Researchers from the School of Public Health and Tropical Medicine at Tulane University in the United States have explored how the age at which adolescence begins can influence long-term health outcomes. Their analysis suggests that an early onset of menstruation, specifically before the age of 13, is associated with a higher likelihood of developing type 2 diabetes later in life. The findings were reported in a study published in the British Medical Journal (BMJ) and contribute to a growing body of evidence on how early hormonal exposure may shape cardiometabolic risk across adulthood.
The study enrolled 17,377 women aged between 20 and 65 years and collected information about the age of menarche, or first menstrual period. Researchers categorized participants into groups based on the age at which menstruation began and compared the prevalence of type 2 diabetes across these groups. Within the study cohort, 1,773 women, or about 10%, had type 2 diabetes, providing a substantial sample to examine potential associations between early puberty and metabolic outcomes.
Analyses accounted for a wide range of potential confounding factors, including age, ethnicity, education level, parity, menopausal status, family history of diabetes, physical activity, alcohol use, lifestyle behaviors, and body weight. After adjusting for these variables, the link between early menarche and diabetes risk remained evident, suggesting that early hormonal exposure may independently contribute to later diabetes risk.
Quantifying the risk, the study found that women who began menstruating at age 10 or younger had a markedly higher probability of developing type 2 diabetes, with an estimated increase of about one-third compared with those who started later. Women whose menarche occurred at ages 11–12 exhibited a substantially elevated risk as well, though not as large as the youngest group. In addition to the diabetes connection, the data indicated that early menarche was associated with a more than twofold increase in the risk of stroke for women with diabetes who were under 65 years old, pointing to broader cardiometabolic implications linked to the timing of puberty.
Experts have proposed that earlier puberty exposes the body to estrogen over a longer period, which may influence metabolic pathways related to glucose regulation, fat distribution, and vascular health. These mechanisms, while plausible, are not yet fully understood, and researchers emphasize the need for further investigation to clarify how early hormonal development interacts with lifestyle and genetic factors to shape disease risk. The findings underscore the importance of early life and adolescent health in shaping adult outcomes and may inform public health strategies focused on risk assessment and prevention in women as they age.
Overall, the Tulane study adds a meaningful piece to the puzzle of how timing in puberty relates to later health. By recognizing early menarche as a potential marker of increased metabolic risk, clinicians and researchers can work toward more targeted screening and interventions that address the unique needs of women who experience puberty earlier than their peers. Continued study is needed to determine the most effective ways to mitigate these risks and to understand how interventions during adolescence might alter long-term trajectories for cardiometabolic disease.