ESPE Abstracts (2019) 92 P1-119

Menarche and its Relation to the Pubertal Growth Spurt

Jenni Gardstedt1, Aimon Niklasson2, Stefan Aronson1, Kerstin Albertsson-Wikland3, Anton Holmgren4


1Halmstad Hospital, Halmstad, Sweden. 2Göteborg Pediatric Growth Research Center (GP-GRC), Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Halmstad, Sweden. 3Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4Göteborg Pediatric Growth Research Center (GP-GRC), Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Halmstad Hospital, Gothenburg and Halmstad, Sweden


Background: Both timing of menarche and growth patterns have changed with time (secular changes), highlighting the need of updated knowledge in this topic1. Questions how growth is related to menarche are common in pediatric/pediatric endocrine outpatient clinics. The QEPS-growth model makes it possible to conduct detailed analyses of pubertal growth2.

Objective: To investigate the relationship between the timing of menarche and pubertal growth, specifically to analyse when menarche occurs related to the pubertal growth spurt and how the pubertal height gain is related to the timing of menarche.

Method: Pubertal growth was analysed and related to the timing of menarche in a longitudinally followed population, the GrowUp1990Gothenburg cohort (community-based setting)3. The analysed study group included 865 females. Analyses of the growth patterns were done with the QEPS growth model2. Information of the timing of menarche for each study subject were related to individual growth functions from the QEPS model. The timing of menarche was related to the percentage of specific pubertal gain attained (P%) and the total pubertal height gain (TgainP5–95).

Results: Menarche occurred in the mean at the time when around 60% of the specific pubertal gain was reached. Mean menarcheal age was 12.85 years (standard deviation 1.58 years) There was a negative linear correlation between the timing of menarche and the total pubertal height gain; in mean 28.7, 26.7 and 25.2 cm for girls with early (8-11 years), average (12-14 years) and late menarche (15-19 years) respectively. The difference in height gain was due to more Q function growth in girls with early menarche.

Conclusion: In a cohort of healthy Swedish girls with longitudinal growth data born in the 1990s, menarche was seen when around 60% of the specific pubertal height gain was achieved. The later the age of menarche, the less pubertal height gain. There is a broad variation in pubertal growth, where menarche is one important factor for different growth patterns around puberty in girls.

References: 1. Human growth patterns -with focus on pubertal growth and secular changes, dissertation © Anton Holmgren 2018, https://gupea.ub.gu.se/handle/2077/58087

2. Holmgren A, et al. Insight into human pubertal growth by applying the QEPS growth model. BMC pediatrics. 2017 Apr 19;17(1):107.

3. Holmgren A, et al. Pubertal height gain is inversely related to peak BMI in Childhood. Pediatric Research 2017:81, 448–454

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