Background: The age at menarche is an important factor in health planning and is known to be influenced by genetic factors, environmental conditions, body stature, and socio-economic status.
Aim of the work: The present study was carried out to determine the average age at menarche and pattern of menstruation among girls of Alexandria, also to identify predictions of age at menarche and to assess knowledge and practice of girls in Alexandria about menarche and menstrual hygiene.
Subjects and Methods: A descriptive, cross-sectional epidemiological approach was chosen. A total of 900 recently menstruating girls and their mothers were randomly selected using a cluster random sampling method. The data were collected using a questionnaire. Body mass index [BMI] was used as indicator of nutrition. Data about girls' knowledge and practices related to menstruation were assessed. The traditional practices of mothers concerning their daughters' menarche were identified. Principal Component Factor Analysis [PCFA] was applied to reduce numerous interrelated socio-economic variables under study to independent components in order to allow better interpretations. A stepwise multiple regression analysis was performed to determine the joint contribution of the significant variables to age at menarche of the studied girls.
Results: Age at first menstruation of the studied girls ranged between 10 to 14.5 years with a mean age of 11.91+0.93 years. Late menarche is significantly correlated to irregular menstruation, prolongation of both menstrual cycle and bleeding period, and more symptoms associated with menstruation. Age of mothers' menarche [b=0.101], body mass index [b=-0.165], socio-economic index [b=-0.137], winter [b=0.107], spring [b=-0.127], summer [b=-0.107] and autumn [b=0.127] were identified as significant predictors of age at menarche in the studied girls. Findings revealed that 59.1% of girls had not any information about menstruation before menarche and had significantly higher negative feelings than those who were prepared [x4=109.43, P<0.001]. The mean percent score of knowledge among all the studied girls, regarding menarche and menstrual hygiene, was 39.86+21.85% while that for their health take caring practices was 41.25+14.44%. The mean percent score of health take caring practices for girls who were prepared before menarche [44.26+13.19%] was significantly higher than that for unprepared ones [36.67+13.41%] where t=4.864 [P<0.001]. However, insignificant correlation was observed between percent score of girls' knowledge and that of their health take caring practices [r=0.091, P=0.113]. The mean percent score of mothers' healthful practices related to their daughters' menarche was 66.71+17.44%.
Conclusion: The study revealed lack of appropriate and sufficient information regarding menstruation and its hygiene among Alexandria girls. Consequently, they adopt some unhealthy practices during menstruation which were found to have a socio-cultural origin. Issue of puberty should be emphasised in school health program during early school years. In addition, a community-based health education program focusing on menstruation and its hygiene should be launched for mothers. Further similar studies are recommended in other regions of Egypt for identification of sub-cultural similarities and variations to provide a comprehensive picture for Egypt.