Age at menarche and body fat in adolescent girls

Main Article Content

Aman Bhakti Pulungan
Resyana Putri Nugraheni
Najib Advani
Arwin AP Akib
Yoga Devaera
Hikari Ambara Sjakti
Attika Adrianti Andarie


Background Menarcheal age is important in adolescent girls due to its associations with health outcomes at adulthood. Modifiable factors that may influence menarcheal age include body fat mass and fat distribution.

Objective: To investigate possible correlations between body fat mass and fat distribution with age at menarche in adolescent girls.

Methods This study was a cross-sectional study on 32 girls aged 10-15 years in Central Jakarta, who experienced menarche within the time period of July to September 2019. Data on menarcheal age was collected by recall. Body fat mass and distribution were calculated using anthropometric measurements and bioelectrical impedance analyzer (BIA) results.

Results  The mean age of study subjects was 12.06 (SD 0.82) years and the mean age at menarche was 11.91 (SD 0.83) years. Correlation tests revealed a moderate negative correlation between body mass index-for-age and menarcheal age (r= -0.45; P=0.01) and weak negative correlation between waist-height ratio and menarcheal age (r= -0.37; P=0.03).

Conclusion Menarcheal age is correlated with body mass index-for-age and waist-height ratio. However, no significant correlations between menarcheal age and body fat mass or distribution are found.

Article Details

How to Cite
Pulungan A, Nugraheni RP, Advani N, Akib A, Devaera Y, Sjakti H, Andarie A. Age at menarche and body fat in adolescent girls. PI [Internet]. 3Sep.2020 [cited 27Oct.2020];60(5):269-. Available from:
Pediatric Endocrinology
Received 2020-08-10
Accepted 2020-09-03
Published 2020-09-03


Batubara JRL, Tridjaja B, Pulungan AB, editors. Pediatric Endocrinology Textbook. In: 2nd ed. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2018. p. 92–101.
2. Gebremariam H. Mean Difference of Age at Menarche and Body Mass Index among Government and Private High-School Students of Mekelle City, Northern Ethiopia. J Nutr Food Sci. 2015;s3(January 2020):6–11. doi: 10.4172/2155-9600.S3-004
3. Karapanou O, Papadimitriou A. Determinants of menarche. Reprod Biol Endocrinol . 2010;8:115. doi: 10.1186/1477-7827-8-115
4. Lakshman R, Forouhi NG, Sharp SJ, Luben R, Bingham SA, Khaw KT, et al. Early age at menarche associated with cardiovascular disease and mortality. J Clin Endocrinol Metab. 2009;94:4953–60. doi: 10.1210/jc.2009-1789
5. Ho AYY, Kung AWC. Determinants of peak bone mineral density and bone area in young women. J Bone Miner Metab. 2005;23:470–5. doi: 10.1007/s00774-005-0630-7
6. Indonesian Ministry of Health. Basic Health Survey. Jakarta; 2010.
7. World Health Organization. Child and Adolescent Health Fact sheets on sustainable development goals: health targets [Internet]. 2017 [cited 2020 Mar 20]. Available from
8. Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS. Relation of age at menarche to race, time period, and anthropometric dimensions: the Bogalusa Heart Study. Pediatrics. 2002;110(4):e43–e43. doi: 10.1542/peds.110.4.e43
9. Tehrani FR, Mirmiran P, Gholami R, Moslehi N, Azizi F. Factors influencing menarcheal age: Results from the cohort of Tehran Lipid and glucose study. Int J Endocrinol Metab. 2014;12. doi: 10.5812/ijem.16130
10. Batubara JRL, Soesanti F, van de Waal HD. Age at menarche in indonesian girls: a national survey. Acta Med Indones. 2010;42(2):78–81.
11. Wahab A, Wilopo SA, Hakimi M, Ismail D. Declining age at menarche in Indonesia: A systematic review and meta-analysis. Int J Adolesc Med Health. 2018;1–9. doi: 10.1515/ijamh-2018-0021
12. Alves Junior CA, Mocellin MC, Gonçalves ECA, Silva DA, Trindade EB. Anthropometric Indicators as Body Fat Discriminators in Children and Adolescents: A Systematic Review and Meta-Analysis. Adv Nutr An Int Rev J. 2017;8(5):718–27. doi: 10.3945/an.117.015446
13. Boswell HB. Normal Pubertal Physiology in Females. In: Female Puberty. Springer New York; 2014. p. 7–30.
14. United Nations' Sustainable Development Goals. Goal 3 .:. Sustainable Development Knowledge Platform [Internet]. [cited 2020 Mar 20]. Available from:
15. Center for Disease Control and Prevention. Defining Childhood Obesity [Internet]. 2018 [cited 2020 Jul 27]. Available from:
16. Moelyo AG, Wulandari A, Imas O, Rahma UP, Hidayah N, Kesumaningtyas C, et al. Paediatrica Indonesiana. 2019;59:33–7. doi: 10.14238/pi59.1.2019.33-7
17. Amaliah N, Pujonarti SA. Hubungan status gizi dengan status menarche pada remaja ( usia 10-15 tahun ) di indonesia tahun 2010 [Association Between Nutritional Status and Menarche Status In Adolescents ( Aged 10-15 Years ) In Indonesia in 2010] [thesis]. J Kesehat Reproduksi [Internet]. 2013;4(1):1–10. Available from:
18. Arifianto. Hubungan antara indeks massa tubuh dengan usia menars dan faktor-faktor lain yang memengaruhinya [Relationship between body mass index with age at menarche and other associated factors] [thesis]. Depok: Universitas Indonesia; 2012.
19. Wahyuni S. Hubungan status gizi, antropometri, dan usia menarche pada siswi MTSN Tangerang II Pamulang tahun 2013 [Relationship between nutritional status, anthropometric measurements, and age at menarche in secondary school students in Tangerang in 2013] [thesis]. Jakarta: UIN Syarif Hidayatullah; 2013.
20. Rebacz-Maron E. Dependence between Age at Menarche, Body Composition and Selected Somatic Indices. Coll Antropol. 2015;39(3):647–52.
21. Gavela-Pérez T, Garcés C, Navarro-Sánchez P, López Villanueva L, Soriano-Guillén L. Earlier menarcheal age in Spanish girls is related with an increase in body mass index between pre-pubertal school age and adolescence. Pediatr Obes . 2015;10:410–5. doi: 10.1111/ijpo.277
22. Siswianti Y. Hubungan berat badan, persen lemak tubuh, status gizi (IMT/U), umur menarche ibu dengan umur menarche pada siswi di SDN Cikaret 01 Cibinong, Kabupaten Bogor tahun 2012 [Relationship between body weight, body fat percentage, body mass index-for-age, mother's age at menarche with age at menarche in students of Cikaret 01 Primary School in Cibinong, Bogor, 2012] [thesis]. Depok: Universitas Indonesia; 2012.
23. Hendry D, Lasmini P, Yusrawati Y, Bachtiar H. . Hubungan kadar leptin serum, indeks massa tubuh, persentase lemak tubuh, dan rasio lingkar pinggang-panggul dengan usia menars [Relationship between serum leptin levels, body mass index, body fat percentage, and waist-hip ratio with age at menarche] [Thesis]. Padang: Universitas Andalas; 2014.
24. Sterling SR. The Effect of BMI on the Age of Menarche in Adolescent Girls [thesis]. St Andrews: St Andrew's University: 2013.
25. Lassek WD, Gaulin SJC. Menarche is related to fat distribution. Am J Phys Anthropol. 2007;133:1147–51. doi: 10.1002/ajpa.20644.
26. Bhadra M, Mukhopadhyay A, Chakraborty R, Bose K, Koziel S, Ulijaszek S. Relative fat distribution in relation to menarcheal status among Bengalee Hindu girls of West Bengal, India. J Nat Sci Biol Med. 2013;4:369–73. doi: 10.4103/0976-9668.116997.
27. Ahmed ML, Ong KK, Dunger DB. Childhood obesity and the timing of puberty. Trends Endocrinol Metab. 2009 Jul 1;20:237–42. doi: doi: 10.3390/ijerph14101266.
28. Lee JM, Appugliese D, Kaciroti N, Corwyn RF, Bradley RH, Lumeng JC. Weight status in young girls and the onset of puberty. Pediatrics . 2007;119(3):e624–30. doi: 10.1542/peds.2006-2188.