Digestive Diseases and Sciences

, Volume 57, Issue 11, pp 2975–2981

Menarche in Pediatric Patients with Crohn’s Disease

  • Neera Gupta
  • Robert H. Lustig
  • Michael A. Kohn
  • Eric Vittinghoff
Original Article

DOI: 10.1007/s10620-012-2235-z

Cite this article as:
Gupta, N., Lustig, R.H., Kohn, M.A. et al. Dig Dis Sci (2012) 57: 2975. doi:10.1007/s10620-012-2235-z


Background and Aims

The timing of menarche in Crohn’s disease (CD) is poorly described. Our objectives were to study age at menarche onset in CD, and factors associated with this.


We compared the age at menarche of 34 CD patients with that for 545 controls, using data in the National Health and Nutrition Examination Survey (NHANES).


Mean chronological age (CA) of CD patients (15.6 years) did not differ from that of the NHANES cohort (15.7 years; P = 0.91). The median CA at menarche (13.9 years) in CD was older than in the NHANES sample (12.0 years) (P < 0.00005). In CD patients, the cumulative incidence of menarche was 10 % at CA 12 years, 51 % at CA 14 years, and 100 % at CA 16 years. Sixty-eight percent reached menarche by bone age (BA) 13.5 years and 100 % by BA greater than 14.0 years. Menarche occurred earliest in South Asians, followed by East Asians, and then Caucasians (P = 0.02).


CA at menarche is delayed in CD compared with the NHANES cohort. BA at menarche in CD is similar to BA at menarche reported for healthy children. CA at menarche in CD differs by race. If menarche has not occurred by BA greater than 14.0 years, endocrinology referral should be considered.


Inflammatory bowel disease Puberty Menses Children Adolescents 



Bone age


Z score based on bone age


Body mass index


Chronological age


Z score based on chronological age


Crohn’s disease


Inflammatory bowel disease


National Health and Nutrition Examination Survey


University of California, San Francisco

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Neera Gupta
    • 1
  • Robert H. Lustig
    • 2
  • Michael A. Kohn
    • 3
  • Eric Vittinghoff
    • 3
  1. 1.Division of Gastroenterology, Hepatology, and Nutrition, Department of PediatricsUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Division of Endocrinology, Department of PediatricsUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA

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