Early menarche: A systematic review of its effect on sexual and reproductive health in low- and middle-income countries
Open accessAbstract
BACKGROUND: Adolescent girls aged 15-19 bear a disproportionate burden of negative sexual and reproductive health outcomes in low- and middle-income countries. Research from several high-income countries suggests that early age at menarche is an important determinant of sexual and reproductive health. We conducted this systematic review to better understand whether and how early menarche is associated with various negative sexual and reproductive health outcomes in low- and middle-income countries and the implications of such associations. METHODS: We systematically searched eight health and social sciences databases for peer-reviewed literature on menarche and sexual and reproductive health in low- and middle-income countries. Two reviewers independently assessed all studies for inclusion, overall quality and risk of bias, and performed data extraction on all included studies. RESULTS: Twenty-four articles met all inclusion criteria-nine of moderate quality and fifteen with several methodological weaknesses. Our review of the minimal existing literature showed that early menarche is associated with early sexual initiation, early pregnancy and some sexually transmitted infections in low- and middle-income countries, similar to what has been observed in high-income countries. Early menarche is also associated with early marriage-an association that may have particularly important implications for countries with high child marriage rates. CONCLUSIONS: Early age at menarche may be an important factor affecting the sexual and reproductive health of adolescent girls and young women in low- and middle-income countries. More research is needed to confirm the existence of the identified associations across different settings and to better understand the process through which early menarche and other markers of early pubertal development may contribute to the increased vulnerability of girls to negative sexual and reproductive health outcomes in low- and middle-income countries. Given the association of early menarche with early marriage, ongoing efforts to reduce child marriage may benefit from targeting efforts to early maturing girls.
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In some cultures, menarche signifies readiness for sexual activity and marriage, with particular implications for sexual and reproductive health as well as educational attainment.
“In some cultures, menarche signifies readiness for sexual activity and marriage, with particular implications for sexual and reproductive health as well as educational attainment [18–20].”
From A qualitative exploration of menstruation-related restrictive practices in Fiji, Solomon Islands and Papua New Guinea (2018) · cites this paper as [19]
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- Authors
- Ibitoye, M., Choi, C., Tai, H., Lee, G., & Sommer, M.
- Affiliations
- Columbia University (US)
- Corresponding author
- Ibitoye, Mobolaji
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-06-07
- Volume
- 12
- Issue
- 6
- Pages
- e0178884
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5462398
- OpenAlex
- W2623396617
- Cited by
- 168
- References
- 83
- Citations by year
- 2026: 13 · 2025: 15 · 2024: 20 · 2023: 16 · 2022: 23 · 2021: 29 · 2020: 22 · 2019: 15 · 2018: 11 · 2017: 2 · 2016: 1
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institute of Child Health and Human Development (F31 HD089592)
- National Institute of General Medical Sciences (R25 GM062454)
- Topics
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- early menarche, age at menarche, adolescent girls, sexual and reproductive health, early sexual initiation, early pregnancy, sexually transmitted infections, early marriage, precocious puberty, low- and middle-income countries
- MeSH terms
- Adolescent, Developing Countries, Female, Humans, Income, Marriage, Menarche, Pregnancy, Sexual Behavior, Sexually Transmitted Diseases, Reproductive Health
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