The Increase in Early Menarche is Associated with the Increase of Chronic Back Pain in Female Adolescents: The HBSC Study 2002-2014.

Objective: Research has shown that there has been an increase in the prevalence of chronic back pain in adolescents, especially in female adolescents. The purpose of the current study was to test the hypothesis that the observed increase in the prevalence of early menarche in female adolescents is contributing to the increase in the prevalence of chronic back pain over time in this population.

Methods: Cross-sectional data from 251,390 female adolescents from 27 countries/regions were drawn from the Health Behaviour in School-aged Children questionnaire-based surveys conducted in 2002, 2006, 2010 and 2014. The Karlson-Holm-Breen method was used to examine the explanatory role of the increase in the prevalence of early menarche on the increase in the prevalence of chronic back pain whilst controlling for socioeconomic status, physical activity, body mass index, and psychological symptoms.

Results: The increase in the prevalence of early menarche between 2002 and 2014 was associated with the increase in the prevalence of chronic back pain (P<0.001). The percent of chronic back pain prevalence increase accounted for by the increase in early menarche was 2.2%.

Conclusions: The increase in the prevalence of chronic back pain in female adolescents observed over the last decade may be explained, in part, by the decrease in the age of menarche. This finding, coupled with research showing a decline in early menarche worldwide, highlights the need to delve deeper into the underlying mechanisms of the association between early menarche and pain ‒ particularly chronic back pain ‒ in female adolescents.