title: Menarche, menstrual problems and suicidal behavior in Chinese adolescents.
abstract: Menarche is the first menstrual cycle. Menstrual problems, such as dysmenorrheal menorrhagia, oligomenorrhea, and irregular cycle are common in female adolescents. This research aims to examine the associations between age at menarche and menstrual problems and suicidal behavior among Chinese female adolescents.
  
  
  
  An epidemiological survey of 5831 female adolescents from eight high schools of three counties of Shandong province, China, was conducted. A self-administered paper-and-pencil questionnaire was used to collect information. Logistic regression analyses were used to examine the association between menstruation and suicidality.
  
  
  
  The mean age of the sample was 15.02 (SD=1.44) years. Of the sample, 5,231 (90.0%) had experienced their first menstrual cycle, and 23.2%, 10.4%, and 4.5% of the sample reported having had suicidal ideation, plan and attempt, respectively. In multivariate models, menarche at ≤11 years was associated with increased risk of suicidal ideation (OR=1.41, 95%CI: 1.10-1.81) and menarche at 12 years was associated with suicide plan (OR=1.23, 95%CI: 1.00-1.51). Irregular menstrual cycle was significantly associated with increased risk of suicidal ideation (OR=1.40, 95%CI: 1.05-1.86) and menstrual period less than or equal to 4 days was significantly associated with increased risk of suicide plan (OR=1.32, 95%CI: 1.06-1.66).
  
  
  
  This cross-sectional study cannot establish the causal directions between menstrual problems and suicidality in adolescents.
  
  
  
  Our study suggests that earlier menarche, irregular menstrual cycle and short menstrual period are associated with suicidal behavior in female adolescents. Further research is warranted to examine the causal relationship between menstrual problems and suicidal behavior in adolescents.
authors.affiliation: Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China.
authors.forename: Xin-Ting
authors.initials: XT
authors.lastname: Wang
authors.affiliation: Centers for Disease Control and Prevention of Lijin County, Lijin, China.
authors.forename: Qi-Gui
authors.initials: QG
authors.lastname: Bo
authors.affiliation: Centers for Disease Control and Prevention of Yanggu County, Yanggu, China.
authors.forename: Dao-Ming
authors.initials: DM
authors.lastname: Zhang
authors.affiliation: Centers for Disease Control and Prevention of Zoucheng County, Zoucheng, China.
authors.forename: Zhen-Biao
authors.initials: ZB
authors.lastname: Qi
authors.affiliation: Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China; The University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Xianchen
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China. Electronic address: jiacunxian@sdu.edu.cn.
authors.forename: Cun-Xian
authors.initials: CX
authors.lastname: Jia
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D044466:Asian People; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008572:Menarche / Q000523:psychology*; D008598:Menstruation / Q000523:psychology; D008599:Menstruation Disturbances / Q000523:psychology*; D009483:Neuropsychological Tests; D010290:Parents; D057566:Self Report; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide; D013406:Suicide, Attempted / Q000523:psychology*
keywords: Adolescents; Menarche; Menstruation; Suicide