Typical Age Range for Menarche
The typical age of menarche (first menstrual period) is approximately 12-13 years, with a mean age of 12.8 years in contemporary populations. 1, 2
Normal Age Range and Timing
Menarche typically occurs between ages 11-13 years in healthy girls, with the median age at menarche estimated at 12.93 years (95% CI: 12.89-12.98) in recent British cohort data. 3
The mean age for onset of menstruation is reported as 12.8 years across multiple populations. 2
By age 13, approximately 60% of girls have attained menarche, while by age 8, only 1 out of 2,953 girls had experienced menarche in longitudinal studies. 3
Pubertal Context
Menarche occurs within the broader context of puberty, which typically begins between ages 8-13 years when the hypothalamus-pituitary-ovary axis reaches maturity. 4
Breast development (Tanner stage >1) begins at a median age of 10.14 years, preceding menarche by approximately 2-3 years. 3
Pubic hair development starts at a median age of 10.92 years. 3
Post-Menarcheal Considerations
The first 2 years after menarche are characterized by anovulatory cycles, which commonly result in menstrual irregularities that are physiologically normal. 1
It can take up to a year or more for a steady menstrual pattern to develop after menarche. 2
Clinical Significance of Timing Variations
Early menarche (before age 12 years) is associated with increased cardiovascular risk factors, including hypertension and metabolic abnormalities in adulthood. 5
Both early and late menarche have been associated with hypertension and other cardiometabolic risk factors leading to greater cardiovascular disease risk. 5
Girls who have not achieved Tanner stage 2 breast development by age 13 years or who fail to progress in pubertal stage for ≥12 months require evaluation for pubertal delay. 5
Contraceptive Use Considerations
- For contraceptive eligibility purposes, the CDC classifies girls from menarche through age 18-20 years as a distinct age category with specific recommendations for different contraceptive methods. 5