Research Article| Volume 101, P57-63, July 2017

Download started.


Early menarche and new onset of asthma: Results from the SAPALDIA cohort study


      • To our knowledge, this study is the first to investigate the association of early menarche and new onset of asthma in the Swiss population.
      • It is also among the first studies to investigate the impact of early menarche, with prospective assessment of asthma incidence in women in later adulthood.
      • Women with early menarche had a tendency to a higher risk of new onset of asthma, especially in young atopic women.
      • To further substantiate this finding further longitudinal research taking atopic status into account is needed.



      The association between early menarche and new onset of asthma warrants further investigation in those aged >30 years.


      Using data from the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), we investigated whether early menarche was associated with new onset of asthma in women aged 18–60 years at baseline.


      Our analysis included 2492 women with information on age at menarche and doctor-diagnosed asthma, who had been asthma free at the time of menarche and had complete covariate information. New onset of asthma was defined as newly reported doctor-diagnosed asthma which occurred at least one year after menarche. Asthma incidence and its association with early menarche was analysed using logistic regression, adjusting for age, atopy, smoking, BMI, parental asthma, urbanity, education and study area, and additionally stratifying by atopy and BMI.


      After adjustment of relevant confounders, women with early menarche did not have a significantly higher risk of onset of asthma than women without early menarche (OR 1.23, 95% CI 0.85–1.80). Young atopic women with early menarche appeared to have an increased risk of asthma compared with non-atopic women (OR 2.21, 95% CI 0.90–5.43); however, our results did not reach statistical significance.


      We could not substantiate an association of early menarche with new onset of asthma in this Swiss population-based cohort aged 18–60 years at baseline. Future studies may need to prospectively assess age of menarche to investigate the association with new onset of asthma in those aged >30 years.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Maturitas
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Hansen S.
        • Probst-Hensch N.
        • Keidel D.
        • Dratva J.
        • Bettschart R.
        • Pons M.
        • Burdet L.
        • Bridevaux P.-O.
        • Schikowski T.
        • Schindler C.
        • Rochat T.
        • Zemp E.
        Gender differences in adult-onset asthma: results from the Swiss SAPALDIA cohort study.
        Eur. Respir. J. 2015; ERJ-02278-2014
        • Eagan T.M.L.
        • Brøgger J.C.
        • Eide G.E.
        • Bakke P.S.
        The incidence of adult asthma: a review.
        Int. J. Tuberc. Lung Dis. 2005; 9: 603-612
        • Lieberoth S.
        • Gade E.J.
        • Brok J.
        • Backer V.
        • Thomsen S.F.
        Age at menarche and risk of asthma: systematic review and meta-analysis.
        J. Asthma. 2014; 51: 559-565
        • Lieberoth S.
        • Gade E.
        • Kyvik K.O.
        • Backer V.
        • Thomsen S.F.
        Early menarche is associated with increased risk of asthma: prospective population-based study of twins.
        Respir. Med. 2015; 109: 565-571
        • Bouloumie A.
        • Marumo T.
        • Lafontan M.
        • Busse R.
        Leptin induces oxidative stress in human endothelial cells.
        FASEB J. 1999; 13: 1231-1238
        • Jartti T.
        • Saarikoski L.
        • Jartti L.
        • Lisinen I.
        • Jula A.
        • Huupponen R.
        • Viikari J.
        • Raitakari O.T.
        Obesity, adipokines and asthma.
        Allergy. 2009; 64: 770-777
        • Wei J.
        • Gerlich J.
        • Genuneit J.
        • Nowak D.
        • Vogelberg C.
        • von Mutius E.
        • Radon K.
        Hormonal factors and incident asthma and allergic rhinitis during puberty in girls.
        Ann. Allergy. Asthma. Immunol. 2015; 115: 21-27.e2
        • Macsali F.
        • Real F.G.
        • Plana E.
        • Sunyer J.
        • Anto J.
        • Dratva J.
        • Janson C.
        • Jarvis D.
        • Omenaas E.R.
        • Zemp E.
        • Wjst M.
        • Leynaert B.
        • Svanes C.
        Early age at menarche, lung function, and adult asthma.
        Am. J. Respir. Crit. Care Med. 2011; 183: 8-14
        • Fida N.G.
        • Williams M.A.
        • Enquobahrie D.A.
        Association of age at menarche and menstrual characteristics with adult onset asthma among reproductive age women.
        Reprod. Syst. Sex. Disord. 2012; 1
        • Gnatiuc L.
        • Kato B.
        • Matheson M.C.
        • Newson R.B.
        • Jarvis D.L.
        The association of asthma with BMI and menarche in the 1958 British Birth Cohort.
        J. Asthma. 2013; 50: 751-758
        • Ackermann-Liebrich U.
        • Kuna-Dibbert B.
        • Probst-Hensch N.M.
        • Schindler C.
        • Felber Dietrich D.
        • Stutz E.Z.
        • Bayer-Oglesby L.
        • Baum F.
        • Brändli O.
        • Brutsche M.
        • Downs S.H.
        • Keidel D.
        • Gerbase M.W.
        • Imboden M.
        • Keller R.
        • Knöpfli B.
        • Künzli N.
        • Nicod L.
        • Pons M.
        • Staedele P.
        • Tschopp J.-M.
        • Zellweger J.-P.
        • Leuenberger P.
        Follow-up of the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA 2) 1991–2003: methods and characterization of participants.
        Soz. Praventivmed. 2005; 50: 245-263
        • Martin B.W.
        • Ackermann-Liebrich U.
        • Leuenberger P.
        • Künzli N.
        • Stutz E.Z.
        • Keller R.
        • Zellweger J.P.
        • Wüthrich B.
        • Monn C.
        • Blaser K.
        • Bolognini G.
        • Bongard J.P.
        • Brändli O.
        • Braun P.
        • Defila C.
        • Domenighetti G.
        • Grize L.
        • Karrer W.
        • Keller-Wossidlo H.
        • Medici T.C.
        • Peeters A.
        • Perruchoud A.P.
        • Schindler C.
        • Schoeni M.H.
        • Villiger B.
        SAPALDIA: methods and participation in the cross-sectional part of the Swiss Study on Air Pollution and Lung Diseases in Adults.
        Soz. Praventivmed. 1997; 42: 67-84
        • The European Community Respiratory Health Survey II Steering
        The European Community Respiratory Health Survey II.
        Eur. Respir. J. 2002; 20: 1071-1079
        • Salam M.T.
        • Wenten M.
        • Gilliland F.D.
        Endogenous and exogenous sex steroid hormones and asthma and wheeze in young women.
        J. Allergy Clin. Immunol. 2006; 117: 1001-1007
        • Al-Sahab B.
        • Hamadeh M.J.
        • Ardern C.I.
        • Tamim H.
        Early menarche predicts incidence of asthma in early adulthood.
        Am. J. Epidemiol. 2011; 173: 64-70
        • Burgess J.A.
        • Walters E.H.
        • Byrnes G.B.
        • Giles G.G.
        • Jenkins M.A.
        • Abramson M.J.
        • Hopper J.L.
        • Dharmage S.C.
        Childhood adiposity predicts adult-onset current asthma in females: a 25-yr prospective study.
        Eur. Respir. J. 2007; 29: 668-675
        • Varraso R.
        • Siroux V.
        • Maccario J.
        • Pin I.
        • Kauffmann F.
        Asthma severity is associated with body mass index and early menarche in women.
        Am. J. Respir. Crit. Care Med. 2005; 171: 334-339
        • Dratva J.
        • Zemp E.
        • Staedele P.
        • Schindler C.
        • Constanza M.C.
        • Constanza M.
        • Gerbase M.
        • Probst-Hensch N.
        • Rochat T.
        • Ackermann-Liebrich U.
        SAPALDIA-Team, variability of reproductive history across the Swiss SAPALDIA cohort--patterns and main determinants.
        Ann. Hum. Biol. 2007; 34: 437-453
        • Castro-Rodriguez J.A.
        A new childhood asthma phenotype: obese with early menarche.
        Paediatr. Respir. Rev. 2016; 18: 85-89
        • Hong C.-C.
        • Pajak A.
        • Teitelbaum S.L.
        • Vangeepuram N.
        • Galvez M.
        • Pinney S.M.
        • Windham G.
        • Kushi L.H.
        • Biro F.M.
        • Wolff M.S.
        Breast Cancer and Environment Research Program, Younger pubertal age is associated with allergy and other atopic conditions in girls.
        Pediatr. Allergy Immunol. 2014; 25: 773-780
        • Varraso R.
        • Siroux V.
        • Maccario J.
        • Pin I.
        • Kauffmann F.
        Epidemiological Study on the Genetics and Environment of Asthma, Asthma severity is associated with body mass index and early menarche in women.
        Am. J. Respir. Crit. Care Med. 2005; 171: 334-339
        • Gemelli I.F.B.
        • dos E.
        • Farias S.
        • Souza O.F.
        Age at menarche and its association with excess weight and body fat percentage in girls in the southwestern region of the Brazilian Amazon.
        J. Pediatr. Adolesc. Gynecol. 2016;
        • Xu B.
        • Järvelin M.R.
        • Hartikainen A.L.
        • Pekkanen J.
        Maternal age at menarche and atopy among offspring at the age of 31 years.
        Thorax. 2000; 55: 691-693
        • Herrera-Trujillo M.
        • Barraza-Villarreal A.
        • Lazcano-Ponce E.
        • Hernández B.
        • Sanín L.H.
        • Romieu I.
        Current wheezing, puberty, and obesity among Mexican adolescent females and young women.
        J. Asthma. 2005; 42: 705-709
        • Must A.
        • Phillips S.M.
        • Naumova E.N.
        • Blum M.
        • Harris S.
        • Dawson-Hughes B.
        • Rand W.M.
        Recall of early menstrual history and menarcheal body size: after 30 years, how well do women remember?.
        Am. J. Epidemiol. 2002; 155: 672-679
        • Casey V.A.
        • Dwyer J.T.
        • Coleman K.A.
        • Krall E.A.
        • Gardner J.
        • Valadian I.
        Accuracy of recall by middle-aged participants in a longitudinal study of their body size and indices of maturation earlier in life.
        Ann. Hum. Biol. 1991; 18: 155-166