Journal of Clinical Endocrinology & Metabolism, Vol 57, 82-86, Copyright © 1983 by Endocrine Society

ARTICLES

Early menarche, a risk factor for breast cancer, indicates early onset of ovulatory cycles

D Apter and R Vihko

The associations between age at menarche and the hormonal patterns of adolescent menstrual cycles were investigated to obtain information as to why early menarche is an important risk factor for breast cancer. An initial group of 200 schoolgirls, 7-17 yr old, was investigated longitudinally 3 times at 1.5-yr intervals. A serum progesterone concentration in the latter part of the cycle exceeding 6.4 nmol/liter (2.0 ng/ml) was considered to signify an ovulatory cycle, and a concentration less than 1.6 nmol/liter (0.5 ng/ml) an anovulatory cycle. The frequency of ovulation depended significantly on both the time since menarche and the age at menarche (P less than 0.001 for both variables). Early menarche was associated with early onset of ovulatory cycles. The times from menarche until 50% of the cycles were ovulatory were about 1, 3, and 4.5 yr when the ages at menarche were less than 12.0, 12.0-12.9, and more than or equal to 13.0 yr, respectively. Girls with a menarcheal age below 12.0 yr had higher serum estradiol but lower testosterone and dehydroepiandrosterone concentrations than subjects with later menarche. The estradiol to dehydroepiandrosterone ratio was already higher before menarche in subjects who displayed early menarche during follow-up. These findings show that the increase in adrenal androgen secretion was mainly related to chronological age and was not affected by the time of menarche. The demonstration of early ovulation after early menarche is in conflict with the estrogen- window hypothesis suggesting a longer duration of anovulatory cycles to explain the increased risk of breast cancer after early menarche. Other theories should therefore be considered, among them the following: 1) high serum progesterone concentration in association with normal or high serum estradiol at puberty increases the risk, 2) only the early and relatively high estrogen concentrations are important, or 3) the estrogen to androgen ratio is the critical factor, with androgens having a protective effect.

This article has been cited by other articles:

				A. Emaus, S. Espetvedt, M.B. Veierod, R. Ballard-Barbash, A.-S. Furberg, P.T. Ellison, G. Jasienska, A. Hjartaker, and I. Thune 17-{beta}-Estradiol in relation to age at menarche and adult obesity in premenopausal women Hum. Reprod., April 1, 2008; 23(4): 919 - 927. [Abstract] [Full Text] [PDF]

				American Academy of Pediatrics, Committee on Adolescence, American College of Obstetricians and Gynecologist, and Committee on Adolescent Health Care Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign Pediatrics, November 1, 2006; 118(5): 2245 - 2250. [Abstract] [Full Text] [PDF]

				A Maitra, A Sherriff, K Northstone, D Strachan, the ALSPAC Study Team, and A J Henderson Maternal age of menarche is not associated with asthma or atopy in prepubertal children Thorax, October 1, 2005; 60(10): 810 - 813. [Abstract] [Full Text] [PDF]

				S. J. Jordan, P. M. Webb, and A. C. Green Height, Age at Menarche, and Risk of Epithelial Ovarian Cancer Cancer Epidemiol. Biomarkers Prev., August 1, 2005; 14(8): 2045 - 2048. [Abstract] [Full Text] [PDF]

				G. Cheng, Y. Li, Y. Omoto, Y. Wang, T. Berg, M. Nord, P. Vihko, M. Warner, Y.-S. Piao, and J.-A. Gustafsson Differential Regulation of Estrogen Receptor (ER){alpha} and ER{beta} in Primate Mammary Gland J. Clin. Endocrinol. Metab., January 1, 2005; 90(1): 435 - 444. [Abstract] [Full Text] [PDF]

				P. J. Adams Hillard Menstruation in Young Girls: A Clinical Perspective Obstet. Gynecol., April 1, 2002; 99(4): 655 - 662. [Abstract] [Full Text] [PDF]

				A. Must, S.M. Phillips, E.N. Naumova, M. Blum, S. Harris, B. Dawson-Hughes, and W. M. Rand Recall of Early Menstrual History and Menarcheal Body Size: After 30 Years, How Well Do Women Remember? Am. J. Epidemiol., April 1, 2002; 155(7): 672 - 679. [Abstract] [Full Text] [PDF]

				L. J Smits, G. A Zielhuis, P. H Jongbloet, and F. W. Van Poppel Mother's age and daughter's fecundity. An epidemiological analysis of late 19th to early 20th century family reconstitutions Int. J. Epidemiol., April 1, 2002; 31(2): 349 - 358. [Abstract] [Full Text] [PDF]

				F. Clavel-Chapelon Evolution of age at menarche and at onset of regular cycling in a large cohort of French women Hum. Reprod., January 1, 2002; 17(1): 228 - 232. [Abstract] [Full Text] [PDF]

				K. Mitrunen, N. Jourenkova, V. Kataja, M. Eskelinen, V.-M. Kosma, S. Benhamou, D. Kang, H. Vainio, M. Uusitupa, and A. Hirvonen Polymorphic Catechol-O-methyltransferase Gene and Breast Cancer Risk Cancer Epidemiol. Biomarkers Prev., June 1, 2001; 10(6): 635 - 640. [Abstract] [Full Text] [PDF]

				E. Faerstein, M. Szklo, and N. Rosenshein Risk Factors for Uterine Leiomyoma: A Practice-based Case-Control Study. I. African-American Heritage, Reproductive History, Body Size, and Smoking Am. J. Epidemiol., January 1, 2001; 153(1): 1 - 10. [Abstract] [Full Text] [PDF]

				K McPherson, C M Steel, J M Dixon, and W R Miller Risk factors for breast cancer BMJ, March 4, 1995; 310(6979): 598b - 598. [Full Text]