Age at menarche, menstrual knowledge and practices in the apple belt of Shimla hills

Summary

The study was designed to determine age at menarche and its relation to body mass index in the apple belt of Shimla hills, with additional assessment of menstrual knowledge and related cultural practices. A cross-sectional survey of 640 school girls in the age group 9–16 years from 12 randomly selected schools was carried out. More than one-third (36·7 per cent) of subjects had started menstruation. Mean age at menarche was 13·2 years. Major reaction to first menstruation was fear (98·5 per cent); 21·3 per cent of girls were not touching anything before having a bath and sleeping separately during periods. Only 41·1 percent girls knew that menarche means the beginning of reproductive life. The higher age at menarche was possibly due to lean physique. Body mass index ≥ 18·5 was significantly related to menstrual status. The observations of embarrassment, fear. and lack of knowledge about the capacity to bear children point to an unmet need for information. Source of knowledge and cultural practices highlight the need for formal sex education among adolescents.