Onset of menarche: differences between urban and rural community in Tangerang District, Banten Province, Indonesia

Abstract

The transition of physical and sexual maturation in becoming an adult occurs in adolescence
period. This transition runs in parallel with the development of cognitive, emotional, social
cultural and adaptation ability. Girls sexual maturity is marked by first menstruation (menarche)
which is the most important phase of reproductive development. The relationship between
menarche and growth rate of body height is very close. The menarche occurs when the growth
rate of the body height begins to decline. Many factors influence the onset of menarche i.e.
physical activity, nutritional intake, socio economic and environmental conditions and availability
of medical services. These factors vary between rural and urban area. Girls in urban area tend to
have modest life style compared with their counterpart in rural area. The purpose of this study
was to compare the onset of menarche of girls in urban and rural area, and to identify factors
that influence the onset of menarche. This was a cross sectional study involving 220 girls
students of elementary school from both urban and rural area in Tangerang District, Banten
Province. The mean onset of menarche of all subjects was 11.46 ± 0.99 years, while the mean
onset of menarche of girls who live in rural area (11.87±0.99 years) was significantly slower
than girls who live in urban area (11.05±0.80 years) (p=0.01). The birth body weight and birth
body length, physical activity and environment condition significantly influenced the onset of
menarche. The girls who live in urban areas had an earlier predictor factors to achieve for onset
of menarche than those who live in rural areas (OR: 3.34 [95% CI: 1.911 to 5.823] and aOR:
2.95 [95% CI: 1.410 - 6.012]).

Keywords: menarche - growth spurt - sexual maturity - urban - rural community