Introduction: Current health literature suggests that there has been a decline in the age of pubertal onset and that pubertal onset/duration of puberty may, besides weight status, be influenced by socioeconomic context. Objective: The goal of this study was to determine whether pubertal onset/ duration and puberty-triggering hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH) vary according to socioeconomic status (SES). Moreover, we aimed to propose cutoff values of serum LH and FSH for predicting gonadarche in boys. Methods: 2,657 apparently healthy children and adolescents between 5.5 and 18 years from the area of Leipzig were recruited from the LIFE Child study. Age at pubertal onset/end of puberty was given in 738/573 children, respectively. Anthropometric parameters of puberty, blood measurements of LH and FSH, and questionnaires assessing SES were evaluated. Results: Lower SES was associated with earlier thelarche and longer duration of puberty in overweight/obese girls, whereas age of menarche was not affected. In boys with low SES, a trend versus earlier puberty onset can be seen. Lower SES was significantly associated with boys’ age at mutation. No significant differences in boys’ and girls’ serum levels of LH and FSH during puberty according to SES were observed. Serum LH levels of 0.56 IU/L and serum FSH levels of 1.74 IU/L showed the best prediction of gonadarche in boys. Conclusion: Puberty onset/duration and boys’ age at mutation is affected by SES. The proposed cutoff levels for serum LH and FSH could provide a serological tool to determine gonadarche in boys

Mon mémoire de recherche considère comment l’héritage historique de l’esclavage continue d’affecter l’expérience de passage à l’âge adulte des jeunes filles afro-américaines. L’impact profond de l’esclavage sur leurs ancêtres est transmis aux générations suivantes, influençant la manière dont ces filles perçoivent et gèrent leurs identités. En lisant « Corregidora » de Gayl Jones et « The Bluest Eye » de Toni Morrison, je présente les défis auxquels les filles afro-américaines sont confrontées lorsqu’elles passent de l’enfance à la vie d’une femme. Le premier chapitre de mon mémoire aborde l’impact des traumatismes intergénérationnels aux niveaux individuel et collectif. Ce chapitre explore comment les traumatismes émotionnels et psychologiques hérités peuvent influencer profondément la manière dont une personne comprend son identité sexuelle. Le deuxième chapitre étudie l’impact du racisme, de la pauvreté et des faibles conditions socioéconomiques sur le développement des filles afro-américaines pendant la période de transition de la puberté. Ce chapitre offre un aperçu de la terreur et de la sexualisation associées à la ménarche. Cette thèse s’appuie principalement sur les travaux de Saidiya Hartman sur la théorie de « the afterlife of slavery » et sur le concept de « living in the wake » de Christina Sharpe. De plus, je m’inspire des travaux des psychiatres Bessel Van der Kolk et Judith Herman pour examiner le traumatisme lié au processus de passage à l’âge adulte et plus précisément l’expérience de la ménarche. / My thesis examines how the historical legacy of slavery continues to affect the coming-of-age experience for young African American girls. The profound impact of slavery on their ancestors is passed down through succeeding generations, shaping the way these girls perceive and manage their identities. Through reading Gayl Jones’s Corregidora (1975) and Toni Morrison’s The Bluest Eye (1970), I present the challenges African American girls face when transitioning from girlhood into womanhood. The first chapter of my thesis addresses the impact of intergenerational trauma on both individual and collective levels. This chapter explores how inherited emotional and psychological trauma can profoundly influence the way a person understands their sexual identity. The second chapter studies the impact of racism, poverty, and low socioeconomic conditions on the development of black girls during the transitional period of puberty. This chapter offers insight into the terror and sexualization associated with menarche. This thesis primarily draws on the works of Saidiya Hartman’s theory of “the afterlife of slavery” and Christina Sharpe’s concept of “living in the wake”. Additionally, I rely on the works of psychiatrists Bessel Van der Kolk and Judith Herman to examine the trauma linked to the coming-of-age process, specifically the menarche experience.

No description available.

More than half of all cases of breast cancer occur among women without any known risk factors. More research is needed on suspected risk factors in order to refine current breast cancer screening tools. The objectives of this thesis were: to determine the breast cancer risk associated with known risk factors (ethnicity, family history, breast biopsy, age at menarche, age at first birth, alcohol, HRT, and BMI), suspected risk factors (smoking, second-hand smoke exposure, smoked/grilled foods, and NSAID use), and to examine the above associations according to tumour receptor status, histologic grade, and menopausal status, with potential confounders also considered. This thesis project was conducted within the framework of the Molecular Epidemiology of Breast Cancer study, a case-control study of women in Vancouver, BC and Kingston, ON, with 1140 cases and 1169 controls recruited from 2005-2010. Information was collected from a detailed questionnaire. Cases and controls were similar in terms of age at menarche, age at first birth, smoking history, second-hand smoke exposure, lifetime smoked/grilled food consumption, HRT, and BMI. Among cases, there were significantly less Europeans and more Chinese, Japanese, and Filipino subjects compared to controls. Cases were more likely to have a first degree relative with breast cancer, as well as a previous benign breast biopsy. Alcohol consumption and past NSAID usage was higher among controls. The level of education completed was higher among controls. Cases were also more likely to be postmenopausal. Family history was associated with breast cancer risk (OR=1.59, CI=1.30-1.94), as was BMI (OR=1.28, CI=1.05-1.58 for overweight and OR=2.28, CI=1.35-3.86 for obese class II). Second-hand smoke was also found to be associated with breast cancer risk (OR=1.42, CI=1.02-1.97 for individuals with a less than 10 pack-year smoking history). Due to reduced sample size with stratification and marginally significant results, it is not possible to draw definitive conclusions regarding pathology sub-types. In summary, these results provide support for the association between several risk factors and breast cancer risk. More research is needed to ascertain how receptor status, histologic grade, and menopausal status affect these associations. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2011-08-15 19:43:06.689

[Truncated abstract] Early psychosocial stress is conjectured to place individuals on a developmental trajectory leading to earlier pubertal maturation, earlier initiation of sexual activity and earlier reproduction than those with less early psychosocial stress. This may have an adaptive function to minimise the chances of lineage extinction, which is more likely in environments of high risk and uncertainty. Previous studies have examined the relationship between early psychosocial stress and life history stages (e.g., age at puberty, age at first sex and age at first birth). However, these studies are limited in that they either examined only a few early psychosocial stressors, examined psychosocial stress relatively late in individuals' lives and/or were restricted to women. Thus, the first aim of the present thesis was to examine these findings in both genders using a measure of early psychosocial stress comprised of 24 categories of retrospectively assessed stressors (e.g., sexual abuse, physical abuse, parental divorce, rated quality of family life) during the first 7 years of life. It was hypothesised that individuals with high, as opposed to low, levels of early psychosocial stress would pass through life history stages earlier. The second aim was to examine how early psychosocial stress affects characteristics associated with life history traits, such as individuals? length, number and type of heterosexual relationships, number of sex partners, adult attachment styles, number of pregnancy terminations, and attitudes and behaviours towards contraceptive use. High levels of early psychosocial stress were predicted to be associated with characteristics reflecting a quantitative, as opposed to a qualitative, reproductive approach (e.g., more sex partners, more short-term relationships, insecure attachment styles). The third aim was to examine how early psychosocial stress is related to mate choice because numerous studies have identified what traits individuals' desire in a mate but not whether early psychosocial stress affects these choices. ... Early psychosocial stress generally had no effects on age at first sex, age at first birth, the number of pregnancy terminations, and mate choices. On the other hand, individuals with high, as opposed to low, levels of early psychosocial stress were more likely to be insecurely attached, had more short-term sexual relationships (men only), had more extra-pair copulations, were more likely to be divorced/separated, had a greater lifetime number of sex partners (men only), and had lower self-rated frequencies of contraception use. Overall, some of these findings are consistent with life history theory, which suggests that individuals with high levels of early psychosocial stress (i.e., those living in environments of high risk and uncertainty) should reach biological maturation earlier, engage in behaviours that facilitate earlier and more frequent reproduction to minimise the chances of lineage extinction. Implications for public health, limitations of the present study and future directions are also discussed.

Made available in DSpace on 2014-08-20T13:58:00Z (GMT). No. of bitstreams: 1 Dissertacao_Jeovany_Mesa.pdf: 493634 bytes, checksum: 2f34996b8fc369ea79d0d558f99a156c (MD5) Previous issue date: 2006-11-20 / Background: there is evidence that rapid growth in early childhood produces negative effects on health in later periods. However, the relationship between these early factors and puberty, especially with regard to the onset of menarche, has been poorly studied. Methods: the current study included 2083 women belonging to The 1982 Pelotas Birth-Cohort Study. Statistical analyses employed Pearson X2 and X2 for linear trends.Moreover, multivariate analyses were performed using Poisson regression, following a hierarquical model reflecting a life-course approach. Results: the mean of age of menarche was 12.4 years and the prevalence of menarche before age 12 was 24.3%. Increasing Z-score values for weight/age, height/age and weight/height at 19.4 and 43.1 months corresponded to linear tendencies of increasing prevalence and relative risks for the onset of menarche before age 12. The relative risks were systematically higher at 43.1 months than at 19.4 months. In addition, those girls who experienced rapid growth (gaining 0.67 Z-score or more) between birth and 19.4 months for weight/age Z-score or between 19.4 and 43.1 months for weight/age or height/age Z-score also showed greater risk. The risk of menarche before age 12 was highest when rapid growth in weight/age Z-score occurred in both periods and showed the highest value among girls who experience it and belonged to the first Williams curves tertile at birth. Rapid growth in weight/height Zscore was not associated with menarche before age 12. Conclusions: menarche is influenced by nutritional status and growth patterns in early childhood. For that reason, avoiding overweight and obesity in early childhood and keeping the normal pattern of growth- avoiding accelerated growth increments in early childhood- seems to be significant preventing health outcome in future life. / A idade da menarca (primeiro sangramento menstrual) é um sinal do começo da fase reprodutiva da mulher, e é considerado por alguns um importante preditor da saúde na adolescência, na vida adulta e também da vida após a menopausa. Ocorre, após a menarca, uma grande maturação uterina, que permite o acontecimento da gravidez. A menarca tem sido estudada em associação com numerosos fatores como raça, etnia e aspetos genéticos. A idade da menarca tem sido usada como preditor do Índice de Massa Corporal (IMC) na vida adulta, como fator de risco para algumas doenças, entre elas, o câncer de mama e, em associação com o desenvolvimento de doenças psiquiátricas como a depressão na vida adulta, entre outros. A adolescência, fase do ciclo vital comumente marcada pela ocorrência da menarca, é considerada um período de grandes desequilíbrios metabólicos e hormonais, que facilitam o desenvolvimento de doenças crônicas como a obesidade, especialmente nas meninas. No National Longitudinal Study of Adolescent Health, realizado nos Estados Unidos, mulheres com menarca precoce foram duas vezes mais propensas ao sobrepeso quando adultas. Em contraposição, segundo estudo da coorte de Bogulasa, a obesidade na vida adulta esteve mais relacionada com obesidade na infância que com a idade da menarca.

Abstract Depression is a common mental disorder in the Finnish population. There are several biological, psychological and social factors in the background of depression. The aim of this study was to investigate depression in association with birth weight, age at menarche, obesity and metabolic syndrome using data from the Northern Finland 1966 Birth Cohort. A large, prospectively collected general population-based birth cohort of originally 12058 liveborn children was used as study population. The database provided information on birth characteristics and features of the primary family. The follow-up studies were performed at the age of 14 years by postal inquiry, and at the age of 31 years by postal inquiry and clinical examination. Information on age at menarche and weight and height was obtained from the postal questionnaire at 14 and 31 years and clinical examination at 31 years. Data on abdominal obesity and metabolic syndrome were gathered from the clinical examination. Data on depressive symptoms measured by the Hopkins Symptom Checklist-25 (HSCL-25), self-reported physician-diagnosed lifetime depression and the use of antidepressants were gathered from the postal questionnaire at 31 years. Females with high birth weight and high ponderal index (index of the birth measures, kg/m3) had a higher risk of depressive symptoms at 31 years measured by the HSCL-25 compared with females with normal birth weight and ponderal index. Males with ponderal index belonging to the lowest 5 percentile had an increased risk for physician-diagnosed depression at 31 years. Females with late menarche (≥ 16 years) had an elevated risk of depression measured by the HSCL-25, the use of antidepressants and self-reported physician-diagnosed depression compared with females with menarche at 12–15 years. Obesity measured by BMI at 14 years increased the risk of depressive symptoms measured by the HSCL-25 at 31 years among both males and females. Females who were obese both at baseline and at follow-up had an increased risk of depressive symptoms, and the proportion of those who used antidepressants was higher among females who had gained weight compared to females who had stayed normal-weighted. Males with abdominal obesity measured by waist-to-hip ratio had an increased risk of depressive symptoms and physician-diagnosed depression, and the proportion of those who used antidepressants was higher compared with subjects without abdominal obesity. Abdominal obesity did not associate with depression in females. Metabolic syndrome did not associate with depression. The results indicate an increased risk of depression at 31 years in females with high birth weight, late menarche, adolescent obesity and weight gain and in males with adolescent obesity and abdominal obesity. / Tiivistelmä Depressio on yleinen mielenterveyden häiriö suomalaisväestössä. Depression taustalla on monia biologisia, psykologisia ja sosiaalisia tekijöitä. Tämän tutkimuksen tavoitteena oli tutkia depressiota selvittäen, onko syntymäpainolla, menarkeiällä, lihavuudella ja metabolisella oireyhtymällä yhteyttä depressioon Pohjois-Suomen vuoden 1966 syntymäkohorttiaineistossa. Tutkimusaineistoon kuului alun perin 12058 elävänä syntynyttä lasta. Tietokantaan oli jo aiemmin kerätty aineistoa syntymään ja primaariperheeseen liittyen. Kohortin jäsenten ollessa 14-vuotiaita tehtiin seurantatutkimus postikyselynä ja 31-vuotiaana tehtiin sekä postikysely että kliininen tutkimus. Tiedot menarkeiästä kerättiin 31-vuotispostikyselystä, paino- ja pituustiedot sekä 14- ja 31-vuotispostikyselyistä että kliinisen tutkimuksen tiedoista. Kliininen tutkimus sisälsi tiedot myös keskivartalolihavuuden ja metabolisen oireyhtymän määrittämiseksi. 31-vuotispostikyselyssä depressio-oireita kysyttiin HSCL-25 -oirekyselyllä; lisäksi kysyttiin, oliko lääkäri todennut aiemmin masennusta sekä oliko tutkittavilla käytössä masennuslääkkeitä. Naisilla, joiden syntymäpaino ja ponderaali-indeksi (syntymäpainon ja pituuden suhdetta kuvaava indeksi, kg/m3) oli korkea, depressio-oireiden riski 31-vuotiaana mitattuna HSCL-25:lla oli suurentunut verrattuna naisiin, joilla oli normaali syntymäpaino ja ponderaali-indeksi. Miehillä, joilla oli hyvin alhainen ponderaali-indeksi kuuluen alimpaan 5 % ryhmään, riski lääkärin toteamaan masennukseen oli suurentunut. Naisilla, joiden menarkeikä oli 16-vuotta tai myöhemmin, riski depressio-oireiden esiintyvyyteen, depressiolääkkeiden käyttöön ja lääkärin toteaman depression esiintyvyyteen oli suurentunut verrattuna naisiin, joiden menarkeikä oli 12–15-vuotta. Lihavuus 14-vuotiaana lisäsi masennusoireiden riskiä mitattuna HSCL-25:lla sekä 31-vuotiailla miehillä että naisilla. Naisilla, jotka olivat lihavia sekä 14- että 31-vuotiaana, masennusoireiden riski oli suurentunut. Naisilla, joiden paino oli noussut, masennuslääkkeitten käyttö oli yleisempää verrattuna naisiin, joilla paino oli pysynyt normaalina. Keskivartalolihavuus oli miehillä yhteydessä suurentuneeseen depressio-oireiden ja lääkärin toteaman masennuksen riskiin, ja he käyttivät yleisemmin masennuslääkkeitä verrattuna miehiin ilman keskivartalolihavuutta. Naisilla keskivartalolihavuus ei ollut yhteydessä masennukseen. Metabolinen oireyhtymä ei ollut yhteydessä masennukseen. Tulokset osoittavat korkean syntymäpainon, myöhäisen menarkeiän ja nuoruusiän lihavuuden sekä painon nousun lisäävän masennusriskiä 31-vuotiailla naisilla, 31-vuotiailla miehillä nuoruusiän lihavuus sekä keskivartalolihavuus olivat yhteydessä suurentuneeseen masennusriskiin.

The aim of this African culturally based research is to establish whether a group of unmarried pregnant teenage girls experience rejection during their period of pregnancy as well as to determine whether they experienced rejection for whatever reason before falling pregnant. Seen in the context of the communal and person-centred life view as upheld by the African culture where respect for and well-being of the individual within the tribal and extended family structure is paramount, one would expect that unmarried girls finding themselves in a precarious situation such as premature pregnancy would experience understanding, acceptance and support. The research is quantitative as well as qualitative. The quantitative research focuses on 341 grade 11-leamers at seven secondary schools in the Free State Province of Education as well as in the Gauteng Department of Education. Questionnaires were presented with the aim of establishing the reason for teenage pregnancy; to research the thoughts, feelings and actions of the peer group toward pregnant teenage girls; to determine the presence of feelings of rejection of a group of pregnant teenage girls at the same schools; to determine the thoughts the girls have about themselves as well as about the future. On account of the fact that that the responses of the pregnant girls seemingly contradicted the responses given by the grade 11-peer group sample it was decided to supplement the quantitative research result with a qualitative research investigation by means of focus group interviews conducted with twelve willing to participate pregnant girls at two ofthe secondary schools who voluntarily agreed to participate. The research result indicates that although the pregnant girls did not experience rejection before falling pregnant they did however experience rejection after falling pregnant, especially from the peer group at school, educators, and certain sections of society. Although the parents of these girls were initially offended and reluctant, their attitude toward the pregnancy changed to include acceptance and even support. / M.A. Psychology, North-West University, Vaal Triangle Campus, 2010

The aim of this African culturally based research is to establish whether a group of unmarried pregnant teenage girls experience rejection during their period of pregnancy as well as to determine whether they experienced rejection for whatever reason before falling pregnant. Seen in the context of the communal and person-centred life view as upheld by the African culture where respect for and well-being of the individual within the tribal and extended family structure is paramount, one would expect that unmarried girls finding themselves in a precarious situation such as premature pregnancy would experience understanding, acceptance and support. The research is quantitative as well as qualitative. The quantitative research focuses on 341 grade 11-leamers at seven secondary schools in the Free State Province of Education as well as in the Gauteng Department of Education. Questionnaires were presented with the aim of establishing the reason for teenage pregnancy; to research the thoughts, feelings and actions of the peer group toward pregnant teenage girls; to determine the presence of feelings of rejection of a group of pregnant teenage girls at the same schools; to determine the thoughts the girls have about themselves as well as about the future. On account of the fact that that the responses of the pregnant girls seemingly contradicted the responses given by the grade 11-peer group sample it was decided to supplement the quantitative research result with a qualitative research investigation by means of focus group interviews conducted with twelve willing to participate pregnant girls at two ofthe secondary schools who voluntarily agreed to participate. The research result indicates that although the pregnant girls did not experience rejection before falling pregnant they did however experience rejection after falling pregnant, especially from the peer group at school, educators, and certain sections of society. Although the parents of these girls were initially offended and reluctant, their attitude toward the pregnancy changed to include acceptance and even support. / M.A. Psychology, North-West University, Vaal Triangle Campus, 2010

INTRODUÇÃO: A puberdade reuni as mudanças físicas da adolescência como o crescimento pondoestatural e a evolução da maturação sexual. Um marco importante da puberdade no sexo feminino é a menarca. Para sua ocorrência é necessária a interação de múltiplos fatores, destacando-se por sua importância a condição nutricional, da qual faz parte um teor de gordura corporal suficiente para deflagrar não só a primeira menstruação, como também a manutenção dos ciclos menstruais regulares. OBJETIVOS: Este estudo avaliou a associação entre indicadores de estado nutricional (peso, estatura, circunferência braquial e índice de massa corpórea) e de maturidade (idade e maturação sexual) para ocorrência da menarca e avaliou a percepção da imagem corporal em relação a presença ou não deste evento. MÉTODOS: Trata-se de um estudo transversal, retrospectivo, observacional, de 98 adolescentes femininas, entre 10 e 19 anos, do subdistrito do Butantã, São Paulo, Brasil, que comparou dois grupos: as que apresentaram menarca até três meses antes da pesquisa (27) e as que ainda não haviam menstruado (71). Os dados são provenientes de um banco de dados, coletados na década de 80, mediante questionários padrão, em pesquisa domiciliar e fizeram parte de estudos anteriores. A variável resposta foi a menarca e as explanatórias foram peso, estatura, circunferência braquial e índice de massa corpórea, idade, desenvolvimento mamário, impressão da estatura e impressão da condição nutricional. O processamento e análise dos dados foi realizado no Departamento Materno- Infantil da Faculdade de Saúde Pública da Universidade de São Paulo, digitados em planilha Excel® e analisados pelo programa EpiInfo versão 3.5.3 CDC e WHO Anthro versão 3.2.2 OMS. As variáveis foram descritas através de suas distribuições, frequências, médias, desvios-padrão e medianas. Testes paramétricos e não paramétricos foram usados na dependência da distribuição normal ou não das variáveis. Os indicadores que apresentaram significância estatística nos modelos univariados e apresentaram baixa correlação entre si foram testados em modelo de regressão logística para controle das variáveis de confusão. A análise da percepção da autoimagem foi realizada pela correlação entre impressão da estatura e condição nutricional com classificação do referencial gráfico. RESULTADOS: Peso, estatura, circunferência braquial, índice de massa corpórea sempre foram superiores para adolescentes com menarca em relação às sem menarca (diferença estatisticamente significativa). A primeira menstruação ocorreu mais frequentemente no estágio de desenvolvimento M4 de Tanner, com média idade de 13,26 anos. Todas as variáveis estudadas se mostraram associadas à ocorrência da menarca nas análises univariadas. No modelo multivariado, o índice de massa corpórea se revelou o principal desencadeante da menarca. Mostraram-se também associados à primeira menstruação: o desenvolvimento mamário e a idade. Foi observada uma correlação positiva entre a percepção da imagem corporal e a classificação gráfica nas meninas com e sem menarca. CONCLUSÃO: O estado nutricional, traduzido pelo índice de massa corpórea, destacou-se como principal fator desencadeante para a ocorrência da menarca, mesmo frente aos indicadores neuroendócrinos e a idade, confirmando a relevância da força do ambiente sobre a herança. Não houve diferença da percepção da imagem corporal para meninas com e sem menarca / INTRODUCTION: Puberty gathers the physical changes of adolescence such as the growth spurt and evolution of sexual maturation. An important biologic mark of puberty in females is menarche. For its occurrence an interaction of multiple factors are required, mainly the nutritional status whose body fat, depending on its amount, might trigger not only the first period, but also the maintenance of regular menstrual cycles. OBJECTIVES: This study evaluated the association between indicators of nutritional status (weight, height, arm circumference and body mass index) and maturity (age and sexual maturity) for the occurrence of menarche and it assessed the perception of body image compared with the presence or absence of this event. METHODS: It is a cross-sectional, retrospective, observational study of 98 female adolescents between 10 and 19 years old, in the sub-district of Butantan, Sao Paulo, Brazil, which compared two groups: those that had menarche up to three months before the survey (27) and those that had not menstruated (71). The data come from a database, collected in 80, through standard questionnaires on household survey. These data have already been part of previous studies. The variable response was the menarche, and the explanatory variables were weight, height, arm circumference, body mass index, age and breast development, height perception and nutritional status perception. The processing and analysis of data were performed in the Department of Maternal and Child School of Public Health, University of São Paulo, typed in Excel ® spreadsheet and analyzed by using EpiInfo version 3.5.3 CDC and WHO Anthro version 3.2.2 WHO. The variables were described according to their distributions, frequencies, means, standard deviations and medians. Parametric and non-parametric tests were used depending on the normal distribution of the variables or not. The indicators that showed statistical significance in the univariate models and showed low correlation between them were tested in a logistic regression model for the control of the confusion variables. The analysis of the perception of selfimage was performed by correlation between height and nutritional status perception with reference graph. RESULTS: Weight, height, arm circumference, body mass index were always higher for the adolescents who had menarche than for those who did not (statistically significant difference). The first period occurred more often in adolescents in stage of breast development M4, at the mean age of 13.26. In univariate analysis, all variables were associated with the occurrence of menarche. In the final model of logistic regression the body mass index was the main trigger of menarche. The other variables associated with the menarche were: breast development and age. It was a positive correlation between the perception of body image and graphical classification in girls with and without menarche. CONCLUSIONS: The nutritional status, reflected by body mass index, stood out as the main triggering factor for the occurrence of menarche, even against neuroendocrine indicators and age, confirming the relevance of the strength of the environment on the inheritance. There was no difference in the perception of body image for girls with and without menarche