{"paper_id":"2c21103e-129b-458e-8c6d-a23a6bc7c744","body_text":"Abstract\nPurpose\nThe relationship between menarche age and endometriosis has been studied extensively; however, the results were inconsistent due to differences in study dates, populations, and methodology. The goal of this meta-analysis was to see how different research populations, dates, and types affected the estimated risk of endometriosis in early menarche.\nMethods\nThe terms “endometriosis”, “early menarche”, and other pertinent terms were searched in PubMed, Medline, and Embase. This meta-analysis comprised 16 papers published between 2000 and 2020, with a start year ranging from 1989 to 2017. Random effects were used to examine endometriosis risks in these articles. Study start years, countries, types (case–control and cohort studies), and quality (Newcastle–Ottawa scale, NOS) were all taken into account in further stratified analysis and meta-regression analyses.\nResults\nEarly menarche (< 12 years) was associated with a significant pooled risk of endometriosis with high heterogeneity (OR = 1.34, 95% CI 1.16–1.54, I2 = 72.0%). Stratified analysis showed that this risk was increased in studies started after 2000 (OR = 1.62, 95% CI 0.96–1.35, I2 = 74.4%), compared to those before 2000 (OR = 1.13, 95% CI 1.16–1.54, I2 = 40.7%); additionally, this risk was higher in low-income countries (OR = 2.11, 95% CI 1.55–2.87, I2 = 0%) than in other countries (OR = 1.25, 95% CI 1.09–1.43, I2 = 70.6%). These results were further confirmed by meta-regression analysis (both P values < 0.1). No significant differences were found between different study types and NOS scores.\nConclusion\nOur results suggested an increasing risk of endometriosis with early menarche, which was more noticeable in low-income countries. Large-scale studies are warranted.\nSimilar content being viewed by others\nAvailability of data and materials\nNot applicable.\nCode availability\nNot applicable.\nReferences\nArmour M, Lawson K, Wood A, Smith CA, Abbott J (2019) The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: a national online survey. PLoS ONE 14:e0223316. https://doi.org/10.1371/journal.pone.0223316\nRoomaney R, Kagee A (2018) Salient aspects of quality of life among women diagnosed with endometriosis: a qualitative study. 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Ann N Y Acad Sci 955:11. https://doi.org/10.1111/j.1749-6632.2002.tb02761.x\nPierce MB, Leon DA (2005) Age at menarche and adult BMI in the Aberdeen children of the 1950s cohort study. Am J Clin Nutr 82:733. https://doi.org/10.1093/ajcn/82.4.733\nFunding\nThis work was supported by Research Foundation of Shenzhen Baoan Women’s and Children’s Hospital, Jinan University to BL (BAFY 2020005).\nAuthor information\nAuthors and Affiliations\nContributions\nMYL: data collection, data analysis, and manuscript writing. JLN: data collection and data analysis. BL: protocol/project development and manuscript writing/editing.\nCorresponding author\nEthics declarations\nConflict of interests\nThe authors have no conflicts of interest to declare.\nEthics approval\nNot applicable.\nConsent to participate\nNot applicable.\nConsent for publication\nThis manuscript is approved by all the authors for publication.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nElectronic supplementary material\nBelow is the link to the electronic supplementary material.\n404_2022_6541_MOESM1_ESM.jpg (download JPG )\nSupplementary file1 Linear analysis between NOS score and log(OR) for 16 included studies. NOS, Newcastle-Ottawa scale. Circle size means the reported OR and its 95% CI. Red Line and grey band means the predicted OR and its 95% CI (JPG 92 KB)\n404_2022_6541_MOESM2_ESM.jpg (download JPG )\nSupplementary file2 Meta-analysis of included studies presented by the subgroups of study countries: Asia & Africa vs. Europe & Oceania vs. North America (JPG 199 KB)\n404_2022_6541_MOESM3_ESM.jpg (download JPG )\nSupplementary file3 Meta-analysis of included studies presented by the subgroups of study area: low-income countries vs. others (JPG 172 KB)\n404_2022_6541_MOESM4_ESM.jpg (download JPG )\nSupplementary file4 Meta-analysis of included studies presented by the subgroups of study type: Case-control studies vs. Cohort studies (JPG 174 KB)\n404_2022_6541_MOESM5_ESM.jpg (download JPG )\nSupplementary file5 Meta-analysis of included studies presented by the subgroups of NOS score: ≤5 vs. >5. NOS, Newcastle-Ottawa scale (JPG 181 KB)\n404_2022_6541_MOESM6_ESM.png (download PNG )\nSupplementary file6 Funnel plot of the publication bias in this meta-analyses. (A)Funnel plot with pseudo 95% CI of 16 included studies. (B), Begg’s test for small-study effects (PNG 88 KB)\n404_2022_6541_MOESM9_ESM.jpg (download JPG )\nSupplementary file9 Forest plot of the association between early menarche and endometriosis in studies with different quality on the ascertainment of exposure (age at menarche): 2(top), studies with poor quality on the ascertainment of exposure. 1(bottom), and studies with higher quality on the ascertainment of exposure (JPG 179 KB)\n404_2022_6541_MOESM10_ESM.jpg (download JPG )\nSupplementary file10 Forest plot of the association between early menarche and endometriosis in 13 included studies, when removing 3 studies with inadequately controlled for potential confounders (JPG 164 KB)\nAppendix\nAppendix\n-\nA.\nPRISMA 2009 CHECKLIST Online Supplementary Material.\n-\nB.\nMOOSE CHECKLIST Online Supplementary Material.\nRights and permissions\nAbout this article\nCite this article\nLu, MY., Niu, JL. & Liu, B. The risk of endometriosis by early menarche is recently increased: a meta-analysis of literature published from 2000 to 2020. Arch Gynecol Obstet 307, 59–69 (2023). https://doi.org/10.1007/s00404-022-06541-0\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-022-06541-0","source_license":"CC0","license_restricted":false}