Erdal EREN, Nihal DÜNDAR, Pınar AKYOL, Hülya ANIL, Bumin DÜNDAR

Isparta’daki kız çocuklarında ortalama menarş yaşının ve menarşı etkileyen etmenlerin saptanması

Amaç: Isparta’da yaşayan kız çocuklarının ortalama menarş yaşı (MY), menarşı etkileyen etmenler ve “menstrüel” özelliklerin belirlenmesi. Gereç ve Yöntem: Etik kurul onayı alındıktan sonra; yedi ilköğretim ve üç liseden menarşın gerçekleştiği saptanan 948 olgu çalışmaya alındı. Tüm olgulara kendilerinin ve aile fertlerinin MY ve “menstrüel” özellikleri, yaşam tarzları, beslenme özellikleri ve sosyoekonomik durumlarını sorgulayan anket formları verildi. Olguların ağırlık ve boy ölçümleri yapılarak vücut kitle indeksleri hesaplandı. Ayrıca tüm olguların meme gelişimleri Tanner sınıflamasına göre değerlendirilerek kaydedildi. Bulgular: Ortalama MY 12,6 ± 0,03 olarak saptandı. Ortalama MY anne ve abla ortalama MY’lerinden anlamlı olarak düşük bulundu. Olguların ortalama MY’leri ile anne ve abla MY arasında anlamlı pozitif ilişki vardı. Olguların vücut kitle indeksleri ile ortalama MY’leri arasında anlamlı negatif ilişki bulundu. MY -2 ve +2 SSS değerleri sırasıyla 10,6 ve 14,7 olarak bulundu. Meme gelişimi Tanner Evre 1 ve 2 olan hiçbir hastada menarş saptanmazken, Tanner Evre 3 olanların %16,8’inde ve Evre 4 olan olguların %50,8’inde menarş saptandı. Olguların çoğunda menarş görülme mevsimi kış ve yaz aylarıydı. Olguların %62,1’i kanamalarının düzensiz olduğunu belirtmişti. Düzensiz “menstrüel” kanama yakınması üç yıldan daha az süredir menstruasyon görenlerde belirgin olarak yüksek saptandı.Çıkarımlar: Bu sonuçlar anne ve abla MY’leri göz önüne alındığında Türk kız çocuklarında MY’de bir erkene kayma olduğunu göstermekte ve erken ve gecikmiş MY sınırlarının yeniden gözden geçirilmesi gerekliliğine işaret etmektedir.

Determination of the mean age at menarche and factors affecting menarche in girls in Isparta

Aim: To determine the mean age at menarche (MAM), factors affecting menarche and menstrual cycle properties of girls living in Isparta. Material and Method: After obtaining approval from The Ethics Committee, 948 girls who had menarche and attended 7 primary and 3 high schools were included in the study. All participants were given questionnaire forms which queried the MAM of their own and their members family and menstrual cycle properties, life style, nutritional properties and socio-economical status. The Children were asked to fill out the forms with their parents. Weight and height measurements were made by using standard devices and body mass index was calculated. In addition, breast development of all subjects were evaluated according to Tanner Classification.Results: The MAM were determined as 12.6 ± 0.03 years. The MAM values of the participants were found to be significantly lower than the MAM values of the mothers and elder sisters. There was a positive correlation between the age at menarche of individuals and both their mothers and elder sisters. A negative correlation was found between the age at menarche and body mass index values of the subjects. -2 and +2 SDS values for the age at menarche were found 10.6 and 14.7 years, respectively. No menarche was observed in any individual with Tanner breast stages 1 and 2; menarche was detected in 16.8 % of the subjects with Tanner stage 3 and 50.8 % of the subjects with Tanner stage 4. The season of the menarche was winter and summer in most of the subjects. 62.1 % of the participants expressed that their menstrual cycle was irregular. The rate of the complaint of irregular menstrual cycle was significantly higher in girls having menstruation less than 3 years.Conclusions: These results show a shift to earlier ages in the MAM when the MAM values of the mothers and elder sisters are taken into consideration and indicate that the age limits for the menarche of Turkish children need to be reevaluated.

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