · Breast Cancer Research · doi:10.1186/s13058-020-01326-2 · Cited by 103 · see citing works
Pubertal Timing Predicts Previous Fractures and BMD in Young Adult Men: The GOOD Study
Kindblom, J. M., Lorentzon, M., Norjavaara, E., Hellqvist, Å., Nilsson, S., Mellström, D., & Ohlsson, C. (2006) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.020602 · Cited by 101 · see citing works
“method is less certain if there is a long time interval between menarche and recall.((8,9)) In men, no reliable method”
MethodAge at menarche and its relationship to body mass index among adolescent girls in Kuwait
Al-Awadhi, N., Al-Kandari, N. A., Alhasan, T. A., Almurjan, D. K., Ali, S., & Al‐Taiar, A. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-29 · Cited by 101 · see citing works
Prenatal and Infant Exposures and Age at Menarche
D’Aloisio, A. A., DeRoo, L. A., Baird, D. D., Weinberg, C. R., & Sandler, D. P. (2013) · Epidemiology · doi:10.1097/ede.0b013e31828062b7 · Cited by 100 · see citing works
Association of puberty timing with type 2 diabetes: A systematic review and meta-analysis
Cheng, T. S., Day, F. R., Lakshman, R., & Ong, K. K. (2020) · PLoS Medicine · doi:10.1371/journal.pmed.1003017 · Cited by 101 · see citing works
“AAM was self-reported and was mainly recalled during adulthood, which may affect its accuracy; however, moderate correlations between prospective and recalled AAM several decades later have been reported [60,61].”
BackgroundVitonis, A. F., Baer, H. J., Hankinson, S. E., Laufer, M. R., & Missmer, S. A. (2010) · Human Reproduction · doi:10.1093/humrep/deq039 · Cited by 98 · see citing works
“Although two well-designed validation studies (Must et al., 1993, 2002) demonstrated that longterm recall of body size using this figure drawing has good correlations with BMI at the same ages, no participants in either of those studies recalled their figures as greater than level 7 at young ages;…”
Body mass index in early and mid-adulthood, and subsequent mortality: a historical cohort study
Jeffreys, M., McCarron, P. A., Gunnell, D., McEwen, J., & Smith, G. D. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802414 · Cited by 98 · see citing works
Gottschalk, M. S., Eskild, A., Hofvind, S. S. H., Gran, J. M., & Bjelland, E. K. (2019) · Human Reproduction · doi:10.1093/humrep/dez288 · Cited by 97 · see citing works
“Previous studies have found moderate to high agreement of age at menarche as reported in adulthood with the true age at menarche (Cooper et al ., 2006; Must et al ., 2002).”
Menarche and Time to Cycle Regularity Among Individuals Born Between 1950 and 2005 in the US
Wang, Z., Asokan, G., Onnela, J.-P. “., Baird, D. D., Jukic, A. M. Z., Wilcox, A. J., Curry, C. L., Fischer‐Colbrie, T., Williams, M. A., Hauser, R. B., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.12854 · Cited by 97 · see citing works
Epperson, C. N., Sammel, M. D., Bale, T. L., Kim, D. R., Conlin, S. E., Scalice, S., Freeman, K., & Freeman, E. W. (2017) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.16m10662 · Cited by 96 · see citing works
17- -Estradiol in relation to age at menarche and adult obesity in premenopausal women
Emaus, A., Finstad, S. E., Veierød, M. B., Ballard-Barbash, R. R., Furberg, A.-S., Ellison, P. T., Grazyna Jasienska, A., Hjartåker, A., & Thune, I. (2008) · Human Reproduction · doi:10.1093/humrep/dem432 · Cited by 95 · see citing works
“Age at menarche was collected retrospectively and misclassification is possible, although several studies have found age at menarche to be recalled with high reliability (Must et al., 2002).”
BackgroundCousminer, D. L., Stergiakouli, E., Berry, D. J., Ang, W., Groen‐Blokhuis, M. M., Körner, A., Siitonen, N., Ντάλλα, Ι., Marinelli, M., Perry, J. R. B., et al. (2014) · Human Molecular Genetics · doi:10.1093/hmg/ddu150 · Cited by 92 · see citing works
Heys, M., Jiang, C., Cheng, K. K., Zhang, W., Yeung, S. L. A., Lam, T. H., Leung, G. M., & Schooling, C. M. (2010) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2010.11.009 · Cited by 89 · see citing works
Age at Menarche: 50-Year Socioeconomic Trends Among US-Born Black and White Women
Krieger, N., Kiang, M. V., Кошелева, А., Waterman, P. D., Chen, J. T., & Beckfield, J. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.301936 · Cited by 90 · see citing works
Stöckl, D., Döring, A., Peters, A., Thorand, B., Heier, M., Huth, C., Stöckl, H., Rathmann, W., Kowall, B., & Meisinger, C. (2011) · Diabetologia · doi:10.1007/s00125-011-2410-3 · Cited by 91 · see citing works
“that different from the mean age at menarche recalled 33 years later [36, 37].”
BackgroundGestational Weight Gain and Daughter's Age at Menarche
Boynton‐Jarrett, R., Rich-Edwards, J. W., Fredman, L., Hibert, E. N. L., Michels, K. B., Forman, M. R., & Wright, R. J. (2011) · Journal of Women s Health · doi:10.1089/jwh.2010.2517 · Cited by 88 · see citing works
Puberty, obesity and ethnicity
Styne, D. M. (2004) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2004.10.008 · Cited by 89 · see citing works
Family composition and menarcheal age: Anti‐inbreeding strategies
Matchock, R. L., & Susman, E. J. (2006) · American Journal of Human Biology · doi:10.1002/ajhb.20508 · Cited by 88 · see citing works
Childhood Abuse and Early Menarche: Findings From the Black Women's Health Study
Wise, L. A., Palmer, J. R., Rothman, E. F., & Rosenberg, L. A. (2009) · American Journal of Public Health · doi:10.2105/ajph.2008.149005 · Cited by 87 · see citing works
Mueller, N. T., Duncan, B. B., Barreto, S. M., Chor, D., Bessel, M., Aquino, E. M. L., Pereira, M. A., & Schmidt, M. (2014) · Cardiovascular Diabetology · doi:10.1186/1475-2840-13-22 · Cited by 86 · see citing works
“79) correlation with original adolescent reports [28].”
Bjelland, E. K., Hofvind, S. S. H., Byberg, L., & Eskild, A. (2018) · Human Reproduction · doi:10.1093/humrep/dey078 · Cited by 84 · see citing works
“are moderately to highly correlated (Must et al., 2002; Cooper et al., 2006).”
MethodAge at menarche and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers
Kotsopoulos, J., Lubiński, J., Lynch, H. T., Neuhausen, S. L., Ghadirian, P., Isaacs, C. J., Weber, B., Kim‐Sing, C., Foulkes, W. D., Gershoni‐Baruch, R., et al. (2005) · Cancer Causes & Control · doi:10.1007/s10552-005-1724-1 · Cited by 84 · see citing works
“001) [36].”
Cairns, B. J., Liu, B. C., Clennell, S., Cooper, R., REEVES, G. K., Beral, V., & Kuh, D. J. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-7 · Cited by 83 · see citing works
“again, greater under-reporting of weight by heavier individuals) [3,4,10].”
BackgroundInfluentialPolotsky, A. J., Hailpern, S. M., Skurnick, J., Lo, J. C.-M., Sternfeld, B., & Santoro, N. F. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.12.059 · Cited by 83 · see citing works
“001) between the BMI percentile at menarche and recalled body size at menarche (19).”
Hosokawa, M., Imazeki, S., Mizunuma, H., Kubota, T., & Hayashi, K. (2012) · BMC Women s Health · doi:10.1186/1472-6874-12-19 · Cited by 81 · see citing works
The reproducibility of self-reported age at menarche: The Tromsø Study
Lundblad, M. W., & Jacobsen, B. K. (2017) · BMC Women s Health · doi:10.1186/s12905-017-0420-0 · Cited by 80 · see citing works
Polychlorinated Biphenyls and Menstrual Cycle Characteristics
Cooper, G. S., Klebanoff, M. A., Promislow, J. H. E., Brock, J. W., & Longnecker, M. P. (2005) · Epidemiology · doi:10.1097/01.ede.0000152913.12393.86 · Cited by 80 · see citing works
Abnormal timing of menarche in survivors of central nervous system tumors
Armstrong, G. T., Whitton, J. A., Gajjar, A. J., Kun, L. E., Chow, E. J., Stovall, M., Leisenring, W. M., Robison, L. L., & Sklar, C. A. (2009) · Cancer · doi:10.1002/cncr.24294 · Cited by 78 · see citing works
“The self-report nature of data collection may be a limitation of this study, although previous work suggests women’s recall of age at menarche is generally quite accurate.(33) In addition, recall of menarche is better than that of other pubertal milestones.”
ResultAntipsychotic Response Worsens With Postmenopausal Duration in Women With Schizophrenia
González-Rodríguez, A., Catalán, R., Penadés, R., Ruíz, V., Torra, M., Seeman, M. V., & Bernardo, M. (2016) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000571 · Cited by 77 · see citing works
Takmaz, T., Gündoğmuş, İ., Ökten, S. B., & Gündüz, A. (2021) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.14900 · Cited by 77 · see citing works
“However, earlier studies have reported that women recall their menstrual history.(51,52) Also, the majority of our study population was using a period tracking application, which may increase the accuracy and reliability of the data.”
BackgroundReproductive and hormonal factors and risk of cognitive impairment among Singapore Chinese women
Song, X., Wu, J., Zhou, Y., Feng, L., Yuan, J., Pan, A., & Koh, W. (2020) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2020.02.032 · Cited by 73 · see citing works
James-Todd, T. M., Terry, M. B., Rich-Edwards, J. W., Deierlein, A. L., & Senie, R. T. (2011) · Annals of Epidemiology · doi:10.1016/j.annepidem.2011.01.009 · Cited by 75 · see citing works
Rubeis, V. D., Bayat, S., Griffith, L. E., Smith, B. T., & Anderson, L. N. (2019) · Obesity Reviews · doi:10.1111/obr.12881 · Cited by 74 · see citing works
“Previous studies have used body size pictograms to aid participants in recalling past body size.(15,16) The use of body size pictograms require participants to choose a body image (ranging from lean to overweight) that most closely corresponded to their own body size(16); the validity of these tools for early life rec…”
MethodSocio-demographic predictors of age at menarche in a group of Colombian university women
Chavarro, J. E., Villamor, E., Narváez, J., & Hoyos, A. C. G. (2004) · Annals of Human Biology · doi:10.1080/03014460310001652239 · Cited by 74 · see citing works
“However, several studies have found the recall method to be reliable, accurate and valid, and have recommended it for epidemiological research (Bosetti et al. 2001, Must et al. 2002).”
BackgroundInfluentialERICA: age at menarche and its association with nutritional status.
Barros, B. D. S., Kuschnir, M. C., Bloch, K., & da Silva, T. L. N. (2018) · Jornal de Pediatria · doi:10.1016/j.jped.2017.12.004 · Cited by 64 · see citing works
Clancy, K. B. H., Klein, L. D., Ziomkiewicz, A., Nenko, I., Grazyna Jasienska, A., & Bribiescas, R. G. (2013) · American Journal of Human Biology · doi:10.1002/ajhb.22386 · Cited by 72 · see citing works
Puberty: Its role in development.
Susman, E. J., & Dorn, L. D. (2013) · Cited by 72 · see citing works
Jorm, A. F., Christensen, H. M., Rodgers, B., Jacomb, P. A., & Easteal, S. (2003) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.20114 · Cited by 72 · see citing works
- Authors
- Must, A.
- Affiliations
- Tufts University (US)
- Corresponding author
- Must, A.
- ORCID
- Must, A.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-04-01
- Volume
- 155
- Issue
- 7
- Pages
- 672-679
- ISSN
- 0002-9262 (ISSN-L)
- OpenAlex
- W2034939744
- Cited by
- 506
- References
- 46
- Citations by year
- 2026: 15 · 2025: 12 · 2024: 22 · 2023: 26 · 2022: 21 · 2021: 16 · 2020: 27 · 2019: 22 · 2018: 29 · 2017: 27 · 2016: 22 · 2015: 23 · 2014: 22 · 2013: 29 · 2012: 19
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200, DK46200.)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- menarche, recall accuracy, age at menarche, menstrual cycle length, breast cancer etiology
- MeSH terms
- Adult, Age Factors, Body Height, Body Image, Body Weight, Female, Humans, Menarche, Menstruation, Mental Recall, Retrospective Studies, Bias, Body Mass Index, Linear Models, Statistics, Nonparametric
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