Menarche

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Menarche (/məˈnɑːrki/ mə-NAR-kee; from Ancient Greek μήν (mēn) 'month' and ἀρχή (arkhē) 'beginning') is the first menstrual cycle, or first menstrual bleeding, in female humans. From both social and medical perspectives, it is often considered the central event of female puberty, as it signals the possibility of fertility.

Girls experience menarche at different ages.^[1][2] Having menarche occur between the ages of 9–14 in the West is considered normal.^[3] Canadian psychological researcher Niva Piran claims that menarche or the perceived average age of puberty is used in many cultures to separate girls from activity with boys, and to begin transition into womanhood.^[4]

The timing of menarche is influenced by female biology, as well as genetic and environmental factors, especially nutritional factors.^[5] The mean age of menarche has declined over the last century, but the magnitude of the decline and the factors responsible remain subjects of contention. The worldwide average age of menarche is very difficult to estimate accurately, and it varies significantly by geographical region, race, ethnicity and other characteristics, and occurs mostly during a span of ages from 8 to 16, with a small percentage of girls having menarche by age 10, and the vast majority having it by the time they were 14.^[3] There is a later age of onset in Asian populations compared to the West, but it too is changing with time. For example a Korean study in 2011 showed an overall average age of 12.7, with around 20% before age 12, and more than 90% by age 14.^[6] A Chinese study from 2014 published in Acta Paediatrica showed similar results (overall average of age 12.8 in 2005 down to age 12.3 in 2014) and a similar trend in time, but also similar findings about ethnic, cultural, and environmental effects.^[7]

The average age of menarche was about 12.7 years in Canada in 2001,^[8] and 12.9 in the United Kingdom.^[9] A study of girls in Istanbul, Turkey, in 2011 found the median age at menarche to be 12.7 years.^{[better source needed][10]} In the United States, an analysis of 10,590 women aged 15–44 taken from the 2013–2017 round of the CDC's National Survey of Family Growth found a median age of 11.9 years (down from 12.1 in 1995), with a mean of 12.5 years (down from 12.6).^[11]