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Later onset of menarche reduces risk for allergic rhinitis, asthma

The older a girl was when experiencing her first menstrual cycle, the less likely she was to develop allergic rhinitis and asthma later in life, according to study results.

“Based on the present results, there seemed to be an inverse dose-response relationship between age at menarche and incidence of asthma, with earlier menarche being associated with a higher risk of developing asthma after puberty,” Junxiang Wei, MSc, of the Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine at the University Hospital of Munich, and colleagues wrote.

Wei and colleagues conducted a prospective, community-based cohort study on 1,191 girls aged 9 to 11 years from Munich and Dresden, Germany and followed them into early womanhood. The researchers sought to determine whether age at first menstrual cycle as well as use of contraceptives predicted new-onset allergic rhinitis (AR) and asthma after puberty.

The first follow-up occurred in 2002 and 2003 as participants ranged in age from 16 to 18 years. The second follow-up took place in 2007 through 2009, with participants aged 19 to 24 years.

Participants experienced their first menstrual cycle at an average age of 12.6 years, and 23% reported experiencing their first menstrual cycle after age 13 years.

The results indicated 869 complete cases for asthma and 748 complete cases for AR. Seventy-three percent of participants had been taking an oral contraceptive or other hormonal contraceptive for at least 1 year by the end of the study.

The later the participant experienced her first menstrual cycle, the more the risk for AR decreased (OR = 0.35; 95% CI, 0.15-0.78). The use of hormonal contraceptives also decreased the risk for incident AR (OR = 0.14; 95% CI, 0.08-0.24) and asthma (OR = 0.27; 95% CI, 0.12-0.58).

The researchers assessed the outcomes by using self-reported age at the first asthma and AR incident and physician diagnosis of asthma and AR at each follow-up study, which they wrote could have been a limitation to the study.

“Some girls might have had asthma or allergic rhinitis symptoms before the onset of menarche and before beginning hormonal contraceptive use but had their first attack of disease afterward, which might have led to some misclassification of disease onset,” the investigators concluded. – by Ryan McDonald