Menarche at an Earlier Age: Results from Two National Surveys of Israeli Youth, 2003 and 2016

Tali Sinai*, Michal Bromberg, Rachel Axelrod, Tal Shimony, Aliza H. Stark, Lital Keinan-Boker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Study Objective: To assess emergent changes in the age at menarche and investigate associated factors in Israeli adolescents in 2003 and 2016. Design: Cross-sectional study. Setting: Two national representative school-based surveys (first and second “Mabat Youth”). Participants: Both surveys included female students in 7th-12th grades (ages 11-19 years). The first (N = 3328) was conducted between the years 2003 and 2004, and the second (N = 2535) from 2015 to 2016. Interventions: The survey questionnaire was self-administered and anthropometric measurements were performed by trained personnel. Main Outcome Measures: The current age at menarche in Israeli girls was determined and independent factors (demographic, clinical, and lifestyle) examined. Changes that occurred since the past national survey more than a decade ago were documented. Results: The estimated median age at menarche declined from 13.0 (interquartile range, 12.0-14.0) years in 2003-2004 to 12.5 (interquartile range, 12.0-13.0) years in 2015-2016 (P < .0001). Jewish girls reached menarche earlier than Arab girls, but both populations experienced a similar downward trend in the past approximately 14 years. Greater body mass index, higher socioeconomic status, and immigrant status were associated with younger menarche onset (P < .001). Age at menarche remained lower in 2015-2016 vs 2003-2004, even after adjustment for these potential confounders, with a high hazard ratio (HR), which decreased as a function of survival time (t): HRt = 15.417 × 0.813t. Conclusion: This study confirms the decline in age at menarche in Israel. Findings were associated with body mass index and population group but also indicated that other factors are likely involved.

Original languageAmerican English
Pages (from-to)459-465
Number of pages7
JournalJournal of Pediatric and Adolescent Gynecology
Issue number5
StatePublished - Oct 2020

Bibliographical note

Publisher Copyright:
© 2020 North American Society for Pediatric and Adolescent Gynecology


  • Adolescents
  • Ethnicity
  • Israel
  • Mabat
  • Menarcheal age
  • Obesity
  • Survival analysis


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