African-American women who were younger at menarche, or the onset of their menstrual periods, were more likely to report a history of childhood sexual abuse, according to a new study led by a researcher at Boston University's Slone Epidemiology Center. The results suggest that a history of sexual abuse may increase the risk of early menarche (i.e., onset of menstrual periods before age 12 years).
The study, which appears currently online in the American Journal of Public Health, examined the prevalence of sexual and physical abuse in childhood among more than 35,000 African-American women aged 21-69 years participating in the Black Women's Health Study, a national prospective cohort study.
The study found that a high proportion of participants reported a history of childhood abuse: 43 percent reported physical abuse and 18 percent reported sexual abuse. Women who reported a higher frequency of childhood sexual abuse had a higher likelihood of early menarche: a 26 percent increased risk of early menarche for 1-3 incidents of sexual abuse and a 34 percent increased risk of early menarche for four or more incidents, compared with women reporting no childhood abuse. There was a weaker association between physical abuse and early menarche.
The study used a considerably larger sample than any of the previous studies; examined African-American women, who have been underrepresented in earlier investigations; controlled for potential confounders that were not controlled previously; and simultaneously accounted for sexual and physical abuse in all analyses. An important limitation was the retrospective nature of data collection, which prevented establishment of the temporal relationship between abuse onset and menarche.
According to lead author Lauren A. Wise, ScD, an epidemiologist at the Slone Epidemiology Center and an assistant professor of epidemiology at Boston University School of Public Health, it is biologically plausible that childhood sexual abuse could influence age of menarche. Wise noted that "A link between sexual abuse and early menarche, if real, could have important public health implications because early menarche is associated with earlier age at initiation of sexual activity and first pregnancy, and is a risk factor for several adult conditions, including gynecologic disorders, cardiovascular disease, and cancer."
Co-authors on the study were: Julie R. Palmer, ScD, a professor of epidemiology and senior epidemiologist at the Slone Epidemiology Center; Emily F. Rothman, ScD, an assistant professor of social and behavioral sciences at the BU School of Public Health; and Lynn Rosenberg, ScD, a professor of epidemiology, associate director of the Slone Epidemiology Center, and Principal Investigator of the Black Women's Health Study.
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