Going Through the Rites of Passage: Timing and Transition of Menarche, Childhood Sexual Abuse, and Anxiety Symptoms in Girls

Menarche is a discrete, transitional event that holds considerable personal, social, biological, and developmental significance. The present longitudinal study examined both the transition and timing of menarche on the trajectory of anxiety in girls with histories of childhood maltreatment (N = 93; 63% European American, 14% multiracial, 10% Latino, 9% African American, and 4% Native American). We hypothesized that because menarche is a novel, unfamiliar experience, girls would show greater anxiety around the time of menarche. The anxiety-provoking nature of menarche may be accentuated among earlier-maturing girls and girls with histories of childhood sexual abuse. Results indicated that earlier-maturing girls were more anxious in the pre- and peri-menarche periods than their later-maturing peers; however, their anxiety declined after menarche. Childhood sexual abuse was associated with heightened anxiety throughout this transition. The developmental significance of the timing and transition of menarche in relation to childhood sexual abuse and anxiety is discussed

Predictive value of basal follicle-stimulating hormone concentrations in a general subfertility population

Objective: To assess the predictive value of elevated basal FSH concentrations during the initial subfertility workup with respect to fecundity in a general subfertility population with ovulatory menstrual cycles.Design: Nested case-control study.Setting: Fertility center of a university hospital.Patient(s): Fifty subfertile women with basal FSH levels &gt;10.0 IU/L and 50 age-matched controls.Intervention(s): Long-term follow-up (3-7 years).Main Outcome Measure(s): Pregnancies, deliveries, and time to pregnancy.Result(s): Patients with elevated basal FSH levels and controls were comparable with regard to basic characteristics, clinical diagnoses, and subfertility treatment. Long-term follow-up showed that 52% of the women with elevated basal FSH concentrations became pregnant (positive predictive value 48%) versus 62% of the controls, and 42% versus 46% eventually delivered a child, respectively. The mean time to pregnancy was 3.0 years in the elevated-FSH group and 3.4 years in controls. Most of the pregnancies in both groups occurred after spontaneous conceptions.Conclusion(s): The results of this study suggest that screening for elevated basal FSH concentrations is of no additional value in a general subfertility population with ovulatory menstrual cycles. (Fertil Steril(R) 2000;74: 97-103. (C) 2000 by American Society for Reproductive Medicine.)</p