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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 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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BackgroundGenome-Wide Copy Number Variation Association Analyses for Age at Menarche
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“Although the accuracy of self ‐ report on the timing of menarche was reported as acceptable, 39 recall bias may occur depending on educational level and factors associated with reproductive health.”
BackgroundAdolescent Growth Spurt and Type 2 Diabetes Risk in Southwestern American Indians
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Early Puberty: Adulthood Metabolic Consequences and Childhood Nutritional Determinants
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“…validity of self-reported age at menarche (Cooper et al ., 2006; Dorn et al ., 2013; Koprowski, Coats, & Bernstein, 2001; Lundblad & Jacobsen, 2017; Must et al ., 2002) in women decades older than women in our sample, as well as strong validity of self-reported gestational age (Chin, et al .,…”
Teen Unions and Intimate Partner Violence in South America
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“…some studies report moderate recall accuracy (e.g., Cooper et al., 2006), many have found that recall of these key reproductive milestones (e.g., menarche, childbirth) is generally reliable and valid over long periods, even in older age (Amster et al., 2020; Bean et al., 1979; Must et al., 2002).”
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“However, previous studies indicated that recalled age at menarche reported during adulthood usually represents the real data [35,36].”
ResultEarly menarche is a risk factor of short stature in young Korean female: Epidemiologic study
Kang, S., Kim, Y. M., Lee, J. A., Kim, D. H., & Lim, J. S. (2019) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.0274 · Cited by 1
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“However, there were high correlations between the recalled and actual menarche age [37, 38], reporting error likely would be irrelevant with T2DM status.”
BackgroundGenetic determinants of breast cancer risk
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“While some studies have suggested that it is quite accurately reported even when reported many years later in adulthood, 38 others suggest poorer recall that declines with time.”
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PubertyThis chapter is based in part on the chapter by Susman and Dorn .
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Welten, S. J. G. C. (2024) · doi:10.5463/thesis.413
Exploring the Effects of Age at Menarche and Pregnancy on Myopia
Ong, N. J., Mackey, D. A., Hunter, M. L., & Lee, S. S. (2024) · Ophthalmic Epidemiology · doi:10.1080/09286586.2024.2379973
“79 Unfortunately, the data collected from the Busselton study were retrospective, which might result in recall bias and may account for the higher age at menarche in the Busselton study compared to the Raine Study.”
Ramadan during pregnancy and offspring age at menarche in Indonesia: a quasi-experimental studyPreprint
Tran, V. M., van Ewijk, R. J. G., & Pradella, F. (2024) · Research Square · doi:10.21203/rs.3.rs-5324852/v1
Relação entre a idade da menarca e o ganho de peso gestacional: um estudo transversal no Brasil
Cassiano, D. R., Bubach, S., dos Santos, A. S., & Poton, W. L. (2024) · Revista Brasileira de Saúde Materno Infantil · doi:10.1590/1806-9304202400000099
Relation between age of menarche and gestational weight gain: a cross-sectional study in Brazil
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Tran, V. M., van Ewijk, R. J. G., & Pradella, F. (2025) · Nutrients · doi:10.3390/nu17091406
“The second subsamples were limited to only younger women, who were thus more likely to correctly recall their AAM at the time of the interview [61], i.e., max 30 (IFLS) and 20 (DHS) years old.”
Genome-wide analysis highlights causal epigenetic link to age at menarchePreprint
Ye, Z., Xu, R., Malone, G. L., Dugué, P., Nguyen, T. L., Giles, G. G., Southey, M. C., Milne, R. L., & Li, S. (2025) · medRxiv · doi:10.1101/2025.08.10.25333251
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“Both menarche and ejacularche—referring to the first conscious ejaculation, as opposed to spermaturia, which was not evaluated in this study—are milestones that are typically well remembered, even retrospectively [38, 39].”
Additional file 5 of 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) · Figshare · doi:10.6084/m9.figshare.13152319
Additional file 6 of 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) · Figshare · doi:10.6084/m9.figshare.13152322
Additional file 2 of 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) · Figshare · doi:10.6084/m9.figshare.13152310
Additional file 4 of 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) · Figshare · doi:10.6084/m9.figshare.13152316
Yaghjyan, L., Austin-Datta, R. J., Oh, H., Heng, Y. J., Vellal, A. D., Sirinukunwattana, K., Baker, G. M., Collins, L. C., Murthy, D. J., ROSNER, B. A., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14913461
Additional file 3 of 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) · Figshare · doi:10.6084/m9.figshare.13152313
Additional file 1 of 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) · Figshare · doi:10.6084/m9.figshare.13152307
Jeong, S.-M., Yoo, J. E., Jeon, K. H., Han, K., Lee, H., Lee, D.-Y., & Shin, D. W. (2023) · Figshare · doi:10.6084/m9.figshare.22603588
Jeong, S.-M., Yoo, J. E., Jeon, K. H., Han, K., Lee, H., Lee, D.-Y., & Shin, D. W. (2023) · Figshare · doi:10.6084/m9.figshare.22603597
Jeong, S.-M., Yoo, J. E., Jeon, K. H., Han, K., Lee, H., Lee, D.-Y., & Shin, D. W. (2023) · Figshare · doi:10.6084/m9.figshare.22603600
Jeong, S.-M., Yoo, J. E., Jeon, K. H., Han, K., Lee, H., Lee, D.-Y., & Shin, D. W. (2023) · Figshare · doi:10.6084/m9.figshare.22603594
Pubertal timing and incident uterine cancer in the Sister Study cohort
Harrell, A. N., O’Brien, K. M., Shaw, N. D., Sandler, D. P., & Goldberg, M. (2025) · International Journal of Cancer · doi:10.1002/ijc.70310
“However, the onset of regular menstrual cycles is difficult to accurately recall, 41 and cycle length may be a relatively poor marker of ovulation among adolescents.”
Zhang, B., Mi, B., Li, C., Xu, K., Cai, J., Kang, Y., Wang, D., Pei, L., Shi, G., Liu, Y., et al. (2026) · Reproductive Health · doi:10.1186/s12978-025-02259-9 · Cited by 1
“Nevertheless, the use of self-reported reproductive characteristics was common in epidemiological studies, as they were salient life milestones for women, and prior evidence suggested that age at menarche was generally recalled with reasonable accuracy [41].”
Tran, T.-V.-T., O’Brien, K. M., Troisi, R. J., Sandler, D. P., & Kitahara, C. M. (2026) · Cancer Causes & Control · doi:10.1007/s10552-025-02085-1
Genome-wide analysis highlights epigenetic link to age at menarche
Ye, Z., Xu, R., Malone, G. L., Dugué, P., Nguyen, T. L., Giles, G. G., Southey, M. C., Milne, R. L., & Li, S. (2026) · Human Reproduction · doi:10.1093/humrep/deag019
Jin, Y., Zhang, L., Ma, Q., Zhang, X., Liu, A., Li, X., Chen, S., Zhang, S., Zhang, S., Lin, J., et al. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1777526
“Nevertheless, previous studies have consistently demonstrated a strong correlation between self-reported AAM in adulthood and actual AAM (65).”
Ralte, L., Sailo, L., Hnamte, L., Lalrinpuia, B., Biakhlupuii, C., & Ralte, V. (2026) · Cureus · doi:10.7759/cureus.106523
Apolipoprotein E Polymorphism and Reproductive Patterns Among Postreproductive Women
Bartecka, P., Galbarczyk, A., Klimek, M., Nenko, I., & Grazyna Jasienska, A. (2026) · American Journal of Human Biology · doi:10.1002/ajhb.70260
“A study on middle-aged women demonstrated a strong positive correlation ( r = 0.79, p < 0.001) between the recalled age at menarche and the age recorded in original childhood medical records (Must et al. 2002).”
InfluentialTang, X., Yang, H., Tang, S., Gao, J., & Xiao, Q. (2026) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.70270
Metadata
- 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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