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  • Nai-Peng Tey (a1), Siow-Li Lai (a1) and Sor-Tho Ng (a1)


There has been a secular decline in age at menarche since the 19th century. Early-maturing women are more likely to have their sexual debut at a younger age, which in turn gives rise to a host of reproductive health and social problems. This study used data from five waves of National Demographic and Health Surveys conducted in the Philippines between 1993 and 2013 to examine the trends and socioeconomic differentials in age at menarche and sexual debut. The changing trend in age at menarche and sexual debut was examined across birth cohorts, and logistic regressions were used to identify the determinants of early sexual debut. In the Philippines, the mean and median ages at menarche declined from 13.2 years and 12.6 years, respectively, among young women born in 1973–1977, to 12.9 years and 12.3 years, respectively, among those born in 1993–1997. The proportion who had their sexual debut by age 20 increased from 41.2% for the 1968–1972 birth cohort to 53.4% for the 1988–1992 birth cohort. Filipino women with low education, from poor families and living in rural areas were more likely to have earlier sexual debut despite attaining menarche at a later age as compared with their higher educated counterparts, and those from wealthier families and urban areas. Logistic regression analysis showed that, besides marital status, women’s education and age at menarche were important determinants of early sexual debut. However, ethnicity, place of residence and family wealth had no significant effects on age at menarche. An increasing proportion of young women were found to be having unprotected sexual debut and at a younger age, with health and social ramifications. Hence, apart from increasing the enrolment of girls in schools and discouraging teenage marriage, there is a need for social and health agencies to implement appropriate adolescent sexual and reproductive health programmes such as counselling and educational campaigns, as well as support services, to address sexual problems among the youth.


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Abma, J., Chandra, A., Mosher, W., Peterson, L. & Piccinino, L. (1997) Fertility, family planning, and women’s health: new data from the 1995 National Survey of Family Growth. National Center for Health Statistics. Vital Health Statistics 23(19), 1114.
Adair, L. S. (2001) Size at birth predicts age at menarche. Pediatrics 107(4), E59.
Agardh, A., Tumwine, G. & Ostergren, P.-O. (2011) The impact of socio-demographic and religious factors upon sexual behavior among Ugandan university students. PLoS One 6(8), doi: 10.1371/journal.pone.0023670.
Anderson, S. E. & Must, A. (2005) Interpreting the continued decline in the average age at menarche: results from two nationally representative surveys of US girls studies 10 years apart. Journal of Pediatrics 147, 753760.
Baldwin, M. K. & Jensen, J. T. (2013) Contraception during the perimenopause. Maturitas 76(3), 235242.
Barbalat, G., Domenech, P., Vernet, M. & Fourneret, P. (2010) Approche neuroe ́conomique de la prise de risque a` l’adolescence. Encephale 36(2), 147154.
Baumgartner, J. N., Geary, C. W., Tucker, H. & Wedderburn, M. (2009) The Influence of early sexual debut and sexual violence on adolescent pregnancy: a matched case-control study in Jamaica. International Perspectives on Sexual and Reproductive Health 35(1), 2128.
Bellis, M. A., Downing, J. & Ashton, J. A. (2006) Adults at 12? Trends in puberty and their public health consequences. Journal of Epidemiology and Community Health 60, 910911.
Bodzsar, E. B. & Susanne, C. (1998) Secular Growth Changes in Europe. Eotvos University Press, Budapest, Hungary.
Boileau, C., Clark, S., Bignami-Van Assche, S., Poulin, M., Reniers, G., Watkins, S. C. et al. (2009) Sexual and marital trajectories and HIV infection among ever-married women in rural Malawi. Sexually Transmitted Infections 85 (Supplement 1), i27i33.
Cabato, R. (2017) Supreme Court asks for proof of contraceptive safety; FDA to comply. CNN Philippines, Metro, Manila.
Charlton, B. M., Corliss, H. L., Missmer, S. A., Rosario, M., Spiegelman, D. & Austin, S. B. (2013) Sexual orientation differences in teen pregnancy and hormonal contraceptive use: an examination across 2 generations. American Journal of Obstetrics and Gynecology 209(3), 204.e201204.e208.
Cooper, R., Blell, M., Hardy, R., Black, S., Pollard, T. M., Wadsworth, M. E. et al. (2006) Validity of age at menarche self‐reported in adulthood. Journal of Epidemiology and Community Health 60(11), 993997.
Crockett, L. J., Bingham, C. R., Chopak, J. S. & Vicary, J. R. (1996) Timing of first sexual intercourse: the role of social control, social learning, and problem behavior. Journal of Youth and Adolescence 25(1), 89111.
Degraaf, H., Vanwesenbeeck, I. & Meijer, S. (2015) Educational differences in adolescents’ sexual health: a pervasive phenomenon in a national Dutch sample. Journal of Sex Research 52(7), 747757.
Deligeoroglou, E., Christopoulos, P. & Creatsas, G. (2004) Pregnancy and abortion in Greek adolescent gynecologic clinics. Akusherstvo i ginekologiia 43 (Supplement 4), 3740.
Demographic and Health Surveys (2009) Measure DHS: Quality Information to Plan, Monitor, and Improve Population, Health, and Nutrition Programs. ICF Macro, Calverton, USA.
Downing, J. & Bellis, M. A. (2009) Early pubertal onset and its relationship with sexual risk taking, substance use and anti-social behaviour: a preliminary cross-sectional study. BMC Public Health 9, 446456.
Eaton, D. K., Kann, L., Kinchen, S., Shanklin, S., Flint, K. H., Hawkins, J. et al. (2012) Youth Risk Behaviour Surveillance – United States, 2011. Morbidity and Mortality Weekly Report (MMWR) 61(4).
Family Health International (2010) Young People Most at Risk of HIV. A meeting report and discussion paper from the Interagency Youth Working Group US Agency for International Development, the Joint United Nations Programme on HIV/AIDS (UNAIDS) Inter-Agency Task Team on HIV and Young People, and FHI. FHI Research Triangle Park, NC, USA.
Feng, Y., Hong, X., Wilker, E., Li, Z., Zhang, W., Jin, D. et al. (2008) Effects of age at menarche, reproductive years and menopause on metabolic risk factors for cardiovascular diseases. Atherosclerosis 196(2), 590597.
Finer, L. B. (2007) Trends in premarital sex in the United States, 1954–2003. Public Health Reports 122(1), 7378.
Fox, K. M., Magaziner, J., Sherwin, R., Scott, J. C., Plato, C. C., Nevitt, M. & Cummings, S. (1993) Reproductive correlates of bone mass in elderly women. Study of Osteoporotic Fracture Research Group. Journal of Bone and Mineral Research 8(8), 901908.
Gaudineau, A., Ehlinger, V., Vayssiere, C., Jouret, B., Arnaud, C. & Godeau, E. (2010) Factors associated with early menarche: results from the French Health Behaviour in School-aged Children (HBSC) study. BMC Public Health 10, 175181.
Gilger, J. W., Geary, D. C. & Eisele, L. M. (1991) Reliability and validity of retrospective self-reports of the age of pubertal onset using twin, sibling and college student data. Adolescence 26(101), 4153.
Gluckman, P. D. & Hanson, M. A. (2006) Changing times: the evolution of puberty. Molecular and Cell Endocrinology 254–255, 2631.
Glynn, J. R., Kayuni, N., Floyd, S., Banda, E., Francis-Chizororo, M., Tanton, C. et al. (2010) Age at menarche, schooling, and sexual debut in northern Malawi. PLoS One 5(12), e15334.
Goodson, P., Evans, A. & Edmundson, E. (1997) Female adolescents and onset of sexual intercourse: a theory-based review of research from 1984 to 1994. Journal of Adolescent Health 21, 147156.
Guo, W., Wu, Z., Qiu, Y., Chen, G. & Zheng, X. (2012) The timing of sexual debut among Chinese youth. International Perspectives on Sexual and Reproductive Health 38(4), 196204.
Halpern, C. T. (2006) Integrating hormones and other biological factors into a developmental systems model of adolescent female sexuality. In Diamond, L. M. (ed.) Rethinking Positive Adolescent Female Sexual Development. New Directions for Child and Adolescent Development. Jossey-Bass San Francisco, CA, pp. 922.
Haynie, D. L. (2003) Contexts of risk? Explaining the link between girls’ pubertal development and their delinquency involvement. Social Forces 82(1), 355397.
Heidi, D. H. (1986) Menarcheal age in Europe. Yearbook of Physical Anthropology 29, 81112.
Herman-Giddens, M. E. (2006) Recent data on pubertal milestones in United States children: the secular trend toward earlier development. International Journal of Andrology 29, 241246.
Herrin, A. N. (2007) Development of the Philippines’ family planning program: the early years, 1967–80. In Robinson, W. C. & Ross, J. A. (eds) The Global Family Planning Revolution: Three Decades of Population Policies and Programs. World Bank, Washington, DC, pp. 277298.
Hillard, P. J. (2005) Contraceptive behaviors in adolescents. Pediatric Annals 34(10), 794802.
Hossain, M. G., Wee, A.-S., Ashaie, M. & Kamarul, T. (2013) Adult anthropometric measures and socio-demographic factors influencing age at menarche of university students in Malaysia. Journal of Biosocial Science 45(5), 705717.
Huen, K. F., Leung, S. S., Lau, J. T., Cheung, A. Y., Leung, N. K. & Chiu, M. C. (1997) Secular trend in the sexual maturation of southern Chinese girls. Acta Paediatrica 86(10), 11211124.
Kirby, D. (2002) The impact of schools and school programs upon adolescent sexual behavior. Journal of Sex Research 39(1), 2733.
Koo, M. M. & Rohan, R. E. (1997) Accuracy of short-term recall of age at menarche. Annals of Human Biology 24(1), 6164.
Kozal, M. J., Amico, K. R., Chiarella, J., Cornman, D., Fisher, W., Fisher, J. & Friedland, G. (2006) A population-based and longitudinal study of sexual behavior and multidrug-resistant HIV among patients in clinical care. Medscape General Medicine 8(2), 72.
Langille, D. B. & Curtis, L. (2002) Factors associated with sexual intercourse before age 15 among female adolescents in Nova Scotia. Canadian Journal of Human Sexuality 11, 9199.
Lenciauskiene, I. & Zaborskis, A. (2008) The effects of family structure, parent–child relationship and parental monitoring on early sexual behaviour among adolescents in nine European countries. Scandinavian Journal of Public Health 36(6), 607618.
Liang, W. & Chikritzhs, T. (2013) Errors in recall of age at first sex. PLoS One 8(8), doi: 10.1371/journal.pone.0072947.
MacQuarrie, K. L. D. (2014) Unmet need for family planning among young women – levels and trends. DHS Comparative Report No. 34, USAID.
Magnusson, D., Strattin, H. & Allen, V. L. (1985) Biological maturation and social development: a longitudinal study of some adjustment processes from mid-adolescence to adulthood. Journal of Youth and Adolescence 14, 267283.
Maslyanskaya, S., Coupey, S. M., Chhabra, R. & Khan, U. I. (2016) Predictors of early discontinuation of effective contraception by teens at high risk of pregnancy. Journal of Pediatric and Adolescent Gynecology 29(3), 269275.
Mauldon, J. & Luker, K. (1996) The effects of contraceptive education on method use at first intercourse. Family Planning Perspectives 28(1), 1924.
Mbalinda, S., Kiwanuka, N., Eriksson, L., Wanyenze, R. & Kaye, D. (2015) Correlates of ever had sex among perinatally HIV-infected adolescents in Uganda. Reproductive Health 12(96), 110.
Measure DHS (2011) Measure Demographic and Health Surveys. Measure Demographic and Health Surveys, Calverton, MD, USA.
Mishra, G. D., Cooper, R., Tom, S. E. & Kuh, D. (2009) Early life circumstances and their impact on menarche and menopause. Women’s Health 5(2), 175190.
Moronkola, O. A. & Oyebami, O. (2007) Age at menarche, menstrual patterns, sexual health knowledge, attitudes and premarital sexual partners of female athletes in Ibadan, Nigeria. East African Journal of Public Health 4(2), 5154.
Morris, J. L. & Rushwan, H. (2015) Adolescent sexual and reproductive health: the global challenges. International Journal of Gynecology & Obstetrics 131 (Supplement 1), S40S42.
Mueller, T., Gavin, L. & Kulkarni, A. (2008) The association between sex education and youth’s engagement in sexual intercourse, age at first intercourse, and birth control use at first sex. Journal of Adolescent Health 42, 8996.
Mulugeta, Y. & Berhane, Y. (2014) Factors associated with pre-marital sexual debut among unmarried high school female students in bahir Dar town, Ethiopia: cross-sectional study. Reproductive Health 11(40), 16.
National Statistics Office & ICF Macro (2009) National Demographic and Health Survey 2008. National Statistics Office [Philippines] and ICF Macro, Calverton, MD, USA.
National Statistics Office & ICF Macro (2014) National Demographic and Health Survey 2013. National Statistics Office [Philippines] and ICF Macro, Calverton, MD, USA.
Negriff, S., Susman, E. J. & Trickett, P. K. (2011) The developmental pathway from pubertal timing to delinquency and sexual activity from early to late adolescence. Journal of Youth Adolescence 40, 13431356.
O’Donnell, L., O’Donnell, C. R. & Stueve, A. (2001) Early sexual initiation and subsequent sex-related risks among urban minority youth: the reach for health study. Family Planning Perspectives 33(5), 268275.
Okigbo, C., Kabiru, C., Mumah, J., Mojola, S. & Beguy, D. (2015) Influence of parental factors on adolescents’ transition to first sexual intercourse in Nairobi, Kenya: a longitudinal study. Reproductive Health 12(73), 112.
Onland-Moret, N. C., Peeters, P. H. M., Van Gils, C. H., Clavel-Chapelon, F., Key, T., Tjønneland, A. et al. (2005) Age at menarche in relation to adult height: the EPIC study. American Journal of Epidemiology 162(7), 623632.
Parent, A. S., Teilmann, G. J., Juul, A., Skakkebaekn, N. E., Toppari, J. & Bourguignon, J. P. (2003) The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocrine Reviews 24(5), 668693.
Remsberg, K. E., Demerath, E. W., Schubert, C. M., Chumlea, W. C., Sun, S. S. & Siervogel, M. (2005) Early menarche and the development of cardiovascular disease risk factors in adolescent girls: the Fels Longitudinal Study. Journal of Clinical Endocrinology & Metabolism 90(5), 27182724.
Riley, A. P. (1994) Determinants of adolescent fertility and its consequences for maternal health, with special reference to rural Bangladesh. Annals of the New York Academy of Sciences 709, 86100.
Simmons, R. G. & Blythe, D. A. (1987) Moving into Adolescence: The Impact of Pubertal Change and School Context. Aldine De Gruyter, New York.
Smith, C. (1997) Factors associated with early sexual activity among urban adolescents. Social Work 42, 334346.
Stattin, H. & Magnusson, D. (1990) Pubertal maturation in female development. In Magnsson, D. (ed.) Paths Through Life. Erlbaum Hillsdale, NJ, USA.
Steinberg, L. (2005) Cognitive and affective development in adolescence. Trends in Cognitive Science 9(2), 6974.
Talma, H., Schonbeck, Y., Dommelen, P. V., Bakker, B., Buuren, S. V. & Hirasing, R. A. (2013) Trends in menarcheal age between 1955 and 2009 in the Netherlands. PLoS One 8(4), doi: 10.1371/journal.pone.0060056.
Teitler, J. O. (2002) Trends in youth sexual initiation and fertility in developed countries: 1960-1995. Annals of the American Academy of Political and Social Science 580, 134152.
Tuppurainen, M., Kroger, H., Saarikoski, S., Honkanen, R. & Alhava, E. (1995) The effect of gynecological risk factors on lumbar and femoral bone mineral density in peri- and postmenopausal women. Maturitas 21(2), 137145.
Udry, J. R., Billy, J. O., Morris, N. M., Groff, T. R. & Raj, M. H. (1985) Serum androgenic hormones motivate sexual behavior in adolescent boys. Fertility and Sterility 43, 9094.
United Nations Development Programme (2014) Human Development Report 2014: Sustaining Human Progress; Reducing Vulnerabilities and Building Resilience. United Nations Development Programme, New York, USA.
UNAIDS (2010) Young People are Leading the HIV Prevention Revolution. UNAIDS. URL:
United Nations Development Programme (1994) Report of the International Conference on Population and Development in Cairo, 5–13th September 1994. United Nations, New York.
United Nations (2013) World Population Policies 2013. United Nations, New York.
Weinstock, H., Berman, S. & Cates, W. (2004) Sexually transmitted illnesses among American youth: incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health 36, 610.
Wellings, K. & Field, B. (1996) Sexual behaviour in young people. Bailliere’s Clinical Obstetrics and Gynaecology 10, 139160.
Whatley, J., Thin, N., Reynolds, B. & Blackwell, A. (1989) Problems of adolescents’ sexuality. Journal of the Royal Society of Medicine 82(12), 732734.
World Bank (2015) Data: Country and Lending Groups. World Bank, Washington, DC.
Wronka, I. & Pawlinska-Chmara, R. (2005) Menarcheal age and socioeconomic factors in Poland. Annals of Human Biology 32(5), 630638.
Zink, T. & Shireman, T. (2000) Teen compliance with contraception. Analysis of the Ohio Medicaid claims data. Journal of Pediatric and Adolescent Gynecology 13(2), 97.


  • Nai-Peng Tey (a1), Siow-Li Lai (a1) and Sor-Tho Ng (a1)


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