Adolescence is the transitional stage between childhood and maturity. The onset of puberty is caused by the activation of complex neuroendocrine regulatory mechanisms, which releases pulsatile GnRH (gonadotropin-releasing-hormone) output. The age of menarche, which is an indication that a female has reached reproductive maturity, has a significant impact on the health of women.
Numerous variables, which would include nutritional status, socioeconomic status, diet, environment, sibling relationships, hereditary and genetic factors, religion, ethnicity, psychological stress, migration, and chronic illness, have been theorised to influence the age of menarche, opinions for and against the theory have varied among clinicians and researchers. Both in industrialised and emerging nations, the average age at menarche has fallen, probably as a result of better nutrition and health.

Women who reach menarche before the average age of 12 years are more likely to face psychosocial challenges, putting them at risk for diseases such as obesity, diabetes, cardiovascular disease, and breast cancer. 5 Early menarche has been implicated as a risk factor for dyslipidaemia, hypertension, and hyperglycaemia in a number of studies. The date of menarche has been associated with cardiovascular disease (CVD), which is assumed to be due, at least in part, to increased lifelong oestrogen consumption.
Reproductive period duration is closely linked to age at menarche and menopausal age, which have been implicating various health consequences for women in later life. Relationship between menarche and menopause helps us understand the importance of effective prevention and management of health problems such as CVD, Osteoporosis, Breast cancer, type 2 DM (diabetes mellitus) etc.
The HRQOL (health related quality of life) of middle aged women in South India is lower than the natural average and has and increased correlation with BMI.

Authors anticipate that the outcome of the current study would provide an insight about availability, attitude and awareness about physiotherapy towards the addressing of health issues among female population, thereby reducing morbidity and mortality and improve the overall HRQOL among the middle-aged female population.
Women matching the study criteria and willing to participate in the survey were approached and informed consent was taken. An interview was conducted on either a physical or virtual mode by a trained therapist as per the check list designed for this study. The content of the checklist was validated with the help of experts in this study domain and subjected to statistical tests which yielded a Cronbach’s score of 0.967. The participants response on this checklist was analyzed and a strong association of physical and psychological health issue was documented particularly among working women, multiparous women, and with type of delivery women had undergone during 1s t pregnancy.
The average menarcheal age in Indian women was documented as 13±1.1 years. The age of menarche plays a major role as an indicator for sexual maturation and other factors i.e., family size, environmental and genetic conditions, BMI and level of education. Early menstrual age is associated with a high risk of the disease conditions, namely, uterine leiomyomata, endometrial cancer, breast cancer, and obesity; besides having an influence on reproductive performance, age of initial sexual activity, age of first pregnancy, and likelihood of additional miscarriages.
This checklist may be used in the future studies to assess physiological and psychological health issues faced by middle aged Indian women, given the ease of administration and shorter time required to respond to it. This survey form may specifically be helpful to cater to a larger women population at the community level.
Source: Sneha S, Sharma K N and Visarapu / Indian Journal of Obstetrics and Gynecology Research 2024;11(3):426–430