Childhood factors causing later menarche impact lifelong adult health

Problems in adulthood such as tobacco use disorder and some conditions related to the digestive system, heart, bladder, joints and brain, are all shown to be affected by some influences that occurred in childhood, according to research presented Saturday at ENDO 2026, the Endocrine Society's annual meeting in Chicago, Ill.

This work greatly expands the number of adult health conditions that are linked to childhood influences. Later timing of menarche can act as an indicator of these childhood influences that can then lead to health problems in adulthood. There is a lot of focus on earlier menarche and what causes it, but our research highlights that the occurrence of later menarche, too, should alert us and can be a signal of underlying issues. We don't yet know the exact identities of these influences in childhood that affect adult health. However, we know that these childhood influences seem to be beyond just socioeconomic effects."

Ambreen Sonawalla, M.D., Boston Children's Hospital, Boston, Mass.

The authors analyzed data from 165,832 women in a large database of adults from the U.K., called the UK Biobank, which contains extensive data including medical diagnoses, self-reported timing of menarche (first menstrual period) in women and genetic data.

The age at which menarche occurs in adolescence can be pushed to be later than it otherwise would have been by adverse health or environmental factors in childhood. In the group's prior research studying the relationship between later age at menarche and higher risk of coronary artery disease in women, they showed that later timing of menarche can be used as an indicator of some influences that occurred in childhood that not only delay menarche but also increase the risk of coronary artery disease in adulthood.

The researchers discovered that later menarche is simply a reflection of something else that happened in childhood that is the real culprit in causing the higher risk of coronary artery disease. They explored if this was true for other adult health conditions as well and used timing of menarche in this study as an indicator/proxy for childhood influences to study its relationship with 1295 medical diagnoses available in the UK Biobank.

Given timing of menarche is affected by genetics as well, they accounted for the known effects of genetics on timing of menarche to be able to focus better on other factors that influence menarche. They used a method called phenome-wide association studies to simultaneously study the relationships of all 1295 diagnoses with age at menarche.

They found that 85 adult health diagnoses show evidence that they are affected by childhood influences. These included tobacco use disorder and conditions related to the digestive system, heart, bladder, joints and brain among others.

"We need a shift in perspective. We need to move from thinking that these health conditions emerge in adulthood to recognizing that they represent a culmination of influences that start in childhood. It is now up to us to figure out what these childhood influences are, and more research and funding towards understanding them will allow us to target specific aspects of childhood health to improve lifelong health outcomes," Sonawalla said.