Abstract
Reproductive events have a significant impact on women’s lives. The aim of this study was to analyze the effects of age at menarche and current menstrual irregularity on psychological well-being and psychopathology. Data were collected in the context of the Finnish population-based Health 2000 study with self-administered questionnaires, a home interview, and a clinical health examination. The Beck Depression Inventory (BDI-21), the General Health Questionnaire-12 (GHQ-12), and the Composite International Diagnostic Interview (M-CIDI) were used to assess psychopathology. The relationships between age at menarche and current menstrual flow irregularity vs. BDI-21 and GHQ-12 scores and M-CIDI diagnoses were studied among 4,391 women aged 30 years and over. Negative, nonsignificant associations were found between age at menarche and BDI-21 and GHQ-12 scores. Young age at menarche was associated with increased risks of any recent mental disorder (OR = 0.894, p < 0.01), major depressive episode (OR = 0.900, p < 0.05), major depressive disorder (OR = 0.888; p < 0.05), and anxiety disorder (OR = 0.892; p < 0.05). Menstrual irregularity was associated with BDI-21 (p < 0.001) and GHQ-12 (p < 0.05) scores, but not with any recent psychiatric diagnosis. Age at menarche and menstrual irregularity have an influence on mental health, particularly on mood and anxiety symptoms. Reproductive features (age at menarche and menstrual irregularity) should be paid attention to during psychiatric evaluations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Akdeniz F (2010) Female-specific health problems in mental patients. Curr Opin Psychiatr 23:378–382. doi:10.1097/YCO.0b013e32833ae437
Albrecht U (2010) Circadian clocks in mood-related behaviors. Ann Med 42:241–251. doi:10.3109/07853891003677432
Angold A, Worthman CM, Worthman EJ (2003) Puberty and depression. In: Hajward C (ed) Gender differences at puberty. Cambridge University Press, Cambridge
Baca-Garcia E, Diaz-Sastre C, de Leon J, Saiz-Ruiz J (2000) The relationship between menstrual cycle phases and suicide attempts. Psychosom Med 62:50–60
Barron ML, Flick LH, Cook CA, Homan SM, Campbell C (2008) Associations between psychiatric disorders and menstrual cycle characteristics. Arch Psychiatr Nurs 22:254–265. doi:10.1016/j.apnu.2007.11.001
Beck A et al (1979) Cognitive therapy of depression. Guilford, New York
Bisaga K, Petkova E, Cheng J, Davies M, Feldman JF, Whitaker AH (2002) Menstrual functioning and psychopathology in a county-wide population of high-school girls. J Am Acad Child Adolesc Psychiatry 41:1197–1204. doi:10.1097/00004583-200210000-00009
Casey BJ, Jones R, Hare TA (2008) The adolescent brain. Ann N Y Acad Sci 1124:111–126. doi:10.1196/annals.1440.010
Cooper R, Blell M, Hardy R, Black S, Pollard TM, Wadsworth MEJ et al (2006) Validity of age at menarche self-reported in adulthood. J Epidemiol Community Health 60:993–997. doi:10.1136/jech.2005.043182
Copeland W, Shanahan L, Miller S, Costello EJ, Angold A, Maughan B (2010) Outcomes of early pubertal timing in young women: a prospective population-based study. Am J Psychiatry 167:1218–1225. doi:10.1176/appi.ajp.2010.09081190
Dahl RE (2004) Adolescent brain development: a period of vulnerabilities and opportunities. Ann N Y Acad Sci 1021:1–22. doi:10.1196/annals.1308.001
Deecher D, Andree TH, Sloan D, Schechter LE (2008) From menarche to menopause: exploring the underlying biology of depression in women experiencing hormonal changes. Psychoneuroendocrinology 33:3–17. doi:10.1016/j.psyneuen.2007.10.006
de la Iglesia HO, Schwartz WJ (2006) Minireview: timely ovulation: circadian regulation of the female hypothalamo–pituitary–gonadal axis. Endocrinology 147:1148–1153. doi:10.1210/en.2005-1311
Genazzani AR, Pluchino N, Luisi S, Luisi M (2007) Estrogen, cognition and female aging. Hum Reprod Update 13:175–187. doi:10.1093/humupd/dml042
Goldberg DP et al (eds) (1978) Manual of the general health questionnaire. NFER, Windsor
Graber JA, Lewinsohn PM, Seeley JR, Brooks-Gunn J (1997) Is psychopathology associated with the timing of pubertal development? J Am Acad Child Adolesc Psychiatry 36:1768–1776. doi:10.1097/00004583-199712000-00026
Graber JA, Seeley JR, Brooks-Gunn J, Lewinsohn PM (2004) Is pubertal timing associated with psychopathology in young adulthood? J Am Acad Child Adolesc Psychiatry 43:718–726. doi:10.1097/01.chi.0000120022.14101.11
Halbreich U, Borenstein J, Pearlstein T, Kahn LS (2003) The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology 28(Suppl 3):1–23. doi:10.1016/S0306-4530(03)00098-2
Heistaro S (2008) Methodology report. Health 2000 survey. Publications of National Public Health Institute, Series B 26/2008
Johnson SR (1987) The epidemiology and social impact of premenstrual symptoms. Clin Obstet Gynecol 30:367–376
Kaltiala-Heino R, Marttunen M, Rantanen P, Rimpela M (2003) Early puberty is associated with mental health problems in middle adolescence. Soc Sci Med 57:1055–1064. doi:10.1016/S0277-9536(02)00480-X
Klemetti R, Raitanen J, Sihvo S, Saarni S, Koponen P (2010) Infertility, mental disorders and well-being—a nationwide survey. Acta Obstet Gynecol Scand 89:677–682. doi:10.3109/00016341003623746
Leenaars AA, Dogra TD, Girdhar S, Dattagupta S, Leenaars L (2009) Menstruation and suicide: a histopathological study. Crisis 30:202–207. doi:10.1027/0227-5910.30.4.202
Lehtinen V, Joukamaa M (1994) Epidemiology of depression: prevalence, risk factors and treatment situation. Acta Psychiatr Scand Suppl 377:7–10
Lien L, Dalgard F, Heyerdahl S, Thoresen M, Bjertness E (2006) The relationship between age of menarche and mental distress in Norwegian adolescent girls and girls from different immigrant groups in Norway: results from an urban city cross-sectional survey. Soc Sci Med 63:285–295. doi:10.1016/j.socscimed.2006.01.003
Luggin R, Bernsted L, Peterson B, Jacobsen AT (1984) Acute psychiatric admission related to the menstrual cycle. Acta Psychiatr Scand 69:461–465
Marcus SM, Young EA, Kerber KB, Kornstein S, Farabaugh AH, Mitchell J et al (2005) Gender differences in depression: findings from the STAR*D study. J Affect Disord 87:141–150. doi:10.1016/j.jad.2004.09.008
Mendle J, Turkheimer E, Emery RE (2007) Detrimental psychological outcomes associated with early pubertal timing in adolescent girls. Dev Rev 27:151–171. doi:10.1016/j.dr.2006.11.001
Partonen T (2012) Clock gene variants in mood and anxiety disorders. J Neural Transm 119:1133–1145. doi:10.1007/s00702-012-0810-2
Patton GC, Hibbert ME, Carlin J, Shao Q, Rosier M, Caust J et al (1996) Menarche and the onset of depression and anxiety in Victoria, Australia. J Epidemiol Community Health 50:661–666
Paykel ES (1991) Depression in women. Br J Psychiatry Suppl 10:22–29
Pluchino N, Cubeddu A, Giannini A, Merlini S, Cela V, Angioni S et al (2009) Progesterone and brain: an update. Maturitas 62:349–355. doi:10.1016/j.maturitas.2008.11.023
Raitasalo R (1995) Elämänhallinta sosiaalipolitiikan tavoitteena. Sosiaali- ja terveysturvan tutkimuksia I. Helsinki: Kansaneläkelaitos [Life Control as a Socio-Political Objective. Social Insurance Institution of Finland. Social and Health Security Research 1. 1995]
Rubinow DR, Schmidt PJ, Roca CA (1998) Estrogen–serotonin interactions: implications for affective regulation. Biol Psychiatry 44:839–850. doi:10.1016/S0006-3223(98)00162-0
Saunders KEA, Hawton K (2006) Suicidal behaviour and the menstrual cycle. Psychol Med 36:901–912. doi:10.1017/S0033291706007392
Sellix M, Menaker M (2011) Circadian clocks in mammalian reproductive physiology: effects of the “other” biological clock on fertility. Discov Med 11:273–281
Stattin H, Magnusson D (1990) Pubertal maturation in female development. Lawrence Erlbaum, Mahwah
Wittchen HU, Lachner G, Wunderlich U, Pfister H (1998) Test–retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 33:568–578
Wittchen HU, Becker E, Lieb R, Krause P (2002) Prevalence, incidence and stability of premenstrual dysphoric disorder in the community. Psychol Med 32:119–132. doi:10.1017/S0033291701004925
Acknowledgments
We wish to thank Dr. Oskari Heikinheimo for his help in revising the article. Funding for this study was provided, in part, by grants from the Research Foundation of the University of Helsinki and the Center for International Mobility (CIMO), and the National Graduate School of Clinical Investigation (CLIGS).
Conflicts of interest
The authors declare that they have no conflict of interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Toffol, E., Koponen, P., Luoto, R. et al. Pubertal timing, menstrual irregularity, and mental health: results of a population-based study. Arch Womens Ment Health 17, 127–135 (2014). https://doi.org/10.1007/s00737-013-0399-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-013-0399-y