title: A systematic review and meta-ethnography of the qualitative literature: experiences of the menarche.
abstract: OBJECTIVE
  This article is a report of a systematic review and meta-ethnography of women's experience of menarche.
  
  
  BACKGROUND
  Adolescents may experience menarche at different ages, but menarche remains an important milestone in the female maturation process, representing the transition from childhood to womanhood.
  
  
  METHODS
  Systematic review and meta-ethnography.
  
  
  METHODS
  Electronic databases were systematically searched and supplemented with reference lists searching. Qualitative studies of women's experience of menarche were purposely selected and questions proposed by the critical appraisal skills programme was adapted and used to assess papers prior to synthesis. Key themes and concepts were extracted and synthesised using meta-ethnography.
  
  
  RESULTS
  Fourteen studies on menarche experience were identified. The majority of studies were descriptive. Five key concepts were identified from all 14 papers as being descriptive of women's experience of menarche. These included: menarche preparation, significant others' response to menarche, physical experience of menarche, psychological experience of menarche and social-cultural perspective of menarche.
  
  
  CONCLUSIONS
  Menarche experience had a major impact on women. Women went through physical, psychological and social-culture changes when their first menstrual flow came. Menarche preparation has been shown to have a beneficial impact on the menarcheal woman. School nurses have accurate knowledge about sexual health; they can and should provide appropriate menstrual education.
  
  
  CONCLUSIONS
  The findings can be used by school nurses working with adolescents as the basis for a framework of intervention strategies directed towards helping adolescents to better accept their menarche and transition into womanhood.
authors.affiliation: Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan. yuting@tccn.edu.tw
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chang
authors.forename: Mark
authors.initials: M
authors.lastname: Hayter
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D008572:Menarche / Q000523:psychology